SLAP Tear

Engaging in sports or activities that involve repetitive overhead motions is a common cause of SLAP tears. Over time, repetitive strain on the shoulder can lead to small tears in the labrum that gradually worsen.

Traumatic injuries are another major cause of SLAP tears. Falling onto an outstretched hand can transfer force from the arm to the shoulder, resulting in a labrum tear. A SLAP tear can also be caused by a direct hit to the shoulder, such as from an accident or collision in contact sports.

The labrum and other shoulder muscles can become more fragile and susceptible to injury with age. Degenerative changes in the shoulder joint, such as arthritis, can weaken the labrum. Because of this natural wear and tear, older people are more likely to tear their SLAP even while performing routine tasks with their shoulders.

A shoulder dislocation, where the upper arm bone pops out of the shoulder socket, can severely damage the labrum. The force involved in a dislocation can tear the labrum, resulting in a SLAP tear.

A sudden, forceful movement that overextends or twists the shoulder can cause a SLAP tear. This can happen during a car accident when the seatbelt restrains the body but the shoulder is jolted or during heavy lifting with improper technique.

People with a history of shoulder injuries, such as rotator cuff tears or previous labral tears, are at a higher risk of developing SLAP tears. The existing damage can weaken the shoulder structure, making it more vulnerable to additional injuries.

The process begins with a discussion of the patient’s symptoms and medical history. Questions typically focus on when the symptoms began, activities that worsen the pain, previous shoulder injuries, and any traumatic events that may have caused the tear.

A physical examination assesses the shoulder’s range of motion, strength, and stability. Specific tests may be used to reproduce SLAP tear symptoms and identify the injury.

Imaging helps confirm the diagnosis and assess the severity of a SLAP tear. MRI, especially with contrast dye (MR arthrogram), provides the clearest view of soft tissues like the labrum. X-rays do not detect labral tears but help rule out fractures or arthritis. A CT scan with contrast dye (CT arthrogram) may be used if MRI is unavailable, offering detailed images of the joint.

Non-surgical treatments are often the first approach for managing SLAP tears, particularly when the tear is minor.

Rest and Activity Modification

Resting the shoulder and avoiding activities that aggravate the pain can aid in the initial stages of recovery. Modifying activities to reduce shoulder strain can help manage symptoms.

Physical Therapy

Physical therapy focuses on strengthening the shoulder muscles, restoring range of motion, and enhancing stability to prevent future injuries. A customised exercise programme will be developed based on the patient’s condition.

Medication

Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen can help reduce pain and inflammation. In some cases, corticosteroid injections may be recommended to relieve pain and inflammation more effectively.

Ice and Heat Therapy

Ice can help reduce inflammation and pain in the acute phase of a shoulder injury. Heat therapy can help relax tense muscles and improve blood flow to the affected area during the later stages of recovery. Patients should alternate between using an ice or heat pack on the affected shoulder for 15-20 minutes at a time, 3-4 times per day.

Surgical treatment may be required for severe SLAP tears or when non-surgical treatments fail to relieve symptoms. Surgery aims to repair the torn labrum and restore shoulder stability and function.

SLAP Tear Surgery

SLAP tear surgery aims to repair a tear in the superior labrum, which is the ring of cartilage surrounding the shoulder socket. The procedure involves making small incisions around the shoulder, through which a tiny camera (arthroscope) is inserted to guide the surgical tools. The torn labrum is then repaired or reattached using sutures or anchors. The incisions are closed with sutures or staples and a sterile dressing is applied.