A SLAP (superior labrum anterior to posterior) tear refers to a tear involving the fibrocartilaginous rim of the shoulder.
The shoulder is a ball and socket joint comprised on the humerus, the scapular, and the clavicle. The ball of the upper part of the humerus sits in the glenoid (socket). The outer edge of the glenoid contains this fibrous like cartilage (labrum) that helps provide stability to the shoulder. The biceps tendon attaches to the upper aspect of the labrum. A tear of this kind occurs near the point where the biceps tendon and the labrum come together.
Symptoms of a SLAP tear include a popping or catching type sensation, a dull throbbing ache, pain in certain positions, painful overhead activity, loss of range of motion, lack of strength, and feeling of in-stability.
Injuries to the labrum can be caused a single traumatic event or from repetitive wear and tear. A SLAP tear can occur from dislocating the shoulder, a fall onto an outstretched arm, a motor vehicle accident, a sports related activity, or excessive forces applied to the arm when it is about shoulder height. SLAP tears are common in overhand athletes such as baseball pitchers and competitive swimmers. Non-traumatic SLAP tears can be from the result of degeneration in which the labrum developed fraying and eventual tearing from normal daily activities and the effects of aging. There are different subtypes of acute tears that can occur, of which, some are more unstable than others.
Following a thorough examination by an orthopaedic surgeon, x-rays may be ordered to ensure that no other bony problems exist within the shoulder. An MRI of the shoulder with contrast enhancement may also be ordered to confirm the presence and nature of a SLAP tear.
Treatment for a SLAP tear usually begins with conservative, non-surgical treatments including the use of NSAIDS to moderate pain and inflammation along with physical therapy to promote range of motion and strengthening. Surgery is the next step if pain does not subside or there is considerable loss of function. Surgery is commonly performed arthroscopically and is based on the nature of the tear. Options include a repair of the SLAP tear versus debridement. This type of surgery can be very complex.
Following surgery, the affected shoulder is usually protected (sling or immobilization) for up to 6 weeks to allow healing to take place and to avoid stress on the repair. A guided rehabilitation program follows and may last for several months.
Outcomes from this type of surgery does vary based on the complexity of the tear(s), surgical tech-niques, and adherence to post-operative guidelines and therapy set by the surgeon.