Shoulder Labral Tears (SLAP Tears)

Apr 23, 2021

What is a SLAP tear?

What is it?

A ring of flexible,
fibrous connective tissue, known as the glenohumeral labrum, surrounds the
shoulder joint. This labrum increases the stability of the shoulder while
allowing for the required flexibility of one of the bodies’ most sophisticated
joints. One well-known muscle of the arm, the biceps, has an attachment
directly into the labrum and is a common site of injury. A tear of the labrum
can occur in many locations, however the most common is at the point where the
biceps tendon attaches to the labrum. Usually, this tear follows a typical
pattern and is referred to as a superior labrum tear, anterior to posterior
(SLAP tear).

What causes it?

SLAP tears can be caused by trauma such as a fall
onto an outstretched hand or a dislocated shoulder. Tears can also develop over
time with repeated throwing actions or overhead activities as the labrum is
weakened and eventually injured. Traumatic tears are more likely to be
symptomatic than tears that develop slowly.

What are the symptoms?

As mentioned, SLAP tears can occur suddenly, through
trauma or develop slowly through repeated stress. Often if the injury develops over
time, patients can be unaware they have sustained a tear and the injury doesn’t
have a significant impact on their pain or function. Preexisting SLAP tears can
however, place more tension on the long head of biceps tendon, leading to
overuse disorders as a secondary complication.

When the tear occurs through a sudden action or
trauma, symptoms can be more marked. Sufferers often notice pain deep in the shoulder
joint with overhead shoulder movements, a feeling of weakness, loss of power
and/or accuracy with throwing activities. Some people may notice a popping or
clicking sensation and occasionally the shoulder may give way. In severe tears,
the shoulder might feel unstable and even be at increased risk of dislocation.

How can physiotherapy help?

Your physiotherapist is able to help diagnose a suspected
SLAP tear and send you for further imaging if needed. SLAP tears are often graded
by severity from I to IV as a way to guide treatment. Physiotherapy is usually
recommended as a trial for all tears before considering surgical repair and in
many cases can effectively help patients return to their previous activities,

If physiotherapy is unsuccessful, surgical repair with a
full rehabilitation program is recommended. Surgery will usually either repair
the tear or reattach the biceps tendon to the humerus (tenodesis). Following
surgery, a period of rest in a sling is required before rehabilitation can

None of the information in this newsletter is a
replacement for proper medical advice. Always see a medical professional for
advice on your individual injury.

If you need any further information on shoulder pain then click


, or call the clinic at 028 92666959 or email

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