17/05/2026
A **SLAP tear** stands for **Superior Labrum Anterior to Posterior** tear. It is a specific injury to the **labrum**, which is the ring of firm, rubbery cartilage that surrounds the shoulder socket (glenoid).
In a SLAP tear, the top (superior) part of this cartilage ring is damaged. This specific area is critical because it is also where the **long head of the biceps tendon** attaches to the labrum.
# # Common Causes & Symptoms
SLAP tears usually happen in one of three ways:
* **Acute trauma:** Falling onto an outstretched hand, a sudden yank on the arm, or a shoulder dislocation.
* **Repetitive overhead motion:** Very common in throwing athletes (like baseball pitchers or javelin throwers) and weightlifters.
* **Wear and tear:** The cartilage naturally frays over time, making SLAP tears common in people over age 40.
People with a SLAP tear often complain of a **deep, aching pain** in the shoulder, a distinct **clicking, popping, or catching sensation** during overhead movements, and a noticeable loss of throwing velocity or shoulder strength.
# # How SLAP Tears are Treated
Treatment strategy depends significantly on the patient's age, activity level, and the specific "type" of SLAP tear (ranging from simple fraying to a complete detachment of the biceps anchor).
# # # 1. Non-Surgical Management (First-Line Treatment)
Most patients—especially those with degenerative tears or lower physical demands—start with conservative management.
* **Rest and Activity Modification:** Avoiding overhead throwing, heavy lifting, or positions that trigger the mechanical clicking.
* **NSAIDs:** Medications like ibuprofen to reduce inflammation.
* **Physical Therapy:** Focuses heavily on restoring normal shoulder mechanics. This involves strengthening the rotator cuff muscles and stabilizing the scapula (shoulder blade), as well as stretching the posterior capsule of the shoulder, which is often tight in overhead athletes.
# # # 2. Surgical Treatment
If 3 to 6 months of dedicated physical therapy fails to relieve pain or restore function, surgery is considered. This is done via **shoulder arthroscopy** (minimally invasive keyhole surgery). The exact surgical path depends on the tear type:
| Surgical Approach | When It's Used | What is Done |
|---|---|---|
| **Debridement** | Type I and minor Type III tears | The torn, frayed edges of the labrum are gently trimmed away ("shaved") to smooth out the joint and stop mechanical catching. |
| **Arthroscopic Repair** | Type II tears in young, active individuals or overhead athletes | The labrum is reattached to the bony socket using tiny implantable anchors and heavy sutures. |
| **Biceps Tenodesis / Tenotomy** | Older patients (typically over 35-40), or failed previous repairs | Because pulling from the biceps tendon often perpetuates the pain, the surgeon detaches the biceps tendon from the torn labrum. In a **tenodesis**, it is reattached lower down on the humerus (arm bone). In a **tenotomy**, it is released completely. |
# # Recovery and Rehabilitation
If a repair or tenodesis is performed, recovery requires patience.
A patient will typically spend **4 to 6 weeks in a shoulder sling** to protect the healing tissue. Initial physical therapy focuses entirely on gentle, passive range of motion. Active movement and gradual strengthening are introduced around the 6-week mark, while a full return to overhead sports or heavy lifting generally takes **4 to 6 months**.
