SUPERIOR LABRAL - SLAP TEARS

The term SLAP refers to the superior labrum anterior and posterior. A SLAP injury refers to damage at the top region of the labrum, where the biceps tendon attaches.

What are the potential causes?

Injury to the top part of the labrum often results from acute trauma or repetitive shoulder movement. Common causes include motor vehicle collisions, sudden falls on an outstretched arm, rapid arm movements, and shoulder dislocation.

Most SLAP tears result from gradual wear of the labrum over time. In older individuals, fraying or tearing of the superior labrum is often considered a normal aspect of the ageing process.

What are the signs of a SLAP Tear?

Common signs include the following:

• A grinding, catching, locking or popping sensation at the shoulder.
• Pain when moving the shoulder.
• Pain with overhead lifting.
• Reduced shoulder strength.
• Limited range of motion.

How Are SLAP Tears Diagnosed?

Diagnosis of a SLAP tear involves a combination of clinical evaluation and imaging studies. Diagnostic Methods Include:

• Medical history review – Assessment of symptoms, injury mechanism, and activity level
• Physical examination – Specific shoulder tests to reproduce pain or instability
• MRI (Magnetic Resonance Imaging) – Provides detailed images of the labrum and surrounding structures
• MRI arthrogram – A specialized MRI with contrast dye that improves detection of labral tears
• Ultrasound (in some cases) – May assist in evaluating associated soft tissue injuries

A definitive diagnosis is often confirmed by combining clinical findings with imaging results.

Treatment for Traumatic SLAP Injuries

The first line of treatment consists of non-surgical approaches, such as the following:

• Nonsteroidal anti-inflammatory medication (NSAIDs): Are prescription anti-inflammatories taken to alleviate swelling and pain
• Corticosteroid injections are administered to treat inflammation
• Physical therapy is designed to improve shoulder mobility, restore movement, and strengthen the shoulder

When is surgery considered?

Surgery is typically considered only when pain does not improve with non-surgical treatments. Arthroscopic surgery, a minimally invasive technique, is commonly used for SLAP injuries. During arthroscopy, a lighted scope with a camera (arthroscope) is inserted into the shoulder joint, providing detailed images of the surgical site. The surgeon determines the most appropriate treatment based on an individualized assessment. Treatment options may include removing the damaged portion of the labrum or repairing the tear with sutures. In some cases, the surgeon may release the biceps tendon attachment to relieve pain instead of performing a repair.