The shoulder is made up of a complex arrangement of bones, muscles and ligaments that enable a wide range of motion, but are also susceptible to stress and injury. One such type of injury is a SLAP lesion, a condition that’s characterized by pain at the top (or “superior”) part of the labrum. With the increased use of advanced imaging over the years, more of these injuries have been identified and diagnosed. Perhaps unsurprisingly, this has also resulted in a significant rise in SLAP lesion repair surgeries. A 2012 study by Alan L. Zhang et al. in The American Journal of Sports Medicine reported a 105% increase in SLAP repairs in the U.S. between 2004 and 2009.
However, many cases of SLAP injuries do not require surgery and can be effectively treated with nonsurgical methods. Also important to note is that not all patients who have pain in the superior labrum have experienced a SLAP lesion. For this reason, it is critical to see an experienced orthopaedist who specializes in shoulder and SLAP injuries to be evaluated.
NYC orthopaedic shoulder surgeon, Francis Mendoza, M.D., will listen to your symptoms and perform a thorough physical examination before making a diagnosis and determining a treatment plan that is best for your unique circumstance. Here’s some more background from Dr. Mendoza about this injury and how it’s treated.
SLAP Lesion Overview
A SLAP lesion, also known as a SLAP tear, is an injury that occurs to the ring of firm tissue (labrum) that’s located around your shoulder socket. SLAP stands for superior labrum anterior and posterior. The superior labrum serves as the attachment for the biceps tendon inside the shoulder. This type of injury can be caused by a number of possible scenarios including falling on the shoulder or an outstretched arm, lifting heavy objects repeatedly, or most commonly, as a result of repeated overhead activities. SLAP tears are typically seen in athletes who regularly perform overhead movements that place stress on the superior labrum such as tennis players, baseball pitchers, swimmers and volleyball players.
Cause of SLAP Lesion Pain
SLAP tears lead to a certain type of shoulder instability that is not enough for the shoulder to fully dislocate, but still enough to cause pain when the superior labrum is stressed. This is called internal impingement. It is different than typical shoulder impingement because it occurs on the underside of the rotator cuff rather than the underside of the acromion (where the rotator cuff meets with the subacromonial bursa).
SLAP Lesion Diagnosis & Treatment
SLAP tears vary in severity and a thorough evaluation is necessary to determine the exact degree of damage and the overall tissue quality. After taking into account the patient’s age and activity level, an appropriate course of treatment will be recommended.
In many cases, conservative options will be very effective at improving symptoms, and may include:
- Applying gentle ice and heat
- Taking anti-inflammatory medications
- Wearing a sling
- Completing physical therapy
If necessary, a SLAP repair surgery may be recommended. SLAP surgery is an outpatient procedure that is typically performed arthroscopically through several small incisions using a camera and tiny surgical instruments.
SLAP Injury Treatment in NYC
If you are experiencing pain in the superior labrum or are seeking a second opinion for a SLAP tear, contact our office to schedule a consultation. Our phone number is 212-628-9600 or you can make an appointment by filling out the form on this page. Remember – not all SLAP injuries require surgery and symptoms of a SLAP lesion may be similar to other types of shoulder injuries and should be evaluated by a specialist to ensure an accurate diagnosis.