SLAP Tear
A SLAP tear (Superior Labrum Anterior to Posterior) is an injury to the cartilage rim—the labrum—that lines the shoulder socket. The tear occurs at the top of the socket where the biceps tendon attaches. SLAP tears are common in overhead athletes like pitchers, swimmers, and volleyball players, and also happen from a single traumatic event like a fall on an outstretched arm or a sudden pull on the shoulder.
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Symptoms
- Deep aching pain inside the shoulder, difficult to pinpoint
- Painful clicking, popping, or catching sensation with shoulder movement
- Pain when reaching overhead or across the body
- Weakness when throwing or lifting
- Decreased range of motion
- A feeling that the shoulder is about to slip out of place
When to See a Doctor
See an orthopaedic shoulder specialist if you have persistent deep shoulder pain with clicking or instability—especially if you throw overhead or had a traumatic shoulder injury. SLAP tears are frequently missed on physical exam alone; MRI arthrography (with contrast dye) gives the clearest diagnosis.
Treatment Options
Physical therapy (non-surgical)
Strengthening the rotator cuff and scapular stabilizers reduces stress on the labrum and often resolves symptoms in older or less active patients. Typically 3–6 months.
Cortisone injection
Reduces inflammation in the shoulder joint and provides temporary pain relief. Not a repair, but can help while pursuing physical therapy.
Arthroscopic SLAP repair
Minimally invasive surgery where the torn labrum is reattached to the bone with suture anchors. Recommended for younger, active patients and throwing athletes. Recovery involves 6 weeks in a sling followed by several months of rehab.
Biceps tenodesis
For older patients or those with significant biceps tendon involvement, the biceps tendon is detached from the labrum and reattached lower on the arm bone. Faster recovery than SLAP repair and equally effective for this group.
Recovery Timeline
Physical therapy alone: 3–6 months. Arthroscopic SLAP repair: 6 weeks in a sling, light activity at 3–4 months, return to throwing at 6–9 months. Overhead athletes frequently need a full year before returning to competitive sport.
Frequently Asked Questions
Can a SLAP tear heal without surgery?
Many SLAP tears—particularly in patients over 40—respond well to physical therapy without surgery. Younger throwing athletes with Type II SLAP tears (the most common type requiring repair) typically do not recover to their pre-injury level without surgery if they want to return to overhead sport.
How is a SLAP tear diagnosed?
Physical examination tests can suggest a SLAP tear, but MRI arthrography—an MRI done after contrast dye is injected into the shoulder joint—is the most accurate imaging study. Standard MRI without contrast can miss SLAP tears, so request the arthrographic version if your surgeon suspects one.
What type of doctor treats SLAP tears?
Orthopaedic surgeons specializing in shoulder surgery or sports medicine treat SLAP tears. If you are a throwing athlete, look specifically for a surgeon with experience in overhead athlete shoulder surgery, as the decision of whether and when to repair versus manage conservatively is nuanced.
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This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.