SLAP stands for superior labrum-anterior and posterior to the biceps tendon. The biceps attaches to the labrum on the upper (“superior”) glenoid If the labrum is detached in this region, the biceps tendon is no longer firmly attached to the socket. This will often cause pain with throwing, reaching to the front or side, or trying to lift objects to or above shoulder level. The most common causes of this injury are repeated strain on the biceps tendon (for example, throwing, repetitive overhead usage of the arm) or a sudden trauma such as falling on an outstretched hand and jamming the shoulder. Pain and popping is frequently noted. The pain is often in the back of the shoulder. Those that throw or use their arms overhead are often unable to continue doing so.
Diagnosis of a SLAP tear is achieved by a careful history and a thorough physical examination. However, other injuries can imitate a SLAP tear, therefore an MRI scan is often necessary to confirm the diagnosis. This scan should be done with some dye injected into the shoulder and often with the arm positioned into the overhead or cocked position. Injecting the dye and scanning the shoulder with the arm in this position are quite helpful in demonstrating these tears.
In general, SLAP tears do not heal by themselves. For successful treatment, the labrum must be reattached to the glenoid. This is done arthroscopically using suture anchors implanted into the bone, which are then used to suture the labrum back into place. The arm must be kept in a sling postoperatively to protect the sutures while the labrum heals. Some limited range of motion is possible but only within these limits! If the arm is moved too vigorously too soon, the sutures will fail and the repair will separate.
Physical therapy will usually begin within the first week after the surgery. We will check you approximately one week postoperatively followed by checks every few weeks until your recovery is advanced. Typical return to deskwork is within a few days after the surgery, reaching overhead approximately 6 weeks after the surgery, and return to throwing approximately 3 months after the surgery. A return to competition for throwers is usually between 4 and 6 months postoperatively. Supervised physical therapy is usually necessary for the first 2-3 months at least.
Slap Tear Pictures
Slap Movie Clips
Below you will find movie clips of actual surgeries. These mpg’s are graphic examples of actual surgical procedures and viewers are informed of this graphic nature. Since these are video clips they may take several minutes to download depending upon the speed of your internet connection.
Slap Anchor Placement