What It Is
A SLAP tear (Superior Labrum Anterior and Posterior tear) is a specific type of injury to the labrum, a ring of cartilage that surrounds the shoulder socket and helps stabilize the joint. In a SLAP tear, the top (superior) part of the labrum is damaged, where the biceps tendon attaches. This injury often occurs from repetitive overhead motions, such as in throwing sports, or as a result of trauma, like a fall onto an outstretched arm.
Signs & Symptoms
- Deep, aching pain in the shoulder, particularly with overhead activities
- A catching, locking, or popping sensation in the shoulder joint
- Difficulty lifting or rotating the arm
- Shoulder weakness or a feeling of instability
- Reduced range of motion, especially when reaching behind the back or lifting objects
- Pain when holding the arm in certain positions, such as lifting or throwing
Diagnosis
To diagnose a SLAP tear, Dr. Romanelli will perform a physical examination to assess shoulder movement, stability, and tenderness. He may use specific tests, such as the O’Brien’s Test, to check for pain and weakness related to the labrum. Imaging tests like an MRI with contrast dye may be recommended to provide a clearer view of the labrum and detect any tears.
Treatment
Treatment for a SLAP tear depends on the severity of the injury and the patient’s activity level. Many cases can be treated with conservative methods, while severe or persistent symptoms may require surgical intervention.
Non-Surgical Treatment
Non-surgical treatment for a SLAP tear may include:
- Rest and Activity Modification: Avoiding activities that aggravate the shoulder, such as overhead movements or heavy lifting, can help reduce stress on the labrum.
- Physical Therapy: Specific exercises can strengthen the muscles around the shoulder and improve joint stability, reducing pain and restoring function.
- Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to manage pain and inflammation.
- Corticosteroid Injections: In some cases, injections of corticosteroids may be used to reduce inflammation and provide temporary pain relief.
Surgical Procedure
If non-surgical treatments do not relieve symptoms, or if the tear is severe, surgery may be recommended to repair the damaged labrum. The procedure, called arthroscopic SLAP repair, is minimally invasive and involves:
- Arthroscopy: A small camera is inserted through tiny incisions to visualize the inside of the shoulder joint.
- Labrum Repair: Specialized instruments are used to reattach the torn labrum to the bone with sutures or small anchors.
- Biceps Tenodesis (if necessary): In some cases, the biceps tendon may also be repositioned to relieve tension on the labrum and reduce pain.
Physical Therapy
Rehabilitation through physical therapy is essential for a full recovery from a SLAP tear, whether treated surgically or non-surgically. After surgery, physical therapy focuses on gradually restoring range of motion, strength, and stability to the shoulder. Dr. Romanelli and his team will create a personalized rehabilitation plan that includes stretching, strengthening, and mobility exercises to help you regain function and return to your daily activities or sports.
If you’re experiencing shoulder pain or symptoms of a SLAP tear, Dr. Romanelli can provide expert diagnosis and treatment to help you get back to your normal activities.