تمزق SLAP

A deep, vague shoulder pain — hard to point to precisely. Pain with overhead or throwing movements — and a drop in throwing power. Catching, popping or clicking — deep within the joint. A sense of weakness — or that the shoulder is not performing as it should.

Repetitive overhead throwing, serving or swimming. A fall onto an outstretched arm. A sudden forceful pull when lifting or catching a weight. Age-related fraying of the upper labrum.

SLAP tears can be difficult to diagnose, as the symptoms overlap with other shoulder problems. A combination of specific provocative tests and an MRI with contrast (MR arthrogram) gives the clearest picture; occasionally the tear is confirmed directly at arthroscopy.

Many SLAP tears, particularly degenerative ones, respond well to non-surgical care. Surgery is reserved for specific patterns and active patients. Rehabilitation: Strengthening the cuff and shoulder blade, with throwing-mechanics work, settles many symptomatic tears. SLAP repair: In younger patients, the torn labrum is reattached arthroscopically with sutures. Biceps procedures: Where the biceps anchor is the problem, repositioning the tendon (tenodesis) is often more reliable, especially over 40.

After surgery the shoulder is protected in a sling, then rehabilitated through a staged programme over three to six months, with overhead and throwing athletes progressing last. Most patients return to their activities, though throwers should expect a patient, carefully graded return to sport.