SLAP Tear

Overview

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SLAP Tear of the shoulder is one of the common injuries leading to Shoulder pain. S.L.A.P the acronym stands for Superior Labrum (Lip) Anterior to Posterior tear. The Labrum (Lip) is the extension of cartilage (lining of the joint) of the socket in the shoulder joint. It labrum provides depth to the socket and also provides the attachment to the long head of the biceps tendon as it takes origin from the upper (Superior) portion of the socket. The biceps tendon stretches over the arm bone (head of the humerus) and acts as a pulley. As it has a long excursion, its origin at the labrum is prone to injuries. When the tear of Superior portion of the labrum occurs from front to back it is called "Anterior to Posterior" tear.

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Why & how does it happen?

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SLAP tear is seen more often in players who are into racket sports. SLAP tear can also occur as an acute injury due to fall on outstretched hand or rapid forceful stretch upwards. It can also happen due to wear and tear. 

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Who gets this injury?

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We see this in 2 different age groups. It was typically seen in sporting population such as tennis and badminton players, basketball players, cricketers and so on. Typical age group is 20 to 45 years.

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Symptoms

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• Clicking, locking, popping sound and sensation

• Pain on lifting the arm sideways

• Feeling of instability or shoulder popping out

• Feeling of dead arm or decrease in throwing velocity

• Pain often felt in the front of the shoulder area

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When to seek medical help?

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Persistent pain, locking, clicking or sense of instability warrants medical attention. Initial assessment, an x-ray and pain relieving medicines form first line of management. Further assessment by an expert Arthroscopy Surgeon and MRI scan are necessary to analyze the extent of injury / tear.

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What happens to the SLAP tear if no treatment is undertaken?

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SLAP tear cannot heal naturally as the joint fluid bathes it and doesn't allow its edges to come in contact with each other. Avoiding playing certain sports may reduce the pain and discomfort. However the pain may gradually worsens over a period of several months to years. This also depends of the type of SLAP Tear. 

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What happens when I visit the Consultant?

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You will be asked about the nature of injury, symptoms further to that so far. Consultant will examine you and discuss the treatment modalities. 

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What treatment options do we have?

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The treatment modalities vary from physiotherapy, activity modification to steroid injection. In patients with no respite, shoulder arthroscopy (Key-hole surgery) and SLAP Repair would be the definitive treatment to heal the SLAP tear.