Shoulder SLAP Lesion
What is a Shoulder SLAP Lesion?
A shoulder SLAP lesion is an injury in the shoulder that is characterized by a tear of the labrum and long head of the biceps tendon insertion (see image below). SLAP stands for "Superior Labrum from Anterior to Posterior", which signifies the location of the labrum injury at the top of the shoulder joint and the direction of the tear running from front to back that is typical for this type of injury. These injuries are common in athletes, particularly with overhead motions such as baseball, tennis, and volleyball.
What Are the Signs of a Shoulder SLAP Lesion?
Pain is the most common symptom and is often a vague discomfort deep within the shoulder that is aggravated with overhead activity, throwing, lifting, or holding the arm out in front of the body. Occasionally, with larger tears, mechanical symptoms of popping or clicking with shoulder motion are noted.
What Causes a Shoulder SLAP Lesion?
A shoulder SLAP lesion typically occurs in overhead athletes such as baseball pitchers, volleyball and tennis players. But a SLAP tear can happen with work related injuries, falls, or overuse conditions as well. A sudden forceful exertion of the shoulder can cause the biceps tendon to detach the labrum from where it attaches to the shoulder, or repetitive small injuries can lead to an overuse type of injury with gradual onset of pain over time. Depending on the severity of the injury the SLAP lesion can either be a partial injury with fraying of the labrum attachment, or a complete tear with a displaced labrum. An MRI is often required to diagnose and determine the severity of the SLAP lesion. Usually this would be an MRI with arthrogram, when contrast is injected into the joint to aid visualization.
What are the Treatment Options for a SLAP Lesion?
Many SLAP lesions respond favorably to nonsurgical treatment with anti-inflammatory medication, corticosteroid injection, and a therapy program. Nonsurgical treatment is typically the first line of treatment. It can take several months for symptoms to resolve however. Occasionally, surgery is required to address the SLAP lesion in cases that fail to respond to nonsurgical treatment, especially for more severe tears.
What is Shoulder SLAP Lesion Surgery?
The particular surgical procedure depends on the type of tear, the physiologic age of the patient, and the activity level of the patient. Some SLAP injuries are amenable to arthroscopic repair by reattaching the labrum to the glenoid with suture anchors. In certain situations however, a biceps tendon procedure can have superior results to a labrum repair. For example, a biceps tenodesis involves detaching the biceps tendon from the labrum and reinserting the biceps further down on the humerus outside of the shoulder joint. Regardless of the type of surgery performed, a period of shoulder immobilization with a sling is required followed by a rehabilitation program with gradual return to work/sport.
Repair Your Shoulder SLAP Tear and Regain Your Function
A SLAP lesion can hinder your athletic performance as well as your daily activities. At Raleigh Hand to Shoulder Center, our specialized approach addresses SLAP lesions with precision and care. Call our office to schedule an appointment or book a visit with us online today!
Updated 6/22/2025
