A superior labrum, anterior to posterior (SLAP) tear is a type of shoulder injury involving the labrum, a ring of tissue that normally stabilizes the shoulder socket. This injury is relatively rare, but can occur in people of all ages as a result of shoulder stress and strain. Treatment options are available to manage the tear and make the patient more comfortable. Usually, patients will need to see a shoulder specialist for evaluation and treatment. The specialist can rule out other conditions and decide on the best treatment approach.
In a SLAP tear, the patient's labrum frays or tears at the edge of the shoulder socket. Sometimes the injury extends all the way into one of the muscles that connects to the labrum, like the bicep. The patient may notice a popping or clicking noise along with stiffness, pain, and tension in the shoulder. If the tear is not treated, there is a possibility it could tear even more, leading to a more serious injury.
Many circumstances can cause a SLAP tear, including falling, bracing significant weight on one shoulder, or repetitive heavy lifting. People who participate in sports like baseball are at risk of such tears from the repetitive overhead motion. Wrenching shoulder injuries, including dislocations, can also create a risk of a SLAP tear. The patient may notice an immediate onset of discomfort after a serious injury, or the symptoms could be more gradual.
The first step in diagnosis is a physical examination. The doctor may want to gently move the shoulder through a range of different poses to assess range of motion and pain levels. Doctors can also request imaging studies like a magnetic resonance imaging (MRI) scan with contrast to look inside the shoulder. Sometimes the only way to make a diagnosis is with arthroscopic surgery, where a surgeon will operate on the shoulder to look inside and learn more about what is going on.
Conservative treatments for a SLAP tear can include anti-inflammatory medications and rest. The patient may need to wear a sling and refrain from heavy activities for a while as the shoulder heals. As the tear resolves, the patient can start physical therapy to rebuild strength in the shoulder. If treatment is not successful, a doctor may recommend surgery to repair the tear and rebuild any damaged portions of the shoulder. After surgery the patient will need to rest before starting a physical therapy program. Recovery from a SLAP tear may be slow, especially if the patient strains his shoulder before it is fully healed.
