Shoulder (SLAP) Tear

SLAP stands for "superior labrum, anterior to posterior,” meaning ”the top part of the labrum, from the front to the back." It refers to the part of the labrum that is injured or torn in a SLAP injury.

A ring of firm tissue around your shoulder socket, called the labrum (“LAY-brum”), helps make your shoulder stable and keep your arm bone in the shoulder socket. 

A shoulder SLAP tear is when the labrum frays or tears because of an injury. Many people with SLAP tears also have other shoulder injuries, such as a tear in the rotator cuff. You may get a SLAP tear if you:

• Fall on your outstretched arm
• Fall on your shoulder
• Brace yourself with your outstretched arm in a car accident
• Lift heavy objects repeatedly or too suddenly
• Do a lot of overhead activities, such as throwing a baseball

Symptoms of a SLAP tear may include:

• Popping, clicking or catching in the shoulder
• Pain when you move your arm over your head or throw a ball
• The feeling that your shoulder is weak or unstable
• Aching pain that is hard to describe or demonstrate in terms of location 

A SLAP tear can be hard to identify, because there are so many other things that can cause shoulder pain and because SLAP tears are not common. Ways to diagnose a SLAP tear include:

• Tests: Your doctor moves your shoulder joint around to see which movements are causing you pain.
• MRI: A special dye is injected into your shoulder before you have an MRI scan. When a dye is used, the test is called an MRI arthrogram.
• Arthroscopic surgery: This is the only definitive way to know whether you have a SLAP tear. Your doctor will make small cuts (incisions) in your shoulder. Then they can look at the inside of your joint by inserting a tiny camera attached to a thin tube. The doctor may be able to repair the tear at the same time.

The first step in treatment is to see whether pain medicine and rehabilitation (rehab) can take care of the problem.

Anti-inflammatory nonsteroidal medicines (NSAIDs) may help alleviate the pain. NSAIDs are available over the counter or by prescription. Ibuprofen and naproxen are commonly used NSAIDs.

You can also try using heat or ice on your shoulder for 15 to 20 minutes at a time. If your shoulder is very painful, try using a sling for a few days to support your arm.

Rehab may include exercises to strengthen the rotator cuff muscles and gently stretch the back of the shoulder. Your doctor or therapist will teach you how to do the exercises and avoid pain, then the exercise program may be done at home.

For many people, surgery is the only thing that helps. With arthroscopic surgery, the doctor can get a close look at the injury and also do some repairs at the same time.