What is a SLAP tear?
SLAP stands for “Superior Labrum, Anterior to Posterior” — a tear of the upper part of the labrum, the ring of cartilage that deepens the shoulder socket. It occurs at the point where the biceps tendon attaches, so the two are closely linked.
SLAP tears arise either from repetitive overhead stress — typical of throwers and swimmers — or from a single injury such as a fall or a sudden pull on the arm. With age, some fraying of this area is also a normal finding, which makes careful interpretation important.
Signs and symptoms
- checkA deep, vague shoulder pain hard to point to precisely.
- checkPain with overhead or throwing movements and a drop in throwing power.
- checkCatching, popping or clicking deep within the joint.
- checkA sense of weakness or that the shoulder is not performing as it should.
Causes & risk factors
- 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.
How it is diagnosed
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.
Treatment options
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.
Recovery & outlook
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.