What Is a SLAP Tear or Labral Tear in the Shoulder?
The labrum is a circular ring of flexible, fibrous connective tissue that surrounds the shoulder joint along the edge of the socket. It increases shoulder stability by making the socket slightly deeper, while still allowing the flexibility required by one of the body’s most complex joints. One well known arm muscle the biceps has a tendon that attaches directly into the labrum, making it a common site of injury.
A labral tear can occur in various locations, but the most common is at the point where the biceps tendon attaches. This type of tear typically follows a specific pattern known as a superior labrum anterior to posterior tear or SLAP tear. A tear in the labrum can reduce the stability of the ball and socket joint.
What Causes It?
SLAP tears may result from trauma, such as falling on an outstretched hand or dislocating the shoulder. They can also develop gradually through repeated overhead motions especially in throwing sports which weaken the labrum over time. Traumatic tears are more likely to cause noticeable symptoms than those that develop slowly.
What Are the Symptoms?
SLAP tears can occur suddenly (due to trauma) or gradually (due to repetitive stress).
If the injury develops slowly, a person may not even realize they have a tear, and it might not cause significant pain or limit function. However, even minor SLAP tears can place additional stress on the long head of the biceps tendon, potentially leading to biceps-related pain.
When a SLAP tear occurs suddenly such as during a fall or shoulder dislocation symptoms are usually more noticeable. These may include:
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Deep shoulder pain during overhead movements
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A feeling of weakness or instability
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Loss of power or accuracy during throwing activities
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Popping or clicking sensations
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Occasional “giving way” of the shoulder
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In severe cases, a sense that the shoulder is unstable or prone to dislocation. How Can Physiotherapy Help?
A physiotherapist can assess and help diagnose a suspected SLAP tear and refer you for imaging if necessary. SLAP tears are typically graded from I to IV based on severity, which helps guide treatment.
Physiotherapy is usually the first line of treatment for all SLAP tears before considering surgery. In many cases, a targeted rehabilitation program can help patients return to their regular activities without pain. Treatment focuses on strengthening the muscles around the shoulder to improve joint stability.
If physiotherapy does not provide adequate relief, surgical repair may be recommended. Surgery often involves either repairing the torn labrum or reattaching the biceps tendon to the upper arm bone (a procedure known as tenodesis). After surgery, the shoulder is typically immobilized in a sling for a period, followed by physiotherapy to restore mobility and strength.
Remember: There are many possible causes of shoulder pain, so it’s essential to get an accurate diagnosis from your physiotherapist.