The labrum is a fibrous bumper that helps to stabilize the shoulder joint. It provides an attachment site for a variety of other shoulder structures including the capsule, ligaments and biceps tendon. When the superior labrum is detached or torn at the site of the biceps tendon insertion, it is termed a superior labrum anterior to posterior tear (SLAP).
A variety of injuries may cause damage to the superior part of the labrum where the biceps tendon inserts. The most common type of injuries are repetitive over arm motions such as throwing a ball, falling on an outstretched arm or lifting a heavy object.
Some other causes may include:
- Motor Vehicle Accident
- Trying to catch a heavy object causing a forceful pulling on the arm
- Forceful movement of the arm when it is above the level of the shoulder
- Shoulder dislocations
Overhead athletes or patients involved in repetitive overhead work can damage the superior labrum. This often generates a deep or posterior pain in the shoulder joint accompanied by a clicking, catching or popping sensation. There may be weakness with overhead activity. The throwing athlete often notices diminished velocity and control with throwing a ball.
Some other symptoms include:
- Pain with shoulder movements or with holding the shoulder in a specific position
- Pain when lifting objects, especially overhead
- Decrease in strength
- Feeling the shoulder is going to “pop out of joint”
- Decreased range of motion
Those at risk of developing a SLAP tear can include but are not limited to:
- Repetitive overhead sports athletes
- Throwing athletes
- Weightlifters
- Those over 40 years of age
- Acute injuries (Falling or a car accident)
For patients over 40 years of age the result of a labrum tear is usually caused by the labrum slowly being worn down over time which leads to tearing or fraying of the superior labrum.
A thorough evaluation by your sports medicine physician is most appropriate to confirm this diagnosis. Plain x-rays may be obtained in order to rule out any type of bony damage. An MRI may also be obtained in order to determine the degree of superior labral injury as well as the existence of any injury in the adjacent capsule, ligaments or biceps tendon.
Treatment options include both non-surgical and surgical route’s.
- Non-surgical treatment may be prescribed first to avoid surgery. This usually includes your physician prescribing non-steroidal anti-inflammatory medication as well as physical therapy.
- Surgical options will be discussed between you and your physician if non-surgical treatment has not helped. If a repair is needed, it is usually done by arthroscopy.
