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