Shoulder SLAP Tear

Topic Overview

What is a SLAP tear?

A SLAP tear is a specific kind of injury to your shoulder.

To help make your shoulder more stable, there is a ring of firm tissue, called the labrum, around your shoulder socket. The labrum (say "LAY-brum") helps keep your arm bone in the shoulder socket.

SLAP stands for "superior labrum, anterior to posterior"—in other words, "the top part of the labrum, from the front to the back." It refers to the part of the labrum that is injured, or torn, in a SLAP injury.

What causes a SLAP tear?

The labrum frays or tears because of an injury. You may get a SLAP tear if you:

• Get a direct hit to your shoulder.
• Fall on your outstretched arm.
• Fall on your shoulder.
• Brace yourself with your outstretched arm in a car accident.
• Lift heavy objects repeatedly or too suddenly.
• Do a lot of overhead activities, such as throwing a baseball.

This injury was first identified in the 1980s in athletes, like baseball players, whose sport requires them to do a lot of overhead throwing.

Today, most SLAP tears happen in a fall or a direct hit to the shoulder.¹

Many people with SLAP tears also have other shoulder injuries, such as a tear in the rotator cuff.

What are the symptoms?

Symptoms of a SLAP tear may include:

• Painful popping, clicking, or catching in the shoulder.
• Pain when you move your arm over your head or reach back.
• Pain when you throw a ball.
• An ache often described as being deep inside the shoulder.

How is a SLAP tear diagnosed?

A SLAP tear can be hard to identify, because there are so many other things that can cause shoulder pain and because SLAP tears are not common. Ways to diagnose a SLAP tear include:

• A series of tests in which your doctor moves your shoulder joint around to see which movements are causing your pain.
• X-rays.
• MRI. A special dye is injected into your shoulder before you have an MRI scan. When a dye is used, the test is called an MRI arthrogram.
• Arthroscopic surgery. This is the only sure way to know whether you have a SLAP tear. Your doctor will make small cuts, called incisions, in your shoulder. Then he or she can look at the inside of your joint by inserting a tiny camera attached to a thin tube. The doctor may be able to repair the tear at the same time.

How is it treated?

The first step in treatment is to see whether pain medicine and physical therapy can take care of the problem.

NSAIDs, which are anti-inflammatory medicines, may help the pain. NSAIDs are available over the counter or by prescription. Aspirin, ibuprofen (such as Advil or Motrin), and naproxen (such as Aleve) are commonly used NSAIDs.

Physical therapy includes taking part in a home exercise program, stretching, and avoiding activities that cause pain. If therapy at home doesn't help, your doctor may want you to go to a physical therapist for treatment.

For many people, surgery is the only thing that helps. With arthroscopic surgery, the doctor can get a close look at the injury and also do some repairs at the same time.

What else could be causing your shoulder pain?

The shoulder is a complex joint, and there are a number of other problems that can cause pain there, such as:

• Arthritis.
• Tendinitis.
• Rotator cuff disease.
• A shoulder joint that is not stable.
• A pinched tendon.
• A compressed nerve.

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Author:	Cynthia Tank	Last Updated: July 20, 2007
Medical Review:	William M. Green, MD - Emergency Medicine Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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