SLAP is an abbreviation of ‘Superior Labrum Anterior and Posterior’. A SLAP tear or SLAP lesion is an injury to the glenoid labrum which is the fibrocartilaginous rim around the socket of the shoulder. It is commonly seen in athletes who perform a repetitive overhead throwing action but can also be the result of direct trauma or degeneration.
SLAP lesions are classified into different types based on their presentation. Typically a SLAP I tear is rare and due to degeneration – these are most commonly seen in older patients. SLAP II to IV tears is classified based on the extent of the tear.
There are many different causes for a SLAP lesion. These include:
The main symptom is pain around the shoulder joint. It is often associated with other shoulder pathologies such as rotator cuff tears, long head of biceps tendinopathy and subacromial bursitis.
Pain is aggravated with overhead actions and there may be reduced strength and range of motion at the shoulder as a result of pain or associated injury. There may also be painful clicking or popping of the shoulder during active shoulder range of motion. For those people who are involved in throwing sports, they may notice a reduction in their throwing speed.
Clinical assessment is difficult as there are often other shoulder pathologies present in conjunction with the SLAP lesion. A detailed subjective history should be carried out by the physiotherapist or doctor, followed by an objective assessment looking at a range of motion, strength and additional special tests specific to the shoulder.
In order to confirm a SLAP lesion, an MR Arthrogram is commonly carried out by the orthopaedic surgeon. They will combine the clinical assessment with the imaging findings to determine the best course of treatment.
Physiotherapy treatment consists of a rehabilitation program consisting of exercises to regain normal range of motion and loading exercises to improve shoulder and scapula control and stability. Other pathologies which are present, such as long head of biceps tendinopathy, will also be addressed through rehabilitation exercises.
Surgical management is often required to repair the SLAP lesion. Surgery typically involves a SLAP repair and may also include the repair of other structures such as the long head of the biceps or rotator cuff.
Physiotherapy is required post-operatively. This will typically involve a period of immobilisation at the shoulder followed by exercises and treatment to increase the range of motion. Strengthening will be gradually introduced into the rehabilitation plan followed by sport-specific exercises as part of end-stage rehabilitation.
At Melbourne Hand Therapy our shoulder physiotherapists are experienced in diagnosing and treating all shoulder pathologies. For all shoulder injuries, the quicker you are diagnosed and commence an appropriate treatment plan the better so don’t delay – book an appointment with one of our therapists today!