Labral Tears (SLAP Tears)
Labral Tears (SLAP Tears) web based movie
The shoulder is a “ball & socket” joint. The upper part of the arm bone (humerus) forms a ball that sits in a socket on the side of the shoulder blade (scapula). The rim of the socket is surrounded like a gasket by a ring of firm, rubbery cartilage called the labral. The labral functions to deepen the socket and provide stability to the shoulder joint. It serves as the attachment site for ligaments. In addition, the long head of the biceps tendon attaches to the superior (or top) part of the labral.
SLAP tears (Superior Labrum Anterior to Posterior) are tears involving the superior part of labral, where the biceps tendon attaches. These tears may lead to subtle instability of the shoulder and to instability of the attachment of the biceps tendon. SLAP tears may result from a traumatic injury (such as a shoulder dislocation) or a sudden traction injury to the arm (such as trying to lift a heavy object or falling on an outstretched arm). These injuries are also often seen in baseball pitchers, where repetitive twisting or torsion on the labral can lead to detachment from the rim of the socket. SLAP tears may also be seen in conjunction with other injuries such as rotator cuff tears.
The most common symptom of SLAP tears is pain in the shoulder that is usually felt “deep” inside the upper part of the shoulder. Pain is often worse with overhead activities, lifting objects, or throwing. The pain may radiate down the front of the arm and into the biceps muscle. Frequently, patients with SLAP tears may experience painful clicking or popping in the shoulder with certain arm motions.
Diagnosis of SLAP tears is typically based on history of the patient’s symptoms and findings from a physical examination. Tears are confirmed via an MRI scan.
Treatment depends on the nature of the injury and symptoms. In patients who experienced a sudden injury, an initial period of “watchful waiting” may be all that is needed to see if the torn tissue will heal spontaneously. Non-operative treatment includes anti-inflammatories, physical therapy to regain full shoulder motion, and possibly a cortisone injection.
For patients who fail initial non-operative treatment, surgery is often recommended to repair the torn labral by re-attaching it to the rim of the socket. This procedure is performed arthroscopically in a minimally-invasive manner.
For more information, visit http://www.orthoinfo.org/topic.cfm?topic=A00426.