What is a shoulder labral tear (SLAP tear)?
On the outside rim of your shoulder socket, there is a ring of cartilage called the labrum. Its purpose is to help hold the ball shaped end of your humerus (your upper arm bone) in place within the shoulder socket. The labrum can become torn in different places, but the most common area is at the front and back where it attaches the bicep muscles in your arm to the tendons. This type of tear is called a SLAP tear, which stands for Superior Labrum Anterior and Posterior.
Common signs and symptoms of a SLAP tear
Often, SLAP tears are symptomless with the pain only occurring when you try to do certain movements with your arm:
- Shoulder pain
- A feeling of the shoulder locking, clicking or catching
- Reduced movement and stiffness in the joint
- A feeling of unsteadiness and weakness in the shoulder
Common causes of a SLAP tear
SLAP tears are usually caused by:
- Trauma — Injury can occur during sports or during an accident where you fall and stretch your arm out to break your fall. The impact of bearing weight on your arm in this way can cause the labrum to tear. It may also happen if you are involved in a car accident or dislocate your shoulder.
- Repetitive movements — Certain repetitive movements such overhead motions during work or sports can result in a SLAP tear.
- Wear and tear — Chronic conditions such as osteoarthritis (wearing down of cartilage in the joints) can make the labrum prone to tearing, as can general wear and tear during your lifetime. If you are over 40, you can be at a higher risk of getting a tear.
Diagnosing a SLAP tear
It can be difficult to diagnose a SLAP tear because you can also tear your labrum in other areas. To reach a diagnosis, your doctor will assess the condition of your shoulder by moving your arm into various positions and reviewing how much movement and pain you have.
Imaging tests
Your doctor may wish to send you for an imaging scan to help look at your shoulder in detail. You may be asked to go for either or both of the following types of scan:
- X-ray – to detect fractures and structural abnormalities
- MRI scan – to look at soft tissue damage in more detail. You may need to have an injection of a contrast material into the joint. This will help to identify the tear if you have one
Treating a SLAP tear
Your doctor will decide on the best course of treatment based on the symptoms and exact diagnosis. Conservative treatment with the use of medication and therapy is usually enough to treat a SLAP tear, but in some cases, surgery may be required.
Medication
Your doctor may suggest you try medication to relieve your shoulder pain. Options may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Brufen (ibuprofen)
- An injection of corticosteroids into the joint to provide temporary relief
Therapy
Physiotherapy may be recommended to help improve your strength, movement and stability. Your therapist may also be able to tell you what kinds of movements are contributing to the problem so that you can avoid them.
Surgery
Surgery is an option when conservative treatment isn’t appropriate or hasn’t helped. An arthroscopic (keyhole) procedure may be required to repair or remove the torn tissue in the shoulder joint. In rare cases, you may need to have open surgery where a larger incision is made.
Recovering after a SLAP tear
Your recovery may differ depending on the extent of your tear and the treatment undertaken. For minor tears requiring conservative treatment, it is possible that you may recover in a few weeks as long as you have followed the advice given by your doctor and physiotherapist.
If you have had arthroscopic surgery, you may need to wear a sling for 4 weeks. In total, it could take up to 2 months for your shoulder to recover after surgery and a further 2 months to regain the strength you had before the injury.
Your doctor and physiotherapist will be able to guide you on when it is safe to return to exercise and more intense activities (such as lifting).
Faqs
الأسئلة الأكثر شيوعا
King’s College Hospital Dubai is the best hospital for shoulder labral tear and SLAP tear treatment in Dubai.
The best doctors for shoulder labral tears and SLAP tears in Dubai are Dr. Shine Ashokan, Dr. Osama Omar, Dr. Farid Ghasemzadeh Mojaveri, and Dr. Charalampos Harry Kremmydas.
A shoulder labral tear is damage to the ring of cartilage that lines the shoulder socket and helps keep the joint stable. A SLAP tear is a specific type of labral tear that affects the top part of the labrum, where the biceps tendon attaches. These injuries can cause pain, catching, weakness, and a feeling that the shoulder is not moving normally.
Symptoms can include deep shoulder pain, pain with overhead movement, clicking or catching in the joint, weakness, and reduced strength or control during sport, gym training, or lifting. Some patients also feel that the shoulder is unstable or notice pain after throwing, falling, or sudden pulling of the arm.
Labral tears can happen after a shoulder dislocation, a fall onto the arm, heavy lifting, or a sudden traction injury. They are also seen in athletes and active adults who do repeated overhead movement, such as throwing, swimming, racket sports, or weight training.
Diagnosis starts with a detailed history and shoulder examination to assess pain, movement, strength, and signs of instability or labral injury. Imaging may also be needed. MRI, and in some cases MR arthrogram, can help show the labrum and identify a SLAP tear or other associated shoulder damage.
Some labral tears can be managed without surgery, especially if symptoms are mild or the tear is not causing major instability. Treatment may include rest, physiotherapy, activity modification, and pain relief. Surgery may be considered if pain continues, shoulder function does not improve, or the tear is affecting stability and return to sport.
You should see a doctor if shoulder pain follows an injury, keeps returning with overhead activity, causes clicking or catching, affects sport or gym performance, or makes the shoulder feel weak or unstable. Early assessment is also important if you have had a shoulder dislocation or symptoms that are not improving with rest.
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