-Cyprus Orthopaedics

Labral (SLAP) Tear

A labral tear is an injury to the labrum or “bumper” around the rim of the socket of the shoulder. A SLAP lesion is a tear of the labrum at the top of the socket.
Shoulder Procedures-Cyprus Orthopaedics

Labral (SLAP) Tear

A labral slap tear is a common injury that affects the labrum, a cartilage structure that surrounds the socket of the hip or shoulder joint. This injury can cause significant pain and discomfort, as well as limited range of motion. Understanding the causes, symptoms, and treatment options for a labral slap tear is crucial for proper diagnosis and effective management of this condition.

What is a Labral slap Tear?

A labral slap tear refers to a tear in the labrum, which is a ring of cartilage that lines the socket of the hip or shoulder joint. The labrum plays a crucial role in stabilizing the joint and providing cushioning to the bones. A slap tear specifically involves a tear that occurs from the top to the bottom of the labrum, resembling a “slap” motion. This type of tear can occur due to repetitive motions, trauma, or degenerative changes in the joint.

Causes of a Labral slap Tear

Labral slap tears can be caused by a variety of factors. Repetitive motions that put stress on the joint, such as throwing or swinging a racket, can gradually wear down the labrum and lead to a tear. Traumatic injuries, such as falls or direct impact to the joint, can also cause labral slap tears. In some cases, degenerative changes that occur with age or as a result of conditions like arthritis can weaken the labrum and make it more susceptible to tearing.

Symptoms and Signs of a Labral Slap Tear

The symptoms of a labral slap tear can vary depending on the location and severity of the tear.

  • Sensations such as a sensation of stiffness, clicking, snagging, or friction.
  • Discomfort experienced when moving the shoulder or maintaining certain shoulder positions.
  • Pain felt while lifting items, particularly those positioned overhead.
  • Reduction in shoulder muscle strength.
  • Sensation of instability in the shoulder, as if it might dislocate.
  • Limited range of motion in the shoulder joint.
  • Pitchers might observe a decline in their throwing speed or the sensation of arm fatigue after pitching.

How is a Labral Slap Tear Diagnosed?

To diagnose a labral slap tear, an orthopedic surgeon will typically conduct a thorough physical examination and review the individual’s medical history. They may also order imaging tests, such as an MRI or an arthrogram, to get a detailed view of the joint and confirm the presence of a tear. These tests can help determine the location and extent of the tear, as well as identify any other potential joint abnormalities.

Treatment Options for a Labral Slap Tear

The treatment approach for a labral slap tear depends on several factors, including the severity of the tear, the individual’s age and activity level, and their overall health. In some cases, non-surgical treatment options may be recommended, while others may require surgical intervention.

Non-surgical Treatment for a Labral Slap Tear

Non-surgical treatment options for a labral slap tear may include rest, physical therapy, and pain management techniques. Resting the affected joint and avoiding activities that exacerbate the symptoms can help promote healing. Physical therapy exercises can help strengthen the surrounding muscles and improve joint stability. Pain management techniques, such as anti-inflammatory medications or corticosteroid injections, may also be utilized to alleviate pain and inflammation.

Surgical Treatment for a Labral Slap Tear

Surgical intervention may be necessary for individuals with severe or persistent symptoms that do not respond to non-surgical treatments. The specific surgical procedure will depend on the location and extent of the tear, as well as the individual’s overall joint health. Arthroscopic surgery, which involves the use of small incisions and specialized instruments, is often performed to repair or remove the damaged labrum. In some cases, additional procedures may be required to address any other joint abnormalities or underlying conditions.

Rehabilitation and Recovery after Treatment

Following treatment for a labral slap tear, rehabilitation is a crucial part of the recovery process. Physical therapy will play a significant role in restoring strength, flexibility, and range of motion to the affected joint. The rehabilitation program will be tailored to the individual’s specific needs and may involve a combination of exercises, manual therapy techniques, and modalities such as heat or ice therapy. It is important to follow the guidance of an orthopedic surgeon and adhere to the prescribed rehabilitation program to optimize recovery and prevent future injuries.

Preventing Labral Slap Tears

While it may not be possible to completely prevent labral slap tears, there are steps individuals can take to reduce the risk of developing this type of injury. Maintaining proper form and technique during sports or activities that involve repetitive motions is essential to minimize stress on the joints. It is also important to listen to your body and take breaks when needed to avoid overexertion. Engaging in regular strength and conditioning exercises can help improve joint stability and reduce the risk of injury. If you have any concerns about the health of your joints or are experiencing any symptoms, it is always recommended to consult with a healthcare professional.

It commonly occurs in individuals who have suffered an injury to the shoulder such as falling on the outstretched arm, vehicular accidents or sporting injuries. It can also develop as a result of attrition in people who engage in overhead sports or activities.

This is a condition that results in symptoms of pain, “popping” or “clunking” of the shoulder. Occasionally the arm may feel “dead”. Pain may often only be experienced with overhead activities. Examination may show signs of pain with certain movements of the shoulder and signs of subtle restriction of movements. Pain may be reproduced on specific provocative tests. X-rays are often normal. Special imaging with an MRI scan is often necessary to obtain further information about the state of the labrum and the ligaments. In some instances an MR arthrogram (MRI scan after injection of contrast fluid in the joint) may be requested.

In the early phase, pain may be controlled with activity modification and the use of pain relieving or anti-inflammatory medication. 

Supervised physiotherapy: You may be advised to see a physiotherapist to start a regime of specific exercises to perform stretching to overcome any tightness in the joint, improve scapular positioning and strengthen the rotator cuff. Symptoms may improve with such treatment and may enable resumption of sporting activities.

Surgery: Surgery may be appropriate if symptoms fail to respond to nonoperative treatment measures. The operation performed will depend on the pathology identified on clinical and radiological assessment. It consists of an Arthroscopic repair where the tears in the labrum and ligaments are repaired with “keyhole” surgery. If there is stiffness in the joint then the tight areas of the capsule (or “sleeve”) may be released. For further information on surgical treatment, please refer to the procedures section.

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