Shoulder injuries are quite common, especially among athletes and individuals involved in repetitive overhead activities. One particular condition that can cause long-standing pain and difficulty is the SLAP tear. SLAP stands for Superior Labrum Anterior to Posterior, which refers to a specific type of injury in the shoulder joint affecting the labrum — the ring of cartilage that surrounds the socket.

A SLAP tear can significantly affect mobility, strength, and comfort. Understanding this condition, its causes, symptoms, and treatment can help patients make informed decisions about care.

What Exactly Is a SLAP Tear?

The shoulder is one of the most mobile joints in the body. Its ball-and-socket structure allows a wide range of movement but also makes it vulnerable to injury.

The socket of the shoulder joint is shallow, and the labrum acts like a rim of cartilage that deepens the socket, stabilises the joint, and provides attachment for ligaments and the biceps tendon.

A SLAP tear occurs when the top (superior) part of the labrum is injured, where the biceps tendon attaches. This tear extends from the front (anterior) to the back (posterior) of the socket, weakening joint stability and causing pain.

Common Causes of a SLAP Tear

A SLAP tear may develop due to a sudden trauma or from gradual wear and tear.

Sports and Overhead Activities

• Athletes involved in cricket, tennis, swimming, or weightlifting often experience repetitive overhead movements that strain the labrum.

Traumatic Injuries

• Falls on an outstretched arm or direct shoulder impact can cause acute tears.
• Accidents, especially involving sudden jerks, may damage the labrum.

Age-Related Changes

• With ageing, the labrum becomes weaker and more prone to fraying.

Repetitive Stress

• Jobs or activities that require frequent lifting or overhead motion can increase risk.

Symptoms of a SLAP Tear

The symptoms of a SLAP tear may mimic other shoulder conditions, such as rotator cuff injuries, which is why accurate diagnosis is important.

Typical Symptoms Include:

• Deep shoulder pain during overhead or behind-the-back movements
• A popping, locking, or grinding sensation in the shoulder
• Weakness or reduced shoulder strength
• Difficulty lifting heavy objects or throwing
• Limited range of motion
• Discomfort when lying on the affected shoulder

If left untreated, these symptoms can worsen and interfere with daily life.

Types of SLAP Tears

SLAP tears are classified into four main types, each requiring a specific treatment approach.

Type I

Mild fraying of the labrum without detachment.

Type II

Most common type where the labrum and biceps tendon detach from the socket.

Type III

“Bucket-handle” tear where a flap of the labrum gets trapped inside the joint.

Type IV

Severe tear that extends into the biceps tendon.

Diagnosis of a SLAP Tear

A correct diagnosis requires a thorough evaluation by a specialist.

Clinical Examination

• Tests are performed to assess range of motion, stability, and pain triggers.
• Special manoeuvres such as the O’Brien test may help detect labral tears.

Imaging Tests

• MRI scans, sometimes with contrast dye, provide detailed images of the labrum.
• X-rays may be used to rule out associated bone injuries.

Arthroscopy

In some cases, the doctor may perform a minimally invasive arthroscopy to directly view the shoulder joint. This also allows treatment at the same time if required.

Treatment Options for SLAP Tears

Treatment depends on the type of tear, patient’s age, lifestyle, and activity level.

Non-Surgical Management

• Rest and activity modification: Avoiding strenuous overhead movements.
• Physiotherapy: Exercises to strengthen the rotator cuff and shoulder muscles.
• Anti-inflammatory medications: Reduce pain and swelling.
• Injections: Cortisone injections may provide temporary relief.

Non-surgical treatment is often effective for minor tears or less active patients.

Surgical Treatment

If symptoms persist or the tear is severe, surgery may be advised.

Arthroscopic SLAP Repair

• Performed through small incisions using a camera and instruments.
• The torn labrum is reattached to the socket with sutures or anchors.

Biceps Tenodesis

• In cases where the biceps tendon is also involved, the tendon may be detached and reattached elsewhere to reduce pain.

Debridement

• Involves removing frayed or damaged labral tissue to smooth the joint.

Recovery After SLAP Tear Surgery

Recovery is a structured process and plays a major role in the success of treatment.

Early Phase

• Arm is kept in a sling for a few weeks.
• Pain managed with medications and cold therapy.

Physiotherapy Phase

• Gradual exercises are started to restore mobility.
• Strengthening of shoulder muscles over 2–3 months.

Return to Full Activity

• Normal daily activities: within 2–3 months.
• Sports and overhead activities: typically 4–6 months.

Adhering to the rehabilitation programme is crucial for long-term recovery.

Living With and Beyond a SLAP Tear

With timely treatment, most patients regain full strength and mobility in the shoulder. However, avoiding re-injury is important.

• Warm up properly before sports or heavy activity.
• Maintain shoulder strength with regular exercises.
• Avoid overexerting the shoulder joint.
• Seek medical advice early if pain returns.

Restore Shoulder Health with Dr. Sumit Dubewar

Shoulder injuries like SLAP tears can severely limit activity and independence if left untreated. Modern treatments, including arthroscopic repair techniques, allow faster recovery and excellent long-term outcomes.

Dr. Sumit Dubewar, a highly skilled Arthroscopy & Robotic Joint Replacement Surgeon, specialises in advanced shoulder procedures, including the diagnosis and treatment of SLAP tears. His expertise in minimally invasive arthroscopy ensures precision, quicker recovery, and lasting relief for patients.

Book an appointment with Dr. Sumit Dubewar today and take the first step towards pain-free, stronger shoulder movement.