Specializing in Spine, Sports & Physical Medicine

Shoulder Pain and SLAP Tears

I have been having a lot of shoulder pain since I was in a car accident a few months ago. I had an MRI of my shoulder and my doctor told me I have a SLAP tear. What is a SLAP tear and can anything be done about it?

A SLAP tear is common type of shoulder injury that can arise from sporting activities. SLAP is an acronym for Superior Labral Anterior Posterior. The injury involves a tear of a structure in the shoulder joint (glenohumeral joint) known as the labrum. The labrum is a thin ring of cartilaginous tissue that helps make the shoulder a bit more stable as well as provides a place for tendons and ligaments to attach.

bony structures of the shoulder showing SLAP lesion and Bankart lesion   mri_slap_tear

 A SLAP tear commonly occurs from lifting heavy objects, falling onto an outstretched hand, rapid pulling on the arm such as trying to catch a very heavy object, shoulder dislocations, car accidents, or large amounts of a repetitive overhead action, such as throwing a football or baseball. Sometimes these SLAP tears are the result of aging and may not be painful at all.

The part of the labrum where a superior labral tear occurs has very few blood vessels, so it is more prone to injury and slower healing. Other parts of the labrum have the ability to heal easier because there is more of a blood supply in the area.

SYMPTOMS – Symptoms of a SLAP tear include a painful ‘catching’ sensation when moving the shoulder, usually more-so with overhead movements such as throwing. A pain that is deep within the shoulder or in the back of the shoulder joint is often commonly reported.

TREATMENT – Many minor tears will respond to conservative treatment including rest, anti-inflammatory medications and physical therapy. However, it is frequent for larger tears brought on by significant trauma to require arthroscopic surgery in order to heal. In patients who experience continued symptoms despite conservative treatment, arthroscopic surgery may be recommended. Several specific procedures may be performed and it is important to understand that SLAP tears are often seen in conjunction with other shoulder problems, such as instability or rotator cuff tears. If this is the case, these other conditions may influence how  the SLAP lesion is dealt with.

Persistent shoulder pain should be evaluated by your doctor and a correct diagnosis if possible be made before beginning a comprehensive treatment program of physical therapy, ultrasound guided injections, oral anti-inflammatories and a surgical consultation if necessary.

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