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SLAP Tear

What is a SLAP tear?

By Jonathan Cluett, M.D., About.com

Updated: March 3, 2006

About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

A SLAP tear is an injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable. To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within.

A specific type of labral tear is called a SLAP tear; this stands for Superior Labrum from Anterior to Posterior. The SLAP tear occurs at the point where the tendon of the biceps muscle inserts on the labrum.

How does a SLAP tear occur?
Common mechanisms of a SLAP tear include:

    • Fall onto an outstretched hand
    • Repetitive overhead actions (throwing)
    • Lifting a heavy object
The area of the labrum where the SLAP tear occurs is susceptible to injury because it is an area of relatively poor vascularity. Other area of the labrum often heal more easily because the blood supply delivers a healing capacity to the area of the tear. In the area of SLAP tears this is not the case, and chronic shoulder pain can result.

What are the symptoms of a SLAP tear?
Typical symptoms of a SLAP tear include a catching sensation and pain with movement, most typically overhead activities such as throwing. Patients usually complain of pain deep within the shoulder or in the back of the shoulder joint. It is often hard to pinpoint symptoms, unless the biceps tendon is also involved. In cases of SLAP tears with associated biceps tendonitis, patients may complain of pain over the front of the shoulder.

How is a SLAP tear diagnosed?
There are several tests a skilled examiner can perform to detect for SLAP tears. These tests are part of a shoulder physical examination. In addition, careful questioning of the patient can help the examiner identify symptoms consistent with a SLAP tear.

Diagnosis of a SLAP tear can be quite difficult, as these injuries may not show up well on MRI scans. SLAP tears tend to be seen best on MRI when the study is performed with an injection of contrast. A contrast MRI is performed by injecting a fluid called gadolinium into the shoulder; the gadolinium helps to highlight tears of normal structures, including SLAP tears. Sometime the diagnosis of a SLAP tear is made at the time of surgery.

Read on for more information about the treatment of SLAP tears...

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