Labral and SLAP Tears

Symptoms most commonly associated with a labral or SLAP tear include:

• Deep shoulder pain, often in the back of the shoulder
• Pain with overhead motion
• Instability without joint dislocation
• Loss of normal shoulder motion
• Shoulder stiffness
• A “popping” or “clicking” sensation
• Decreased performance such as loss of control or velocity when pitching

Dr. Waterman will perform a thorough physical examination to determine if there is a labral or SLAP tear present. X-rays and an MRI may be reviewed to rule out any underlying problems such as a fracture or impingement. When evaluating a patient for a SLAP tear, it is important to determine if the shoulder tear is associated with any type of pre-existing instability or if it is from a traumatic event. In some cases, dye is injected into the shoulder prior to an MRI scan to help identify the labrum and any possible tear.
Treatment of a Labral Tear or SLAP Tear

Dr. Waterman will discuss the treatment options after reaching a diagnosis. Several factors are taken into consideration such as age, athletic activity, prior treatement and type of tear.

Non-Surgical

If the injury is mild, the patient will most likely rest the shoulder, use ice and take anti-inflammatory medications. Physical therapy may also be recommended to help stretch and strengthen the shoulder.

Surgical

If non-surgical treatments are not beneficial, Dr. Waterman may recommend shoulder surgery to correct the labral or SLAP tear. These tears are almost always treated with arthroscopic surgery. The exact type of surgery will depend on the severity of the tear, condition of the biceps tendon and any other associated injuries.

There are three main surgical options for a SLAP tear in the shoulder:

• Debridement: The torn labrum is smoothed out during a debridement procedure. This shoulder surgery is recommended for stable SLAP lesions that do not involve the biceps tendon.
• SLAP repair: The labrum is reattached to the socket using strong sutures. This surgical option is normally reserved for young, overhead athletes who want to remain active in sports. A SLAP repair is the most common procedure for symptomatic SLAP lesions.
• Labrum Repair: Most commonly in the setting of instability, the labrum may be torn in the lower half of the socket. In this case a repair of the labrum is carried out to restore stability to the shoulder.
• Biceps tenodesis: This involves removing the injured biceps tendon from the torn labrum and reinserting it into a different area of the shoulder. By decreasing the pulling forces in the SLAP region, the troublesome symptoms will be alleviated.