SLAP Tear
What is SLAP?
SLAP stands for superior labrum from anterior to posterior. It is part of the cartilaginous ring (labrum) attached to the periphery of the socket (glenoid) in the shoulder joint. It serves as an important stabilizer of the shoulder joint and provides an anchor point for various ligaments and the long head of the biceps tendon.
What Causes SLAP Tears?
SLAP tears can result from acute trauma, such as a fall on an outstretched hand, or more commonly, from repetitive overhead activities, especially among throwing athletes, weightlifters, racket players, or manual laborers.
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SLAP tears can vary in severity from mild fraying of the labrum to complete detachment from the socket.
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What Are the Symptoms of SLAP Tears?
Patients with SLAP tears may present with varying degrees of shoulder pain, especially with overhead movement, sometimes accompanied by a popping, clicking, or grinding sensation. Some may experience deep vague aches, easy fatigue, or a decrease in performance in sporting activities.
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How Are SLAP Tears Diagnosed?
SLAP tears can be diagnosed by your doctor after assessing your symptoms, performing a shoulder examination, and conducting MRI imaging.
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What Are the Treatments for SLAP Tears?
The available treatments include pain control, rest, physiotherapy, and surgery.
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The treatment algorithm is often individualized depending on the patient's demographics, activity demands, and the severity of the condition. In most cases, non-operative treatments are carried out first. Physiotherapy with a focus on rotator cuff strengthening and correcting any muscle imbalances (scapulothoracic dyskinesia) is particularly beneficial.
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When symptoms persist despite non-operative measures, surgery may be needed.
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What Are the Surgical Procedures for SLAP Tears?
Depending on your age, activity level, types, and severity of the SLAP tears, your doctor may recommend one of the following operations suitable for you.
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2. Biceps Surgery - Tenotomy vs Tenodesis
Biceps tenotomy is the surgical release of the biceps tendon from the superior labrum, relieving its tension and pain.
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Biceps tenodesis is the reattachment of the biceps tendon after its release from the superior labrum, usually much lower down at the humerus (arm bone).
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