SLAP Tear Treatment in Dallas, Plano, Frisco, and Wylie, TX
Superior Labrum Anterior and Posterior Tear, SLAP Lesion
What Is a SLAP Tear in the Shoulder?
SLAP tears are an injury to the soft tissues inside the shoulder joint. SLAP stands for Superior Labrum Anterior and Posterior. When a SLAP tear occurs, a piece of cartilage in the inner shoulder joint is torn partially or completely. These injuries are often painful and can limit movement in the shoulder, particularly overhead motions. SLAP tears are also called labrum tears.
What Is a Type 1 SLAP Tear?
SLAP tears are categorized into types by the severity of the tear. In a type 1 tear, the labrum still functions, but is frayed or appears shredded rather than completely torn. This type of labrum tear is most common in people who are middle-aged or older.
What Is a Type 2 SLAP Tear?
Type 2 SLAP tears are the most common types of labrum tears. A type 2 shoulder labrum tear affects both the labrum and the biceps tendon. Both the labrum and the biceps tendon attachment are torn away from the shoulder socket (glenoid).
What Is a Type 3 SLAP Tear?
In a type 3 labral tear, some of the torn labrum is caught in the shoulder joint.
What Is a Type 4 SLAP Tear?
In a type 4 shoulder labral tear, the initial tear that began in the glenoid labrum spreads to tear the bicep tendon. This is different from a type 2 tear, as it involves the tearing of the bicep tendon instead of just its detachment from the shoulder socket (glenoid).
What Is a SLAP Lesion?
The term “SLAP lesion” is frequently used interchangeably with “SLAP tear,” although many use it to specifically refer to a type 1 SLAP tear. In medical terminology, a lesion is an area of a tissue that has suffered damage from an injury or disease. Therefore, SLAP lesions are areas of damage to the labrum, such as the fraying we see in a type 1 tear.
SLAP Tear Anatomy
Three bones make up the shoulder anatomy: the upper arm bone (the humerus), the shoulder blade (scapula), and the collarbone (the clavicle).
The shoulder joint is a ball-and-socket joint, formed by the rounded head of the humerus. The humerus sits in a socket in the shoulder blade called the glenoid. When you move your arm, the ball of the humerus rotates inside this socket.
Around the rim of the glenoid is a ring of soft tissue known as the labrum. The labrum helps to stabilize the ball of the humerus inside the glenoid socket. It also serves as an attachment point for several ligaments and tendons in the arm, including the biceps tendon. Tears to this tissue can cause looseness or instability in the shoulder joint. A SLAP tear always occurs in the tissues in the top (superior) part of the socket.
What Causes a SLAP Tear?
Repetitive shoulder motion or acute trauma to the shoulder area can cause a SLAP tear. Injuries that could possibly tear the superior labrum include:
- Car accidents
- Falling onto an outstretched arm
- Forceful pulling on the arm, such as when trying to catch a heavy object
- Shoulder dislocation
- Rapid or forceful movement of the arm when it is elevated above the level of the shoulder
SLAP tears are also common in athletes like weightlifters or baseball pitchers who engage in repeated overhead motions.
However, many SLAP tears are simply caused by the labrum wearing down over time. SLAP tears are more common in people over 40 and could be seen as a normal aging process. They can occur in older adults without a history of repeated overhead shoulder movement or injury to the shoulder area. Labrum tears can also arise if a younger person suffers an acute shoulder injury.
How Do You Diagnose a SLAP Tear?
Dr. Berry will ask you questions about your medical history, symptoms, and when your symptoms began. During a physical examination, he will examine your shoulder and move it into certain positions. He will also likely examine the head or neck to rule out a compressed nerve as the cause of your symptoms.
Dr. Berry will likely be able to determine a diagnosis through signs, symptoms, and a physical examination, but if more confirmation is needed, X-rays and an MRI of the area may be ordered. An X-ray will give your doctor a clear view of your bones and potentially help them rule out other causes of your symptoms. An MRI is better able to show soft tissues like the labrum and may be able to reveal a tear in those tissues.
What Does a SLAP Tear Feel Like?
When people suffer labral tears, they will likely feel several sensations, including shoulder pain, popping, clicking, or grinding, front of shoulder pain, and a limited range of motion. Most symptoms worsen if someone lifts their injured shoulder above their head. They may also experience shoulder stiffness.
What Are SLAP Tear Symptoms?
SLAP tear symptoms can appear superficially like symptoms of many other shoulder injuries or conditions, such as biceps tendonitis, or shoulder arthritis. They include:
- Decreased range of motion
- Difficulty moving the shoulder normally
- Shoulder stiffness
- Pain with movement or while holding the shoulder in certain positions
- Decrease in shoulder strength
- Feeling that the should is about to “pop out of joint”
- Pain with lifting objects, especially overhead
- Sensation of locking, popping, catching, or grinding
- Pitchers may notice a decrease in their throw velocity or numbness and heaviness in their arm after pitching
Notably, shoulder labrum tears can cause pain, range of motion issues, and other shoulder problems in both the labrum and the biceps muscle.
How Serious Is a SLAP Tear?
It depends. Some SLAP injuries only involve minor fraying, but others completely tear both the labrum and the bicep tendon. If left untreated, SLAP lesions can lead to chronic shoulder pain, limited range of motion, and other problems.
What Are SLAP Tear Treatment Options?
There are surgical and nonsurgical treatments for SLAP tears, depending on whether or not the tear occurred in conjunction with another injury, as well as the severity of the tear. Many shoulder labrum tears can fully recover with rest and rehabilitation. Others require surgery as soon as possible.
SLAP Tear Treatment Without Surgery
These types of treatments can heal the majority of SLAP tears.
- Non-steroidal anti-inflammatory medication. Drugs like ibuprofen and naproxen (Aleve) can be used to manage pain and swelling.
- Physical therapy. A physical therapist can teach you specific exercises to restore movement and strengthen the shoulder.
- Corticosteroid injections. These are strong anti-inflammatory medications that help to relieve pain.
- Platelet-rich plasma (PRP) injections. PRP injections are made with platelets from the blood. Platelets contain substances known as growth factors that can stimulate the healing process.
Do I Need Surgery for My Slap Tear Injury?
If nonsurgical treatments aren’t effective, surgical treatment or other procedures may be necessary, such as the following.
- Shoulder arthroscopy. This surgical technique is most commonly used for repairing a SLAP tear. A small camera will be inserted directly above the injury. Your surgeon will use these images to guide small, pencil-like surgical instruments while they perform the SLAP repair. Arthroscopic surgery is minimally invasive and tends to have shorter recovery periods.
- Debridement. When only a portion of the torn labrum is torn, your surgeon may shave away the damaged portion, leaving a smooth edge. This technique is generally not done if the biceps tendon is unstable.
- Biceps tenodesis. During this procedure, the surgeon cuts where the biceps tendon attaches to the labrum, then inserts it into another area. This choice is common in patients over 40 years old who have tearing or biceps tendonitis.
- Other repair options. Other types of minimally invasive procedures can be used to repair SLAP tears. Your doctor will determine the best way to repair your specific SLAP tear after he has seen the tear arthroscopically. This may require simply removing the torn part of the labrum or replacing it with stitches. Sometimes your surgeon will be required to detach or reattach the biceps tendon.
How Long to Recover From a SLAP Tear Surgery?
After surgery or any other procedure, you will likely need to wear a sling for two to four weeks to stabilize your arm. Once pain and swelling have reduced to a manageable level, your doctor will start you on a physical therapy program. The results of the physical therapy program depend entirely on your dedication to it.
Though there are general guidelines, the time required for complete recovery differs for everyone. Despite it being a slow process, following your surgeon’s and physical therapist’s guidelines are key to a successful outcome.
What Is the Success Rate of SLAP Repairs?
Generally, the success rate of SLAP tear surgery is very high. The arthroscopic SLAP repair is the most common surgical technique, with a success rate of more than 90%. What’s more, is that around 85% of patients can return to competitive athletics.
Although every surgery has its risks, a labrum repair is unlikely to encounter serious complications. The most common risks involved with SLAP repairs are infection, stiffness, and shoulder weakness.
SLAP Tear Physical Therapy
Two main forms of physical therapy may be employed before or after one’s surgery. These forms are conservative management and postoperative rehabilitation. Conservative management usually begins with a wait-and-see approach.
Patients will cease throwing activities and excessive overhead motions, then take anti-inflammatory medication. Once the pain subsides, the patient can begin physical therapy to restore their strength and range of motion.
After surgery, the physical therapy process is somewhat different. Immediately following surgery, the patient’s arm will be immobilized. Then, they will work with a physical therapist to restore motion. Lastly, they will focus on building strength to help with shoulder stability.
Contact SPORT Orthopedics + Physical Therapy for SLAP Tear Treatment Today
If you have suffered a superior labrum anterior to posterior (SLAP) tear in your shoulder, the specialists at SPORT Orthopedics + Physical Therapy are here for you. We offer both surgical and non-surgical treatments, as well as physical therapy for those with shoulder pain. To schedule an appointment with us, please call our office at 469-200-2832 today.