SLAP Lesion

What is a SLAP Tear?
The SLAP tear, is a superior labrum tear of the shoulder. The biceps tendon attaches inside the shoulder joint at the superior labrum or at the top of the shoulder joint.

SLAP tear
Tears of the superior labrum are called SLAP Tears and can cause shoulder pain mimicking other shoulder problems. These are often difficult to diagnose and can often times be only seen at the time of arthroscopic surgery.

The mechanism of a SLAP tear
The most common cause is a fall or injury to the shoulder. Some patients fall landing directly on their shoulder or others fall on their outstretched hand. Another cause of SLAP tears is repetitive overhead activities seen in tennis players, or other over head athletes. Some patients can recall a specific injury while others cannot.

What is the most common complaint?
The most common complaint is pain. In addition, over half the patients with SLAP tears will also complain of painful clicking and popping. SLAP tears are often seen with a combination with other shoulder problems which makes it difficult to diagnose.

How is diagnosed?
With any shoulder problem, the first step in diagnosing a SLAP tear is to get a complete history and physical examination from a qualified shoulder surgeon. X-rays are also taken and if the symptoms warrant, an MRI is also done. A regular MRI may not show a SLAP tear and so often times an MRI with a dye injected into the shoulder, a so called MRΙ arthrogram, is ordered. This is able to detect a SLAP tear better than just a normal MRI.

MRI arthrogram
MRΙ arthrogram

How is treated?
SLAP tears are difficult to diagnose and are often seen with other shoulder problems such as bursitis and rotator cuff tears. Although bursitis and even rotator cuff tendonitis often responds to physical therapy and a cortisone injection, SLAP tears do not.
They typically need to be repaired with surgery. This can be done using advanced arthroscopic techniques.

Arthroscopic techniques

What about rehabilitation?
It does require physical therapy for about six weeks after the surgery and most patients are able to return to their activities about three months following the surgery.