Shoulder Labral Tear or Strain (SLAP tear)

Overview

A shoulder labral tear or strain also referred to as a SLAP tear, is often caused by a traumatic shoulder injury, which results in a tear in the labrum. The labrum is the soft cartilage in the socket-shaped joint in the shoulder bone.  The purpose of the labrum is to connect the two joints between the upper arm and shoulder.

A labral tear or strain is painful. Most people with the condition also temporarily lose strength and range of motion in the shoulder.

There are three types of shoulder labral tears or strains:

• Complete – The labrum is torn completely off the bone. Typically, this type of shoulder labral tear can occur if you dislocate your shoulder.
• Partial – The edges of the labrum fray. You may not experience any symptoms with a partial tear.
• SLAP lesion (superior labrum, anterior (front) to posterior (back) – A tear in the rim above the middle part of the shoulder socket that often involves the biceps.

Shoulder labral tear or strain causes

Labral tears and strains often occur from a traumatic shoulder injury or by overuse from repetitive activities such as golf, baseball, or softball.

Specific causes include:

• A sudden tug on the arm
• A direct hit to the shoulder
• Falling on a hyperextended arm
• A forceful blow to the shoulder while reaching overhead

Shoulder labral tear or strain symptoms

The most common symptom of a shoulder labral tears or strains is pain. Typically, the tear or strain will cause discomfort during daily activities or while you are trying to sleep.

Other common symptoms of shoulder labral tears and strains include:

• Loss of strength or motion
• Grinding, popping, catching, or locking in the shoulder area

Shoulder labral tear or strain complications

If diagnosis and treatment are delayed, a shoulder labral tear or strain can increase friction in the joint and enhance the progression of osteoarthritis. Complications that can occur include:

• Chronic shoulder instability and pain
• Weakness in the shoulder joint
• Reduced movement in the joint

Shoulder labral tear or strain risk factors

If you have had a recent shoulder injury or play in a sport that requires overhead activities, like swimming, softball, and baseball, you are more likely to develop a shoulder labral tear or strain.

Also, people over 40 have a higher likelihood of developing a shoulder labral tear or strain as the tendons and ligaments age.

Shoulder labral tear or strain prevention

Since most cases of shoulder labral tears are caused by trauma or overusing the shoulder, the most effective way to prevent a shoulder labral tear or strain is to reduce the stress and strain on the shoulders by modifying activities.

Other ways to reduce the risk of shoulder labral tears or strains include:

• Warming-up and stretching the shoulder before any activities
• Using a proper form in sporting events

Shoulder labral tear or strain diagnosis

Your doctor will be able to perform a physical examination to determine your diagnosis. During the exam, your doctor will evaluate the range of motion in your shoulder.

Your doctor will also review your medical history to determine when your symptoms began and potential activities that might have caused the tear or strain.

To confirm your diagnosis, your doctor may order an X-ray, MRI, or arthroscopic surgery.

Shoulder labral tear or strain treatment

Often shoulder labral tears or strains can be treated nonsurgically through ice, rest, and anti-inflammatory medications.

Other nonsurgical treatments for a shoulder labral tear or strain include:

• Physical therapy
• Cortisone injections

If the shoulder labral tear requires surgery, arthroscopic surgery may be a treatment option. During arthroscopic surgery, the damaged section of the labrum is removed.

When should I seek care?

If you are experiencing shoulder pain or other symptoms related to shoulder labral tears or strains, contact your doctor to make an appointment.

Next Steps

Your doctor will develop a customized treatment plan for your case. For mild cases, he or she may recommend you ice and rest your shoulder as well as prescribe nonsteroidal anti-inflammatory medication.

If you are active or participate in sports that require strenuous overhead activity, take precautions such as:

• Warm-up
• Stretch
• Learn proper activity techniques

If your symptoms worsen, call your doctor to schedule a diagnostic appointment.