The shoulder joint is a ball-and-socket joint. A ‘ball’ at the top of the upper arm bone (the humerus) fits neatly into a ‘socket’, called the glenoid, which is part of the shoulder blade (scapula). The term SLAP (superior –labrum anterior-posterior) lesion or SLAP tear refers to an injury of the superior labrum of the shoulder. The labrum is a ring of fibrous cartilage surrounding the glenoid for stabilization of the shoulder joint. The biceps tendon attaches inside the shoulder joint at the superior labrum of the shoulder joint. The biceps tendon is a long, cord-like structure that attaches the biceps muscle to the shoulder and helps to stabilize the joint.
The most common causes include falling on an outstretched arm, repetitive overhead actions such as throwing, and lifting a heavy object. Overhead and contact sports may put you at a greater risk of developing SLAP tears.
The most common symptom is pain at the top of the shoulder joint. In addition, catching sensation and pain most often occur with activities such as throwing.
Diagnosis is made based on the symptoms and physical examination. A regular MRI scan may not show a SLAP tear and therefore, an MRI with a contrast dye injected into the shoulder is ordered. The contrast dye helps to highlight SLAP tears.
Your doctor may recommend anti-inflammatory medications to control pain. For athletes who want to continue their sports, arthroscopic surgery of the shoulder may be recommended. Depending on the severity of the lesion, SLAP tears may simply require debridement or some may need to be repaired, while others may require a biceps tendon repair or “biceps tenodesis.” A SLAP repair can be done using arthroscopic techniques that require only two or three small incisions.
Regular exercises that make the shoulder muscles strong should be done. Adequate warm-up exercises before activities and avoiding high-contact sports can help prevent injuries that cause instability.
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