The shoulder is one of the most active joints in the body. This constant activity means shoulders are also prone to injuries. Superior labrum anterior to posterior (SLAP) tear frequently happens in many sports. The labrum tears from the front to back with SLAP tears, often due to a bicep tendon injury. The injury is tough to detect but can benefit from non-surgical and surgical treatment.
What happens with a SLAP tear?
The shoulder is a ball and socket joint where the humerus fits into the glenoid socket. The glenoid has a labrum, a cartilage ring on the socket’s outer rim. The labrum increases the depth of the glenoid and serves as a partial anchor for one of the bicep tendons. A SLAP tear can occur if the bicep tendon is injured and detaches from the labrum. SLAP tears cause a dull ache deep in the shoulder, instability, crepitus, and pain during simple movements.
The cause of tears
Doctors classify SLAP tears as incidental or chronic. Incidental SLAP tears, also called acute tears, happen due to a sudden blow to the shoulder. Falls, sports collisions, lifting a heavy object incorrectly, and car accidents are common examples. Accidental injuries are usually traumatic injuries where the tendon is suddenly ripped from the labrum. These injuries are very painful and need immediate help.
A chronic injury
Chronic tears, on the other hand, are degenerative injuries. These injuries happen over years of wear and are typical with age. Over time, the tendon frays from the labrum, eventually damaging both the tendon and labrum. Repetitive motion from decades of lifting objects is an example of a chronic injury. Baseball pitchers, tennis players, and quarterbacks also suffer chronic SLAP tears. Patients with chronic tears ignore the damage until the pain becomes unbearable.
Surgery is often needed
SLAP tears can feel like most shoulder injuries, so a doctor must perform a scan and physical tests to confirm the damage. The injury can benefit from surgical and non-surgical treatment, but doctors recommend non-surgical remedies first. These treatment options include rest, anti-inflammatory medication, regenerative medicine, and physical therapy. If these fail to bring relief, surgery is the next step.
A minimally invasive approach
SLAP repair surgery is a minimally invasive process. The orthopedic surgeon uses arthroscopic means to access, assess, and repair the tear. If repair is possible, the surgeon will close the torn labrum with sutures. The tendon is anchored to a nearby bone. The surgeon may sometimes need to shave off part of the labrum. Then, the end of the tendon is relocated to another part of the shoulder.
Rehab and next steps
Surgery can only work to improve function with a rehab program. Rehab involves rest and physical therapy, taking between 6-12 months for a full recovery. SLAP tears have as high as a 90% success rate. Yet, there is the risk of complications, including reinjuring the shoulder. The surgeon will outline the best practices to ensure the best possible outcome.