Superior Labrum from Anterior to Posterior Warana

November 17, 2010

A SLAP tear is an injury to the labrum (the cuff of cartilage in the socket) of the shoulder. It stands for Superior Labrum from Anterior to Posterior. The SLAP tear occurs at the point where the tendon of the biceps muscle inserts on the labrum. This injury can occur and result from trauma, repetitive motion/ overhead activities, a fall onto an outstretched hand, a sudden pull to the shoulder when lifting a heavy object or a direct blow to the shoulder. Patients often complain of catching/ clicking/ locking sensation, pain at the front or on top of the shoulder that is aggravated with movement and a loss of range. A SLAP tear can be in association to a rotator cuff or biceps tear. There are several physical tests to indicate a SLAP tear but the best way to diagnose is by either MRI or arthroscopic investigation.

There are 4 types of SLAP tears:

  • fraying of the labrum
  • when the biceps tendon and labrum become detached from the socket joint attachment
  • when the labrum has a flap of tissue hanging down into the joint.
  • tear is when the labral tear extends into the biceps tendon

Some will respond to conservative treatment and others will require surgery. Surgery can usually be done arthroscopically and can be: a debridement (shave off torn portion, type I), SLAP repair (stitches labrum/ tendon back down- type II & III) or biceps tenodesis (relocation of the biceps tendon attachment- type IV). Post-op rehab depends on the surgeon and type of surgery but Physiotherapy is vital to regain full range and strength. Full recover is usually between 3-4 months.