SLAP TEAR                                                      KANDILNOTES                       

INTRODUCTION

  • Superior Labrum from Anterior to Posterior (SLAP) tears describe tears of the shoulder labrum at the top of the shoulder socket

  • Common in dominant arm of overhead or throwing athletes

  • SLAP tears are important because they can often involve the biceps tendon anchor onto the shoulder, causing pain

  • Often associated with glenohumeral internal rotation deficit (GIRD)

  • There are 4 main types of SLAP tears

  • Type 1: Fraying of labrum, biceps anchor intact

  • Type 2: Fraying of labrum, biceps anchor torn

  • Type 3: Tear of labrum (bucket handle), biceps anchor intact 

  • Type 4: Tear of labrum (bucket handle), biceps anchor torn

CAUSES

  • Repetitive overhead activities and/or throwing motions

  • Fall on outstretched arm with biceps flexed

  • Hard pull or traction on arm

SIGNS AND SYMPTOMS

  • Feeling a pop and pain in the front of the shoulder with overhead activity

  • Diffuse, deep shoulder pain

TREATMENT​​

  • A period of rest from throwing and overhead activity in conjunction with NSAIDs is first line of treatment

  • A course of physical therapy focusing on dynamic strengthening of the rotator cuff is indicated

  • Treating glenohumeral internal rotation deficit is important for optimal outcomes

  • Surgery is indicated when nonoperative treatment fails

  • Surgery is arthroscopic and involves one or more of the following procedures, depending on pathology and tear type

  • Arthroscopic debridement of labrum

  • Arthroscopic repair of the superior labrum

  • Arthroscopic biceps tenotomy

  • Arthroscopic or mini-open biceps tenodesis

PREVENTION

  • Preventing repetitive overhead or throwing activities and not ignoring pain when you do

Slap tear capture 2.PNG