SLAP Shoulder Tears

Shoulder injuries can significantly impact your daily life, hindering your ability to perform simple tasks and participate in physical activities. One such injury that often affects athletes and active individuals is a SLAP (Superior Labrum Anterior to Posterior) tear.

Causes and Risk Factors of SLAP Shoulder Tears

Here are some common causes and risk factors associated with SLAP tears:

  • Repetitive overhead activities: Repetitive overhead motions can strain the shoulder joint excessively, leading to wear and tear over time. Activities like throwing (baseball or softball), weightlifting, swimming, and specific occupational tasks that require frequent reaching overhead can contribute to developing SLAP tears.
  • Sports involving repetitive arm motions: Athletes who play sports that need repetitive arm movements are at a higher risk of SLAP tears. Baseball pitchers, tennis players, volleyball players, and swimmers are examples of athletes who frequently perform repetitive arm motions.
  • Traumatic events: SLAP tears can also occur due to direct trauma or sudden impact on the shoulder. Falls onto an outstretched hand, direct blows to the shoulder, or collisions during contact sports can lead to SLAP tears. These traumatic events can cause the labrum to tear or become detached from the shoulder socket.
  • Age-related degeneration of the shoulder joint: As individuals age, the structures within the shoulder joint, including the labrum, can naturally undergo degenerative changes. Over time, the labrum may weaken and become more susceptible to tears, making older adults more prone to SLAP tears.
  • Participation in contact sports: Contact sports, such as football, rugby, and martial arts, involve physical contact and potential impact on the shoulder joint. The repetitive stress and direct blows associated with these sports increase the risk of SLAP tears.
  • Poor shoulder mechanics or posture: Improper shoulder mechanics or poor posture can contribute to increased stress and strain on the shoulder joint. Weak shoulder muscles, muscle imbalances, improper technique during physical activities, or prolonged periods of poor posture can cause this.
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Symptoms of SLAP Shoulder Tears

Early detection of a SLAP tear is vital for initiating prompt treatment and preventing further damage to the shoulder joint. Common symptoms include:

  • Pain or discomfort deep within the shoulder joint: One of the primary indicators of a SLAP tear is persistent pain or discomfort felt deep within the shoulder joint. The pain may be dull, aching, or sharp and can worsen with certain movements or activities. It is important to note that the location of the pain can be specific to the front or back of the shoulder, and it may radiate down the arm.
  • Popping, clicking, or grinding sensation during shoulder movement: Individuals with a SLAP tear may experience abnormal sounds or sensations when moving their shoulder. These can include popping, clicking, or grinding sensations within the joint. These sensations may occur with particular movements, such as rotating the arm or lifting objects overhead.
  • Shoulder instability or a feeling of the shoulder “catching”: SLAP tears can lead to shoulder instability, where the joint feels loose or unstable. Individuals may experience a sensation of the shoulder “catching” or giving way during movements. This instability can affect daily activities and limit the range of motion in the shoulder.
  • Loss of strength and decreased range of motion: As a SLAP tear affects the stability and function of the shoulder joint, individuals may notice a loss of strength and reduced range of motion. Activities that need strength or mobility, such as lifting weights, reaching overhead, or performing sports-specific movements, may become challenging or painful.
  • Pain when lifting or carrying objects: SLAP tears can cause pain, specifically when lifting or carrying things, especially those that need an extended reach or strain of the shoulder joint. The pain may be aggravated by gripping or holding heavy objects, and individuals may feel a sense of weakness in the affected shoulder.
  • Difficulty with overhead activities: Overhead activities like throwing a ball, serving in tennis, or reaching for objects on high shelves, can be particularly problematic for individuals with a SLAP tear. Pain, weakness, or limited range of motion can make these activities difficult or impossible to perform without discomfort.
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Diagnosis and Medical Evaluation of SLAP Tears

During your evaluation, Dr. Peter Howard may perform several diagnostic tests to assess the extent of the injury. These tests can include:

  1. Physical examination: A thorough physical examination of your shoulder will assess your shoulder’s range of motion, stability, and strength. By examining how your shoulder moves and feels, Dr. Howard can gather valuable information about the potential presence of a SLAP tear.
  2. Imaging tests: Various imaging techniques can be utilized to visualize the structures of your shoulder joint and identify the location and severity of the SLAP tear. Standard imaging tests include:
    1. Magnetic Resonance Imaging (MRI): An MRI scan uses powerful magnets and radio waves to produce detailed images of the soft tissues in your shoulder. It can provide clear visualization of the labrum and help identify the presence and extent of a SLAP tear.
    2. Computed Tomography (CT) scan: A CT scan combines X-ray images taken from different angles to create cross-sectional images of your shoulder joint. This imaging technique may provide additional information or assess bony abnormalities that could contribute to the SLAP tear.
    3. Arthrogram: An arthrogram involves injecting a contrast dye into your shoulder joint before undergoing imaging tests, such as an MRI or CT scan. The dye helps enhance the visibility of the labrum and any associated tears, allowing for a more accurate diagnosis.
  3. Provocative tests: Exams involving manipulating the shoulder joint in specific positions to reproduce symptoms and assess the presence of a SLAP tear.
  4. O’Brien’s Test: The patient’s arm is extended and rotated internally at shoulder level. Pain felt during resistance, relieved by external rotation, indicates a positive test for a SLAP tear.
  5. Speed’s Test: The patient tries to lift their forward-extended arm against the examiner’s resistance. Pain in the bicep area suggests a SLAP tear.
  6. Crank Test: The examiner lifts the patient’s arm overhead, rotates it internally, and applies pressure. If this causes discomfort or pain, it may suggest a SLAP tear.
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Treatment for SLAP Tears

The treatment approach for SLAP tears depends on several factors, including the tear’s severity, age, activity level, and overall health. Here are some commonly recommended treatment options:

Non-surgical Management

  • Rest, ice, compression, and elevation (RICE) for pain and swelling management.
  • Physical therapy to strengthen the shoulder muscles, improve stability, and restore range of motion.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. These include aspirin, Advil and Motrin (ibuprofen), and Aleve (naproxen sodium).

Surgical Intervention

  • Arthroscopic repair: Minimally invasive surgery using a small camera and specialized instruments to repair the torn labrum.
  • Biceps tenodesis: Relocating the biceps tendon relieves symptoms and restores stability.
  • SLAP debridement: Trimming or removing the torn part of the labrum when a repair is not an option.

Seeking Help for SLAP Tears

Remember, seeking the expertise of a trained professional is vital in ensuring an accurate diagnosis and receiving appropriate care. Contact us today to see how Dr. Peter Howard can treat your SLAP Shoulder Tears.