A superior labral tear from anterior to posterior (SLAP) tear—also known as a labral tear—is a common sports injury of the shoulder. This is particularly true for athletes participating in sports that involve overhead motion, such as football, baseball, swimming, and weightlifting.
This injury occurs because the labrum, a piece of cartilage in the shoulder, gradually wears down due to repeated overhead motion, like throwing. Other causes of SLAP tears include acute traumatic events like falling on an outstretched arm, or from general wear and tear over time.
For athletes, a SLAP tear can be season ending. Braxton Miller, formerly a football player at Ohio State University (OSU) and currently with the Houston Texans, is a classic example. He tore his labrum when trying to throw a pass during practice, and missed his 2014 season at OSU. Alas, he’s not alone.
Nonsurgical treatment options
There are treatment options to get you back competing on the field or in the pool. Physicians tend to manage SLAP tears nonsurgically first with treatment steps that can include:
- Take a break from throwing activities and rest from activities causing pain.
- Take anti-inflammatory medications such as ibuprofen to decrease pain and swelling.
- Start physical therapy exercises once pain has decreased. The aim is to strengthen shoulder muscles and improve shoulder movement.
Opinions vary on the success of nonsurgical treatment.
Surgical treatment and recovery
Surgery may be an option if nonsurgical treatment does not work or if symptoms persist. Another professional football player, Mark Sanchez, sustained a season-ending torn labrum injury during a 2013 pre-season game. He had surgery after several weeks of nonsurgical rehabilitation.
Arthroscopic surgery is the favored surgery used to treat SLAP tears. The small incisions involved in an arthroscopic procedure mean:
- It is minimally invasive.
- You’ll have less swelling, discomfort, and decreased risk of complications.
- The healing process begins sooner.
The majority of patients undergoing this procedure do not experience complications, 1 Dodson CC, Altchek DW. SLAP Lesions: An Update on Recognition and Treatment. Journal of Orthopedic & Sports Physical Therapy. 2009; 39: 71- 80. but there are risks associated with any surgery. Complications with arthroscopy for a SLAP tear can include nerve and blood vessel damage, stiffness, or bleeding.
SLAP tear surgery involves postoperative management. While guidelines vary, patients can expect to:
- Wear a sling for several weeks after surgery.
- Complete exercises geared to increase flexibility, strength, and motion.
When can you return to sport?
It usually takes 4 to 6 months for a complete recovery from SLAP tear surgery, depending on several factors: 2 SLAP tears. American Academy of Orthopedic Surgeons Website. http://orthoinfo.aaos.org/topic.cfm?topic=A00627 Updated August 2011. Accessed May 12, 2016.
- Recovery pace.
- Severity of injury at the time of operation.
- Postoperative complications, if any.
- How the injury was managed after surgery, including the effort put into the rehabilitation process.
A SLAP tear can be devastating injury for athletes. While Braxton Miller and Mark Sanchez both sat out a season of play, both have recovered from surgery and are back on the field. Fortunately, arthroscopic SLAP tear surgery is successful in 85 to 95% of patients. 3 Patient Guide to Labral Tears. Orthopedic Specialists. http://www.stlorthospecialists.com/content/259/Dr-Richard-Howard/Shoulder-Labral-Tears Accessed May 12, 2016.
- 1 Dodson CC, Altchek DW. SLAP Lesions: An Update on Recognition and Treatment. Journal of Orthopedic & Sports Physical Therapy. 2009; 39: 71- 80.
- 2 SLAP tears. American Academy of Orthopedic Surgeons Website. http://orthoinfo.aaos.org/topic.cfm?topic=A00627 Updated August 2011. Accessed May 12, 2016.
- 3 Patient Guide to Labral Tears. Orthopedic Specialists. http://www.stlorthospecialists.com/content/259/Dr-Richard-Howard/Shoulder-Labral-Tears Accessed May 12, 2016.