A SLAP tear is an injury to the labrum of the shoulder, which is the ring of cartilage that surrounds the socket of the shoulder joint.

AP tears of the shoulder are tears to the labrum, which is a meniscus, or cartilage-like O-ring around the socket. And the SLAP basically stands for “superior labrum, anterior to posterior.” So it’s located on the superior side of the glenoid, or the socket of the shoulder joint. And the biceps tendon enters the shoulder and attaches to that superior labrum. In treating this condition, often seeing a local massage therapist for muscle tension, a local personal trainer for muscle strength and a physiotherapist for release and conditioning is a good option.  

SLAP tears usually occur in overhead athletes. So baseball pitchers, football players, volleyball players, people who play tennis. And it usually occurs from that overhead throwing motion, due to the torque from the biceps tendon, we think that you get a tear in the labrum, superiorly in the joint, and it can lead to symptoms of pain, sometimes catching sharp acute short-term pain in the shoulder joint.

Symptoms from SLAP tears usually consist of pain during a throwing motion or when the arm is in a position of elevation over the head. You may get the occasional sharp pain in the shoulder that lasts briefly and then settles when you stop that activity.

You can get a sense of instability sometimes in the shoulder, although rarely. It’s more often a deep-seated pain, deep in the shoulder joint, you can’t put your finger on it, and patients usually present with those symptoms occurring during their sporting activities.

The diagnosis of SLAP tears is a little more difficult than other shoulder disorders, because it’s a bit nefarious, you know, where the symptoms – they cross over a lot of different pathologies. But beginning with a thorough history and a physical exam of the patient can make you suspicious for a SLAP tear, but usually it’s either diagnosed with advanced imaging such as an MR arthrogram, or at the time of arthroscopy.

If non-surgical treatment of a SLAP tear fails to provide relief of your symptoms, then you’re ultimately going to require surgical intervention, which is done with arthroscopic day surgery. What happens at the time of surgery is sutures are placed in the superior labrum, and they are reattached back onto the socket, if it is a repairable labrum.

Sometimes it’s not, and if it’s a non-repairable labrum then what we do is we just debride or clean out the torn pieces of the labrum, and that usually settles the majority of the symptoms. Often talking to your local family physician for a referral to an orthopedci surgoen is a great place to start with a slap tear of the shoulder. 

If you’re an overhead-throwing athlete or you participate in overhead sports, and you develop pain in that’s deep in your shoulder, you should seek the advice of an orthopedic surgeon to determine whether or not physiotherapy is all that you’re going to require, or surgical intervention to treat a SLAP tear if it gets diagnosed. Local Physiotherapist

Presenter: Dr. Jordan Leith, Orthopaedic Surgeon, Burnaby, BC

Now Health Network Local Practitioners: Orthopaedic Surgeon

Well MRI really just came onto the scene in 1982, and it's changed dramatically over the years. The magnet strength has increased, and the resolution of the images has increased dramatically over that time. And we have other techniques, such as the coils that we put on patients to receive the information to produce the images that technology has improved over the last 10 years especially. We are seeing much more detail in a number of the injuries, such as ligament injuries, a meniscal injury is a really good example.

We can see the more subtle tears much easier now in the knee, for example, or the other area that we're seeing much better is the cartilage injuries which is especially important in the knee but also in the shoulder, in the ankle as well. So we can see cartilage detail much better than we used to. And the other area that has shown great improvement, specifically with sports injuries, is in the brain. So, assessing for concussion or traumatic brain injury, the detail in the brain is much greater compared to 10 years ago, so that's really improved, made a big difference for brain MRI.

If people have any more questions about the advantages of the new technology and the advances with MRI in the past 10 years they should talk to their family doctor or their referring physician or an imaging center.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist