Common Baseball Throwing Injuries and How They're Treated
Despite required or recommended pitch counts and rest days, baseball throwing injuries are common. Unfortunately, your enthusiasm for your game could be the thing that takes you out of it.
Just Diagnosed with a SLAP Tear? Here's What To Expect
Everyone with a hurt shoulder, raise your hand. Wait..you can’t. Shoulder injuries are common. This highly mobile joint is housed in a shallow socket, held in place by numerous muscles, tendons, and ligaments, any or all of which can be stretched, torn, or injured.
About a quarter of people in the United States experience shoulder pain at some point. Of course, athletes — especially throwing athletes — are more at risk than the average person.
Up to 8% of shoulder injuries are SLAP tears. SLAP stands for Superior Labrum, Anterior to Posterior. That’s a mighty tear.
David Lintner, MD, a world-renowned sports medicine specialist, diagnoses, evaluates, and repairs SLAP tears at Houston Methodist Orthopedics & Sports Medicine in Kingwood and Houston, Texas. As the head team physician for the Houston Astros, he has expertise in treating and rehabbing all types of shoulder injuries, including SLAP tears.
Do you have a SLAP tear? What can you expect next?
What’s a SLAP tear?
Your labrum (the “L” in SLAP) lies between the ball and socket in your shoulder. It is like a rubbery ring between the ball and socket that cushions and stabilizes your shoulder. Ligaments and the bicep tendon also attach to the labrum and serve to stabilize your shoulder during your movements and activities.
The “S,” “A,” and “P” in SLAP all refer to location. “S” stands for superior, which means the top of your labrum is torn. “A” stands for anterior (i.e., front), and “P” stands for posterior (i.e., back), which means the tear runs from front to back.
Keep in mind that some tearing of the labrum occurs with normal activities, particularly throwing and other overhead usage. The majority of these SLAP “tears” are harmless and often painless. In fact, studies show that up to 80% of throwers have painless SLAPs in their shoulders. So, if you are a thrower and your MRI shows a SLAP, this may be totally benign and your pain would be coming from another issue in your shoulder. Most patients with SLAPs do not need surgery and feel much better with physical therapy and NSAID medications. An MRI finding of a SLAP “tear” sounds scary, but don’t panic if your MRI detects a SLAP! Have your shoulder evaluated by an experienced sports medicine shoulder doctor to see if your SLAP is actually the source of your pain, and then treat that source.
What gets slapped down with SLAP?
When the top of your labrum is torn from front to back, your shoulder loses stability. It can also be painful. When you have a painful SLAP tear, your pain would be worse when you:
- Raise your arm
- Reach overhead
- Stretch your arm behind your head
- Throw
- Swing
Your shoulder might grind when you move it. In addition to pain, you may also have the sensation that your shoulder is not in its socket. You may have experienced a SLAP injury due to repetitive motions, an acute injury (such as a traumatic fall), or simply as a result of aging.
SLAP tears come in types
During diagnosis, we explain exactly the type of SLAP tear you have. The most common is Type 2, which is when both the labrum and the bicep tendon are detached from the socket of the shoulder joint.
Type 1 SLAP tears refer to frayed but still functional labrums and are often the result of aging tissues. In Type 3, some of the torn labrum tissue is caught in the shoulder joint. A type 4 SLAP tear extends from the labrum all the way into the bicep.
SLAP tear treatment depends on the severity
Don’t ignore a SLAP tear or try to play despite it. Untreated SLAP tears can worsen and eventually make it difficult to use your upper arm. The key is to pay attention to your symptoms. If pain is severe enough, seek treatment (surgical or non-operative) which can be very successful in getting you back in the game.
Your treatment and rehab regimen depends on the severity of the SLAP tear. A simple SLAP tear may just need TLC, such as resting the shoulder and controlling any pain or inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs). More severe SLAP tears might require:
- Cortisone injections
- Debridement
- Arthroscopic labral repair
- Bicep tenodesis
- Physical therapy
Dr. Lintner recommends his shoulder rehab protocol for athletes with SLAP tears. Recovery can take months.
If you've had a SLAP tear, you won’t be back in play quickly. Recovery usually takes months. If you had surgery or must immobilize your shoulder joint, you may need to wear a sling.
Have you been diagnosed with a SLAP tear? Contact our friendly and knowledgeable staff by phone or the online form for a shoulder evaluation and treatment today. If you’re far from the Houston area, you can send Dr. Lintner an MRI for a treatment recommendation.
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