If first-line nonoperative treatment fails, surgical options may be considered. The optimal surgical management of SLAP lesions in athletes is debated. Historically, return to play rates among athletes who have undergone arthroscopic SLAP repair have been unsatisfactory, prompting clinicians to seek alternate surgical options.
Can a SLAP tear be treated?
Pamela has had two shoulder surgeries ten years apart under the care of Dr. Christensen and she says she is back to full function and feels amazing following her latest SLAP tear procedure. Slap tears are first treated conservatively, meaning surgery is not the first option.
What are the side effects of a SLAP tear?
These may include infection, stiffness, and/or shoulder weakness. Your recovery from surgery can be affected if you also have had other shoulder injuries in addition to the SLAP tear. 1 SLAP tears are a common cause of shoulder discomfort, especially for athletes who have frequent overhead movements.
How long does it take to recover from a SLAP tear?
If surgery is required, the Type II SLAP is definitely an ordeal, requiring several weeks in an immobility sling followed by several months of therapy. TYPE III SLAP TEAR: This is the “bucket handle tear” where the top part of the labrum peels away from the bone without tearing the biceps tendon as occurs in the Type II.
Do SLAP tears always need surgery?
SLAP tears are often painful and can cause clicking in the shoulder. They often occur as a result of a jarring motion of the arm. Unfortunately, SLAP tears do not heal on their own and usually require surgery to allow them to heal properly.
Is a SLAP tear serious?
SLAP tears (also called SLAP lesions) vary in severity from minor fraying to complete detachment from the shoulder socket. They are common injuries among overhand athletes who make forceful arm movements, such as baseball players or tennis players.
How long does it take a SLAP tear to heal without surgery?
Recovering from SLAP tear treatment is a marathon, not a sprint. It can take three to four months for non-surgical treatment to help relieve your pain and improve your functioning. It can take up to a year to fully recover from SLAP tear surgery.
Does a Type 3 SLAP tear require surgery?
Type III SLAP tear consists of a bucket-handle tear, where the torn labrum could droop into the shoulder joint. The biceps tendon remains intact. Arthroscopic surgery is often needed to remove the bucket-handle segment.
Will a SLAP tear get worse?
Can a SLAP tear get worse if untreated? Yes, if a SLAP tear is left untreated, some common and long-term problems could occur, including: shoulder dislocation or instability, reduced range of motion, chronic pain, and adhesive capsulitis (frozen shoulder).
What happens if a labral tear goes untreated?
If left untreated, this may lead to chronic or recurrent shoulder instability, pain, and weakness.
Can a torn labrum get worse?
When this happens, the labral tissue may start to tear. If the tear gets worse, it may become a flap of tissue that can move in and out of the joint, getting caught between the head of the humerus and the glenoid. The flap can cause pain and catching when you move your shoulder.
IS SLAP tear surgery painful?
You will be in pain, and although you can mask that pain with pain medications, you may discover that doing so prevents you from taking care of your responsibilities. Your doctor will give you a sling, which he or she will advise you to wear for anywhere between two and four weeks.
Is labral tear surgery worth it?
Doctors recommend labral tear surgery to patients who they think are good candidates—these patient are not at high risk for surgical complications and are likely to have good postsurgical results. For other patients, a hip replacement or other hip surgery may be considered.
Can you live with a torn labrum?
Typically, patients with SLAP injuries that are less severe, involving either a partially torn labrum or frayed labrum, will find that physical therapy alone will improve their symptoms. However, if symptoms do not resolve after 6-12 weeks of physical therapy, surgery is necessary for a full recovery.
What is a Level 5 SLAP tear?
In a type 5 injury, the SLAP tear extends to the front lower part of the labrum. It's known as a Bankart lesion. A type 6 tear is a bucket handle tear, but the “flap” is torn.
What is a Grade 2 SLAP tear?
SLAP Type 2 Type 2 is the comonest type of SLAP tear. The superior labrum is completely torn off the glenoid, due to an injury (often a shoulder dislocation). This type leaves a gap between the articular cartilage and the labral attachment to the bone.
What are the symptoms of a slap tear?
SLAP tear symptoms include: shoulder popping, locking, or grinding. pain with certain movements or positions. pain when lifting things, especially over your head. reduced range of motion.
What type of tear is a slap injury?
Type 2 tears are the most common SLAP injuries. Depending on the location of the labral tear, type 2 tears are split into three categories: type 2A (front top) type 2B (back top) type 2C (both the front and back top)
What is a type 1 labrum tear?
In a type 1 tear, the labrum is frayed but the biceps tendon is attached. This type of tear is degenerative and usually seen in older people.
What is a slap tear?
Shoulder SLAP tear. A SLAP tear is a type of shoulder injury. It affects the labrum, which is the cartilage on the rim of the shoulder’s socket. The labrum is a rubber-like tissue that holds the ball of the shoulder joint in place. SLAP stands for “superior labrum anterior and posterior.”. The tear occurs in the top (superior) ...
How to diagnose a slap tear?
SLAP tear diagnosis. A doctor will use several methods to diagnose your injury. These might include: Medical history. This helps a doctor understand what type of activity might have caused your injury. Physical examination. A doctor will observe your shoulder and its range of motion.
How many types of slap injuries are there?
SLAP injuries are classified into 10 different types. Each injury is categorized based on how the tear forms. Originally, SLAP tears were classified into types 1 through 4. The other types, known as extended SLAP tears, were added over time. The descriptions of these types vary slightly.
How to repair a slap tear in shoulder?
They insert a small camera, or an arthroscope, into the joint. The surgeon then uses miniature surgical tools to repair the SLAP tear.
What is a slap tear?
Surgery is among the treatment options for a superior labrum from anterior to posterior (SLAP) tear, a type of shoulder joint injury. While outcomes are generally good after SLAP tear surgery, most people improve with non-surgical treatments. If you've had a SLAP tear, you will be advised to rest after your injury to allow ...
What are the risks of arthroscopic shoulder surgery?
Risks of surgical treatment include the usual risks of arthroscopic shoulder surgery . These may include infection, stiffness, and/or shoulder weakness. Your recovery from surgery can be affected if you also have had other shoulder injuries in addition to the SLAP tear. 1 .
What to do if shoulder pain persists?
Physical Therapy. Anti-inflammatory Medications. Cortisone Injections. If your symptoms persist despite these treatments, your doctor might recommend that you have minimally invasive arthroscopic surgery, with a small incision in your shoulder.
Can you recover from a slap tear?
There are several different surgical procedures that can help you recover after a SLAP tear . Since SLAP tears often occur in conjunction with other shoulder problems, such as rotator cuff tears or shoulder arthritis, your surgical planning may have to take these factors into account. 1
Can a slap tear be surgically treated?
However, when nonsurgical treatment doesn't adequately alleviate symptoms, surgical treatment of the SLAP tear can be considered. There are several surgical options for the treatment of a SLAP te ar, each with advantages and disadvantages. Selection of the right surgery can help to ensure a successful treatment outcome. 1
Can a slap tear be debrided?
This option is only suitable for minor tears that do not involve the biceps tendon. The biceps anchor, which is the portion of the biceps tendon within the shoulder joint, must be stable for a debridement surgery to be effective. If the biceps anchor is not secure, debridement of the torn portion of the labrum is unlikely to alleviate symptoms. Recovery following an isolated debridement is faster than recovery after a surgical repair. 2
What Are SLAP Tear Treatment Options?
Pamela has had two shoulder surgeries ten years apart under the care of Dr. Christensen and she says she is back to full function and feels amazing following her latest SLAP tear procedure.
What Is the SLAP Tear Repair Recovery Process Like?
Once the pain and swelling from surgery have diminished, your surgeon will prescribe a physical therapy protocol. Recovery time is anywhere from two to 12 weeks depending on the severity of the injury.
How Can an Arthroscopy Help Treat a SLAP Tear?
During an arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the shoulder joint to see what damage has been caused to the shoulder. From there, surgeons can diagnose and repair problems to a joint.
How to tell if you have a slap tear?
Symptoms of a SLAP tear include: A locking, popping, catching or grinding sensation. Pain when lifting objects. Decreased range of motion. Feeling as if the shoulder is going to pop out of joint.
Why does my laptop have a slap tear?
A SLAP tear can be caused by a motor vehicle accident, falling onto an outstretched arm, shoulder dislocation, repetitive overhead sports, or repetitive motions over time . Most SLAP tears are caused by the slowly wearing down of labrum over time. If playback doesn't begin shortly, try restarting your device.
What Is A SLAP Tear?
A SLAP tear occurs in the glenohumeral joint aka shoulder. This is where the top part of the arm bone (the head of humerus), which is shaped like a ball, fits in a socket on the front of the shoulder blade (glenoid fossa).
How to tell if you have a slap tear?
SLAP Tear Symptoms. The most common SLAP tear symptoms are: Pain: with shoulder movements or when lifting things above the head. It tends to be a dull ache, rather than a sharp pain. Weakness: decreased strength in the upper arm. Instability: it may feel as if the shoulder is going to “pop-out”.
What type of tear is a slap tear?
Type 1 and type 2 SLAP tears are the most common. Slap tears can also be associated with a Bankart Lesion, where there is damage to the bottom part of the glenoid labrum, or a rotator cuff tear, damage to the shoulder muscles. You can find out more in the Bankart Lesion and Rotator Cuff tear sections.
What is a type 3 labrum tear?
Type 3: A bucket-handle tear of the labrum where part of the rim detaches forming a flap which can get caught in the joint, causing locking or catching sensations. The biceps tendon is unaffected
What are the different types of SLAP tear?
The four most common types of SLAP tear are: Type 1: Degeneration (wear and tear) where the edges of the labrum fray, but stay attached to the glenoid rim. Biceps tendon is unaffected. Type 2: The superior (top) part of the labrum and the biceps tendon are torn off the glenoid rim. Type 3: A bucket-handle tear of the labrum where part ...
How to treat a slap lesion?
Conservative, i.e. non surgical, treatment for a SLAP lesion will likely include: 1 Medication: pain-relief and anti-inflammatories such as naproxen and ibuprofen 2 Rest: from aggravating activities 3 Physical Therapy: exercises to regain the strength, stability and movement of the shoulder - visit the rotator cuff exercises section to find out more
How long does it take to heal a slap tear?
If you are still having problems after three to six months of rehab, SLAP repair surgery may be advised. SLAP tear surgery is usually done arthroscopically, keyhole surgery. A small camera known as an arthroscope is inserted into the shoulder joint so the surgeon can see exactly what damage has been done.
WHAT CAUSES A SLAP TEAR?
Repetitive overhead activities is one cause. Throwing athletes, such as pitchers, tennis players and quarterbacks have a high incidence of SLAP tears. A fall on an outstretched arm can also be a cause. Lastly, weight training, such as in the gym, can often lead to a labral tear.
What is a type IV slap tear?
A Type IV SLAP tear is the same as Type III but with an unstable biceps attachment. This very often will require repair.
Is the bicep attachment still intact?
The biceps attachment, though, is still intact . An attempt of conservative treatment can be made for this tear and, because the biceps attachment is stable, some patients do improve. Unfortunately, because of the size and displacement of the tear, many patients require arthroscopic repair.
Can weight training cause labral tears?
A fall on an outstretched arm can also be a cause. Lastly, weight training, such as in the gym, can often lead to a labral tear. The symptoms are, obviously, pain in the shoulder.
Can a slap tear be repaired?
An attempt of conservative treatment can be made with this type of tear. Unfortunately, younger, athletic, and active patients often do not improve with conservative treatment and arthroscopic surgery to repair the SLAP tear is warranted .
Overview
SLAP tear surgery, or arthroscopic SLAP tear surgery, is often done to repair damaged shoulder cartilage, called a SLAP tear. SLAP stands for S uperior L abrum, A nterior to P osterior.
Procedure Details
Your surgeon either repairs your torn labrum, attaches it to your shoulder socket or cuts your biceps tendon that’s attached to your labrum and attaches it to your humerus.
Additional Details
Hamula M, Mahure SA, Kaplan DJ, et al. Arthroscopic Repair of Type II SLAP Tears Using Suture Anchor Technique. Arthrosc Tech. Accessed 10/19/2021.
Why do people with slap tears call?
People with SLAP tears who call or email us, do so because they want to avoid surgery. Perhaps it is the athlete who cannot afford to miss a High School or Collegiate season or it is a house painter or the tree trimmer or the carpenter who cannot afford extended time away from his/her business.
What is the first line of treatment for slap lesions?
Nonsurgical treatments are usually the first-line therapy for symptomatic SLAP lesions. However, some patients cannot obtain a satisfactory improvement of their symptoms, leading to dysfunction of the shoulder and diminished pitching performance.
What is the procedure called when you cut the tendon in your bicep?
and biceps tenodesis or tenotomy (13.0%). This is a more radical procedure usually reserved for aging patients and involves cutting the tendon attachment of the bicep to the shoulder labrum and attaching it to the humerus bone (upper arm).
How many categories of SLAP lesions are there?
The management of SLAP lesions can be divided into 4 broad categories:
What is the tear in the Glenoid Labrum?
It is a tear in the Glenoid Labrum, the fibrocartilagenous structure that forms a deep pocket that helps keep the humerus bone in the shoulder socket and provides a pain-free range of motion.
Why should shoulder surgery be reviewed?
As you can see there are reasons surgery should be strongly reviewed is that the surgery may not help, may make your shoulder situation worse .
Is a slap tear a cure all?
Because surgeons are publishing study results suggesting that the surgical option is not the “cure-all to end-all,” when it comes to a SLAP tear. There is some disheartening research about the reality of surgery. Understanding your realistic options may help you make a realistic plan for recovery.
WHAT CAN BE DONE TO ADDRESS SLAP TEARS NON-SURGICALLY?
There are many studies on SLAP tear surgeries that tout success rates of over 90%. What you need to understand, however, is that their criteria for success and your criteria for success may be radically different. It’s not difficult to find online articles explaining how these huge success rates are being manipulated.
What is a type 1 slap tear?
TYPE I SLAP TEAR: These are characterized by fraying and soft tissue degenerative changes and are not considered a surgical problem because the labrum and biceps tendon is still anchored to the bone (if surgery is required it’s simple debridement that does not necessitate re-anchoring the labrum to the bone. In similar fashion to the ASYMPTOMATIC DISC HERNIATION, it is thought that the majority of individuals over the age of fifty have some degree of a Type I SLAP Tear. The Type I tear is typically worse in the posterior aspect (back) of the labrum, meaning it’s likely your pain will be in the back of the shoulder — not so much the shoulder blade but the back of the shoulder itself. Honestly; if you have a SLAP this is the SLAP you would rather have. While all areas of the labrum have a poor blood supply, the posterior aspect is better-supplied than the anterior (front), giving it the best hope for healing without surgery.
What physical tests are used to determine if a slap lesion is present?
The physical tests included from 1 to 6 of the anterior slide test, SLAPprehension test, biceps load tests, crank test, O’Brien test, active compression, compression rotation, Speed’s test, Yergason’s test, Jobe test, bicippital groove pain, and pain provocation. The likelihood ratios for these tests could not rule in, or rule out, the presence of a SLAP lesion.” From a 2010 issue of the Clinical Journal of Sports Medicine (Physical Examination Tests are not Valid for Diagnosing SLAP Tears: A Review)
How long does it take for a slap to heal?
This was confirmed by the 2018 recommendations of the National Athletic Trainers’ Association (NATA), which stated that “ Patients with SLAP lesions should undergo 3-6 months of nonoperative management with the goals of decreasing pain, improving shoulder function, and returning to previous activity levels. ”
What does SLAP mean in medical terms?
SLAP is an acronym for S uperior L abrum, A nterior to P osterior. Although the labrum can tear anywhere (a Bankhart Tear is one such example), the most common place for it to tear is along the top (superior) margin, with the tear running horizontally (anterior to posterior).
Why does my labrum tear?
And while labrum can certainly tear due to overuse (particularly true in overhead athletes such as pitchers, swimmers, climbers, etc), the most common cause pf the SLAP tear is probably trauma — a fall onto an outstretched arm, getting the arm jerked by a dog on a leash or water ski tow-rope, an UGLY CAR ACCIDENT, or any number of others. All of which begs the question; what exactly is a SLAP lesion?
How many types of slap tears are there?
There are four chief kinds of SLAP tears. Research has shown that SLAP tears are not always easily classified and that there is frequently a great deal of crossover from one lesion to the next.