The shoulder is one of the largest and most complex joints in the body, where many muscles act to provide the widest range of motion of any part of the body. This flexibility is also what makes the shoulder prone to instability and injury.
The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket. The clavicle (collarbone) extends across the front of the shoulder from the sternum to the scapula and helps stabilize the shoulder’s movements.
WHAT IS A SLAP TEAR?
SLAP stands for Superior Labrum Anterior and Posterior. A SLAP tear affects the labrum, which is the cartilage on the rim of the shoulder’s socket. The labrum is a rubber-like tissue that holds the ball of the shoulder joint in place.
When a SLAP tear occurs, the top (superior) part of the labrum is injured. This top area is also where the biceps tendon attaches to the labrum. A SLAP tear occurs both in front (anterior) and back (posterior) of this attachment point, and the biceps tendon can be involved in the injury as well.
WHAT ARE THE SYMPTOMS OF A SLAP TEAR?
SLAP tear symptoms are similar to that of other shoulder injuries. These symptoms include:
- A popping, locking, or grinding sensation in your shoulder
- Pain in the shoulder with certain movements or positions
- Pain with lifting objects, especially overhead
- Weakness in the shoulder
- Lower range of motion
WHAT ARE THE CAUSES AND RISK FACTORS OF A SLAP TEAR?
There are 3 main causes of a SLAP tear:
- Repetitive motions and overuse
Repetitive shoulder motions are likely to result in SLAP tears, often experienced by athletes (weight lifting, tennis, swimming) and people who do regular physical work (construction workers, painters)
- Physical injury
SLAP tears can be caused by impact on your arm area, such as falling and landing on an outstretched arm, a motor vehicle collision, shoulder dislocation, and rapid movement of the arm while it is above shoulder level.
As we age, our labrum experiences wear and tear. This increases the chance of getting a SLAP tear, especially in people over 40 years of age where the top part of the labrum might also fray.
WHAT IS THE DIAGNOSIS OF A SLAP TEAR?
As there are different ways your labrum can tear (with SLAP tear being one of them) and as the symptoms are usually similar, it may be difficult to diagnose.
Your Doctor will first check on the history of the injury by talking to you about your symptoms and when they first began, pain level, and where it hurts.
A physical examination of the shoulder will then be conducted, where your doctor will check the range of motion, strength, and stability of your shoulder by performing tests such as placing your arm and shoulder into different positions. If a pinched nerve or inflammation is ruled out to be the cause, your Doctor will take an x-ray or MRI of your shoulder.
An x-ray will help to reveal if there are any fractures in your shoulder that is causing the pain, while an MRI will help your Doctor examine your labrum. To make a tear in the labrum appear more clearly on the MRI, a dye may be injected into your shoulder before the scan is taken.
WHAT ARE THE TREATMENT OPTIONS FOR A SLAP TEAR?
At Cove Orthopaedic Clinic, nonsurgical treatments are always the first line of treatment. This includes:
- Prescription of anti-inflammatory drugs for pain and swelling
- Physiotherapy to strengthen the shoulder muscles and restore the range of motion, flexibility and strength of the shoulder
- Application of ice packs to the affected area to reduce the pain
- Resting the shoulder to let it heal
Should these methods not work, surgery may be recommended. The most common surgical method used to treat a SLAP tear is an arthroscopy. During this procedure, your surgeon makes small incisions and inserts a small camera, or an arthroscope, into the shoulder joint. The camera displays pictures on a video monitor, and your surgeon then uses miniature surgical tools to repair the SLAP tear.
RECOVERY AFTER SURGERY
With the proper rehabilitation and care, regaining full range of motion after a SLAP tear surgery is possible! To keep your arm in place and still as much as possible, expect your arm to be in a sling for 2 to 6 weeks, depending on the extent of your injury and surgery. After the swelling and pain has reduced, you may start on your rehabilitation program with your physiotherapist.
Depending on your age and the extent of your tear, it could take up to 2 months for your labrum to heal and another 2 months to regain the same strength you had before the tear.