What is a Shoulder SLAP Tear?

A SLAP tear is an injury to the labrum of the shoulder, which is the ring of cartilage that surrounds the socket of the shoulder joint.

Local Orthopedic Surgeon

James Dreese

James Dreese

Orthopaedic Surgeon
Lutherville, MD
Dr. Jack Rocco

Dr. Jack Rocco

MD
Orthopaedic Surgeon
Hollidaysburg, PA
Dr. Jamal Rakem

Dr. Jamal Rakem

Orthopaedic Surgeon
Welland, ON

Dr. Jordan Leith, MD, MHSc, FRCSC, Sport Med Orthopeadic Surgeon, discusses what a shoulder SLAP tear is.

Nicole Fournier, BHKin, MSc (PT), CAFCI, Physiotherapist, discusses shoulder and neck injuries and pain.

Quiz: Do You Understand Shoulder Surgery?

Test your knowledge by answering the following questions:

Questions
True
False
1

The usual treatment for shoulder injuries is surgical options.

Explanation:
The usual treatment for shoulder injuries is non-surgical options such as medications, bracing and physiotherapy. Shoulder surgery is generally only explored if the non-operative options fail.
2

Arthroscopic shoulder surgery is often performed to repair soft tissue injuries.

Explanation:
Arthroscopic shoulder surgery (otherwise known as keyhole surgery) can be a good option for some patients. It is often performed to repair soft tissue injuries, and enables surgeons to introduce a fiber optic camera through a two- to three- millimeter incision.
3

For more severe shoulder injuries, surgeons may recommend a reverse shoulder replacement surgery.

Explanation:
For more severe shoulder injuries, surgeons may recommend a reverse shoulder replacement surgery. It is often done to repair rotator cuff tendons that have been damaged, often by arthritis.
4

Patients with recurrent shoulder dislocations may won't benefit from surgical reconstruction, only from non-surgical options.

Explanation:
Patients with recurrent shoulder dislocations may benefit from surgical reconstruction of the damaged tissues in the shoulder joint. This usually involves an arthroscopic day procedure, where the surgeon identifies the torn labrum or ligaments that have occurred with each shoulder dislocation.
5

Following shoulder surgery, most patients will benefit from physiotherapy.

Explanation:
Following shoulder surgery, most patients will benefit from physiotherapy to get their range of motion back, decrease pain and increase strength.
(Answer all questions to activate)

What is a Shoulder SLAP Tear

LAP tears of the shoulder are tears to the labrum, which is a meniscus, or cartilage-like O-ring around the socket. And the SLAP basically stands for “superior labrum, anterior to posterior.”

So it’s located on the superior side of the glenoid, or the socket of the shoulder joint. And the biceps tendon enters the shoulder and attaches to that superior labrum.

SLAP tears usually occur in overhead athletes. So baseball pitchers, football players, volleyball players, people who play tennis. And it usually occurs from that overhead throwing motion, due to the torque from the biceps tendon, we think that you get a tear in the labrum, superiorly in the joint, and it can lead to symptoms of pain, sometimes catching sharp acute short-term pain in the shoulder joint.

Symptoms from SLAP tears usually consist of pain during a throwing motion or when the arm is in a position of elevation over the head. You may get the occasional sharp pain in the shoulder that lasts briefly and then settles when you stop that activity.

You can get a sense of instability sometimes in the shoulder, although rarely. It’s more often a deep-seated pain, deep in the shoulder joint, you can’t put your finger on it, and patients usually present with those symptoms occurring during their sporting activities.

The diagnosis of SLAP tears is a little more difficult than other shoulder disorders, because it’s a bit nefarious, you know, where the symptoms – they cross over a lot of different pathologies. But beginning with a thorough history and a physical exam of the patient can make you suspicious for a SLAP tear, but usually it’s either diagnosed with advanced imaging such as an MR arthrogram, or at the time of arthroscopy.

If non-surgical treatment of a SLAP tear fails to provide relief of your symptoms, then you’re ultimately going to require surgical intervention, which is done with arthroscopic day surgery. What happens at the time of surgery is sutures are placed in the superior labrum, and they are reattached back onto the socket, if it is a repairable labrum. Local Physiotherapist 

Sometimes it’s not, and if it’s a non-repairable labrum then what we do is we just debride or clean out the torn pieces of the labrum, and that usually settles the majority of the symptoms. Local orthopedic Surgeon 

If you’re an overhead-throwing athlete or you participate in overhead sports, and you develop pain in that’s deep in your shoulder, you should seek the advice of an orthopedic surgeon to determine whether or not physiotherapy is all that you’re going to require, or surgical intervention to treat a SLAP tear if it gets diagnosed.

Presenter: Dr. Jordan Leith, Orthopaedic Surgeon, Burnaby, BC

Local Practitioners: Orthopaedic Surgeon

For patients that have currently undergone an orthopaedic shoulder surgery it is important to follow key instructions from your Orthopeadic Surgeon carefully. To help you in your recovery, the following is a list of commonly asked questions and answers.

  1. How long do I keep the bandages on after surgery? ANSWER: 3 – 4 days
  2. Can I shower after surgery? ANSWER: Yes, you may shower as long as you keep the wounds dry. After 7-10 days when the wounds are healed you can then shower without worrying about keeping the wounds dry.
  3. Should I put ice on the joint after surgery? ANSWER: Yes, you should ice the affected joint regularly, 10 -15 minutes on and then off. You may re-apply the ice once the skin returns to room temperature.
  4. Should I wear a sling after surgery? ANSWER: Yes, you should wear a sling to protect the shoulder from sudden movements or falling. It should be worn most of the time if there is a risk to the shoulder. If you are in a safe environment where there is no risk to the shoulder then you can remove the sling. However, you should not move the arm without the assistnace of the other arm and not through any pain.
  5. Should I be doing the pendulum swing? ANSWER: You may begin gentle pendulum swings if it is not uncomfortable for you.
  6. What exercises do I do? ANSWER: Prior to your first follow up appointment you should begin to move the arm with the other arm only through pain free ranges. You should not lift or reach for anything.
  7. How often do I do the exercises? ANSWER: You can work on your motion as many times as possible during the day without causing pain or discomfort.
  8. How soon after surgery can I drive? ANSWER: You are able to drive when you have full control and movement of both arms that will allow you to steer the vehicle rapidly to avoid a collision with another vehicle or pedestrian.

General Shoulder Information

The usual treatment for shoulder injuries is non-surgical options such as medications, bracing and physiotherapy. Shoulder surgery is generally only explored if the non-operative options fail, and the type the orthopaedic surgeon performs depends on the severity of your issue.

Arthroscopic Shoulder Surgery & Shoulder Replacement Surgery

Arthroscopic shoulder surgery (otherwise known as keyhole surgery) can be a good option for some patients. It is often performed to repair soft tissue injuries. In the past, orthopaedic surgeons had to make a large incision in an attempt to gain access into the joint. Arthroscopic surgery has enabled surgeons to introduce a fiber optic camera through a two- to three- millimeter incision. That allows the orthopaedic surgeon to magnify the structures on a TV screen and perform the procedure in finer detail. The benefits of arthroscopic shoulder surgery include a potentially shorter healing time, which means you can start rehab sooner.

For more severe shoulder injuries, surgeons may recommend a reverse shoulder replacement surgery. It is often done to repair rotator cuff tendons that have been damaged, often by arthritis. These rotator cuff tendons rotate the shoulder around and keep the ball and socket centered, but when they are no longer present or are deemed irreparable, the ball can slide upwards. When the head and socket are longer aligned, it changes the joint reaction forces, resulting in a different type of arthritis known as cuff tear arthropathy. These artificial shoulder implants last between 10 and 15 years.

Surgery for Shoulder Dislocations

shoulder-physioPatients with recurrent shoulder dislocations may benefit from surgical reconstruction of the damaged tissues in the shoulder joint. This usually involves an arthroscopic day procedure, where the surgeon identifies the torn labrum or ligaments that have occurred with each shoulder dislocation. The orthopaedic surgeon passes sutures through the ligaments and reattaches them to keep the ball in the socket. Following shoulder surgery, most patients will benefit from physiotherapy to get their range of motion back, decrease pain and increase strength.

Talk to your healthcare provider if you’d like more information on shoulder surgery.

Visit HealthChoicesFirst.com for more videos and resources on orthopedics.

Print this Action Plan and check off items that you want to discuss with your healthcare provider

  • The usual treatment for shoulder injuries is non-surgical options such as medications, bracing and physiotherapy. Shoulder surgery is generally only explored if the non-operative options fail.
  • Arthroscopic shoulder surgery (otherwise known as keyhole surgery) can be a good option for some patients. It is often performed to repair soft tissue injuries, and enables surgeons to introduce a fiber optic camera through a two- to three- millimeter incision.
  • For more severe shoulder injuries, surgeons may recommend a reverse shoulder replacement surgery. It is often done to repair rotator cuff tendons that have been damaged, often by arthritis.
  • Patients with recurrent shoulder dislocations may benefit from surgical reconstruction of the damaged tissues in the shoulder joint. This usually involves an arthroscopic day procedure, where the surgeon identifies the torn labrum or ligaments that have occurred with each shoulder dislocation.
  • Following shoulder surgery, most patients will benefit from physiotherapy to get their range of motion back, decrease pain and increase strength.

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