SLAP Tear

Shoulder Conditions

SLAP Tear 

A SLAP tear affects the top of the glenoid labrum, the tough yet slippery rim that deepens your shoulder socket. The condition can lead to pain and other symptoms, and it is treatable. Specialists at Sports Med London can examine your shoulder and offer surgical and non-surgical treatments in London. 

 

SLAP Tears Explained 

SLAP is an acronym for Superior Labral Anterior Posterior, which refers to the top part of the glenoid labrum, between the 11 o’clock and 1 o’clock positions. The long head of the biceps tendon extends from the fibrocartilaginous rim that makes your shoulder socket deeper at that position. 

The tendon may be torn off its attachment to the glenoid. The tear may extend in the front or the back, and their patterns may be complex. 

SLAP tears usually happen when the arm is bent inwards and twisted at the shoulder. When this happens, the head of the upper arm bone (humerus) levers and tears the biceps tendon’s anchor. Such injuries often occur when the arm is pulled, during a throwing injury, when tackled, or when weightlifting. 

In some sports, such as baseball, pitchers develop a type of SLAP tear that does not cause pain or affect their ability. Instead, the tear enables them to generate energy like a coiled spring and throw the ball at a much greater speed. 

 

Symptoms Of SLAP Tears 

The common symptoms of SLAP tears include 

  • Pain 
  • Clicking in and on top of the shoulder 

These symptoms are present especially when you perform activities overhead. 

Slap Tear Page

SLAP Tear Diagnosis 

Diagnosing SLAP tears is usually based on our specialist’s consultation with the patient and on a careful physical examination of the affected shoulder. If the specialist would like to confirm the diagnosis, they will send you for an MRI or MR Arthrogram, which sees special dye injected into the joint before the scan. 

 

Treatment At Sports Med London 

Sports Med London offers various treatments for SLAP tears. Our specialist will recommend the most appropriate course of treatment for the tear in your glenoid labrum. 

 

Non-surgical treatment usually is limited to: 

  • Analgesia (painkillers)
  • Physiotherapy 

 

If pain and/or clicking continues to happen when you perform activities overhead, our specialist may recommend keyhole surgery (arthroscopy). The surgeon will make two tiny incisions, through which they will use special stitches to reattach the biceps tendon anchor to the glenoid socket 

You will need to wear a sling for a few days following surgery to keep your shoulder still. You will also receive a physiotherapy programme to help rehabilitate the joint. 

 

 

Technical Information:

What is a SLAP tear?

A SLAP tear or Superior Labral Anterior Posterior tear affects the top part of the glenoid labrum (typically at the 11o’clock to 1o’clock position). The long head of biceps tendon originates from the labrum at this position and its anchor is torn off its attachment to the bony socket (glenoid). Sometimes the tears extend anteriorly (in the front) or posteriorly (backwards) and may have complex patterns.

 

How does a SLAP tear occur? 

A SLAP tear may occur as a result of the arm being bent inwards and twisting at the shoulder. The humeral head acts a lever and tears the biceps tendon anchor. This can occur in sportsmen with a pull on the arm, a throwing injury or tackle or even weightlifting. 

 

How do SLAP tears present?

Pain and clicking deep within and at the top of the shoulder especially with overhead activities.

 

How are SLAP diagnosed?

This is based on the history, mechanism of injury and careful physical examination of the patient. An MRI or MR Arthrogram (MRI scan with special dye injected into the joint) is often used to confirm the diagnosis.

 

How are SLAP tears treated? Surgical vs Non-Surgical Management

Physiotherapy and analgesia will help improve symptoms. Certain types of throwing sports such as the pitcher in baseball develop some type of superior labral “tear” in order to achieve an effective throw. These SLAP tears often do not cause pain and allow the pitcher to generate enough coiled energy (like a spring about to be released) to allow them to throw the ball at incredible speeds. 

If a patient complains of pain and /or clicking with overhead activities then an arthroscopic (keyhole) SLAP repair can be performed via two very small incisions in which the biceps anchor is reattached to the glenoid socket with special stiches. Postoperatively the shoulder is immobilised for a period in a sling and then started on a physiotherapy rehabilitation programme.

As surgical techniques have improved significantly over the last decade, complications are reduced and recovery much quicker than in the past.

Following surgery, a rehabilitation program with physiotherapy is commenced to help you return to your normal day to day activities. The progress of this is dictated by patients meeting milestones and is run under the supervision of the surgeon and specially trained physiotherapist.