SLAP Tears

A SLAP tear is a specific type of shoulder injury that affects the labrum, a ring of cartilage that surrounds the socket of the shoulder joint. The acronym “SLAP” stands for “Superior Labrum Anterior and Posterior,” indicating that the tear occurs in the upper (superior) part of the labrum and extends both in the front (anterior) and back (posterior) directions.

Signs and symptoms of a SLAP tear can vary, but common indicators include:

1. Pain: Persistent pain in the shoulder, especially with certain movements or when lifting objects.
2. Catching or popping sensation: You may feel a catching or popping sensation in the shoulder when moving it.
3. Weakness: Weakness or decreased strength in the affected arm or shoulder.
4. Instability: A feeling of shoulder instability or “giving way” during certain activities.
5. Decreased range of motion: Limited range of motion in the shoulder, particularly in overhead or rotational movements.

SLAP tears can occur due to various reasons, including repetitive overhead motions (such as throwing a ball), trauma (such as a fall on an outstretched arm), or degeneration over time. Diagnosing a SLAP tear usually involves a thorough physical examination, imaging tests like MRI or arthroscopy, and a discussion of your symptoms and medical history with a healthcare professional.

Treatment for a SLAP tear depends on the severity of the tear, your age, activity level, and specific symptoms. Non-surgical treatment options may be recommended for minor tears and can include:

1. Rest and activity modification: Avoiding activities that worsen the symptoms and modifying your movements to protect the shoulder.
2. Physical therapy: Strengthening exercises to improve shoulder stability and range of motion, as well as techniques to reduce pain and inflammation.
3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers may be prescribed to manage pain and reduce inflammation.

In more severe cases or when conservative measures fail to provide relief, surgical intervention may be considered. Surgical options can include arthroscopic procedures to repair or remove the damaged portion of the labrum and, if necessary, address any associated shoulder instability.

When operating on a SLAP tear there are two different choices in surgeries to perform, a superior labrum repair or a biceps tenodesis.  The choice between a superior labral repair and biceps tenodesis for treating a SLAP tear depends on various factors, including the specific characteristics of the tear, the individual patient’s condition, and the surgeon’s expertise

In general, both procedures have shown success in treating SLAP tears, but they have different goals and considerations:

1. Superior Labral Repair: This procedure involves reattaching the torn labrum to the shoulder socket. It aims to restore stability to the shoulder joint and alleviate symptoms. Superior labral repair is typically recommended for younger patients with a healthy biceps tendon and minimal degenerative changes. It is especially useful when the biceps tendon is not significantly involved in the injury and the primary focus is on restoring the labrum.
2. Biceps Tenodesis: Biceps tenodesis involves detaching the biceps tendon from its original attachment in the superior labrum and reattaching it to a different location on the humerus bone. This procedure is often considered when there is a significant biceps tendon involvement or when the labrum is extensively damaged or frayed. Biceps tenodesis can provide pain relief and stability by eliminating the abnormal tension and stress on the biceps tendon and labrum. It is commonly recommended for older patients or those with pre-existing biceps tendon issues.

The success of the surgery depends on several factors, including the surgeon’s skill and experience, the patient’s commitment to rehabilitation and post-operative care, and the specific characteristics of the injury. Both procedures have demonstrated positive outcomes in appropriate cases, but the decision regarding which surgery is more successful is highly individualized and depends on the patient’s unique circumstances.

It’s important to consult with a qualified healthcare professional, such as our Long Island orthopedic surgeons or sports medicine specialists, for an accurate diagnosis and personalized treatment plan for a SLAP tear. At Total Orthopedics and Sports Medicine we have a group of sports medicine specialists who have a vast experience in successfully treating SLAP tears conservatively.  For those requiring surgery we have sports medicine orthopedic surgeons with the knowledge and technical skills to perform the correct individualized surgery to ensure the best possible outcome.