Understanding your shoulder diagnosis: SLAP tear

Pain in the shoulder. Muscular male body. Handsome bodybuilder posing on gray background with red dotThe glenohumeral joint is a ball-in-socket joint where the glenoid of the scapula joins with the
head of the humerus. Cartilage, called the labrum, extends from the edge of the glenoid to the
humerus to improve stability of the shoulder. A SLAP tear is an acronym for a superior labral
tear from anterior to posterior.

SLAP tears can either occur acutely from a fall that forces the shoulder upward or from
repetitive stress. Overhead throwing athletes, such as baseball pitchers, are at the highest risk
of this injury because of the force placed on the shoulder with each pitch. Weight lifting is
another common cause.

A SLAP tear is usually diagnosed though a physical examination. X-rays can be used to rule
out any fracture but an MRI is the imagining technique used to confirm the diagnosis. Dye is
commonly used during the imaging process (MRI arthrogram) to help fully determine the extent
of the injury.

SLAP tears are broken down into four types:

Type 1- Partial tear with frayed edges but the labrum is still attached
Type 2- Labrum is completely torn from the glenoid
Type 3- Bucket-handle tear of the labrum
Type 4- Tear of the labrum extends into the biceps

A dull, deep ache is present with a SLAP tear that is, at times, difficult to describe. Pain will
worsen with activity and overhead motions. The shoulder will also become “unstable” and may
feel “loose”.

The labrum receives little blood flow and, therefore, very little healing occurs. The first course of
treatment after diagnosis is rest, ice, pain medication, and anti-inflammatories. Physical
therapy follows with a program to increase range of motion and improve shoulder stability.
Most individuals are able to return to all activities without the need for surgery. In the instance
where pain persists, surgery is required. Physical therapy after surgery consists of an
immobilization phase, a period that focuses on improving motion, and a final phase of
increasing strength to return to all previous activities. A full return to advanced activities, such
as throwing and weight lifting, can take up to 6 months.

Posted in: Physical Therapy, Shoulder

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