It's definitely more than the name might convey -- for me it was a major S-L-A-P !
If you're one of the many who have experienced a SLAP Tear, then you know that it can be quite painful. Speaking from personal experience, I've had a SLAP Tear in which the glenoid labrum of my left shoulder was torn along with a total detachment of the bicep muscle from the shoulder bone.
Having 2 separate shoulder surgeries to repair my injury, presented me with many challenges over the past several years. The first repair surgery lasted over 3-1/2 hours ... much longer than my surgeon expected! Have you also experienced a SLAP Tear and had surgery? I'd love to hear from you! Please leave me a comment in my guestbook.
PS Thanks to Google for including my pictures post-surgery on the first page of the image search.
Quick, cast your vote about the SLAP Tear!
Have you experienced a SLAP Tear?
After my second SLAP surgery : surgeon's marks!
"I had 3 titanium anchors to reattach my biceps tendon to the bone along with the labral repair."
After my second SLAP surgery : lots of bruising!!
The Surgical Procedure ...
Glenoid & labrum roughened to increase contact surface area and promote regrowth.
Locations for bone anchors are selected based on number and severity of tear. Bad tears involving SLAP and Bankart lesions may require 7 anchors. Simple tears may only require 1.
Glenoid is drilled for the anchor implantation.
Anchors are inserted in the glenoid.
The suture component of the implant is tied through the labrum and knotted so the labrum is in tight contact with the glenoid surface.
Had a SLAP Tear, let me know ...
I'd love to hear about your experiences as mine seemed to drag on for a few too many years. Had surgery or therapy? What worked for you ... or didn't?
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Reply
- AndyPo AndyPo Dec 9, 2009 @ 5:04 am
- Very interesting. Sounds painful.
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Reply
- brottiers@hotmail.com brottiers@hotmail.com Oct 8, 2009 @ 5:19 pm
- I had surgery a year ago to repair a slap lesion. Things were going well six months after surgery. That's when two dogs tried to bite me and I picked up 3 rocks and threw them at the dogs,After thr third rock my shoulder exploded and sent pings of pain down my arm. I went to my doctor who sent me through two bouts of pt, then went for regular erays, then finally to the surgeon who ordered an mri. the mri showed a torn rotator cuff. As the surgeon went in for sugery he saw not a rotator cuff problem but, i had torn out the sutures from the previous surgery. he repaired the sutures and reattached my bicep and i am now 2 weeks post op. This time i am taking my time, not lifting a thing and being very carefull. I never want to go through that again.
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What's SLAP?
It stands for Superior Labrum from Anterior to Posterior!
So, what is a SLAP Tear anyway?
Believe me, you'll know it ...
The shoulder joint is considered a 'ball and socket' joint. However, in bony terms the 'socket' (the glenoid fossa of the scapula) is quite small, covering at most only a third of the 'ball' (the head of the humerus). The socket is somewhat deepened by a circumferential rim of fibrocartilage which is called the glenoidal labrum.
Previously there was some argument as to the structure (it is fibrocartilaginous as opposed to the hyaline cartilage found in the remainder of the glenoid fossa) and function (whilst it has previously been considered a redundant evolutionary remnant, it is now considered an integral structure in the shoulder's stability).
Currently most authorities agree that the tendon of the long head of the biceps brachii muscle proximally becomes fibrocartilaginous prior to attaching to the superior aspect of the glenoid, and in a similar arrangement the long head of the triceps brachii inserts inferiorly. Together these cartilaginous extensions of the tendon are termed the 'glenoid labrum'.
A SLAP (Superior Labrum from Anterior to Posterior) tear or lesion occurs when there is damage to the superior or uppermost area of the labrum. SLAP lesions have come into public awareness with their increasing frequency in overhead and particularly throwing athletes. The increased frequency relates to the relatively recent description of labral injuries in throwing athletes [2] and the initial definitions of the 4 SLAP sub-types [3] all happening in the last 20 years or so. The identification and treatment of these injuries continues to evolve today, however it is safe to say that a baseball pitcher suffering a 'dead arm' caused by a SLAP lesion today is far more likely to recover such that he can return to the game at its highest level than was the case 20 or 30 years ago.
A SLAP tear or SLAP lesion is an injury to the Glenoid labrum (fibrocartilaginous rim attached around the margin of the glenoid cavity). SLAP is an initialism that stands for "superior labral tear from anterior to posterior".
More about the Glenoid labrum
:For the hip joint, see the Acetabular labrum, also known as the "glenoidal labrum of the hip joint" in older texts.
The glenoidal labrum (glenoid ligament) is a fibrocartilaginous rim attached around the margin of the glenoid cavity in the shoulder blade. The shoulder joint is considered a 'ball and socket' joint. However, in bony terms the 'socket' (the glenoid fossa of the scapula) is quite shallow and small, covering at most only a third of the 'ball' (the head of the humerus). The socket is deepened by the glenoidal labrum.
The labrum is triangular in section, the base is fixed to the circumference of the cavity, while the free edge is thin and sharp.
It is continuous above with the tendon of the long head of the Biceps brachii, which gives off two fasciculi to blend with the fibrous tissue of the labrum.
It deepens the articular cavity, and protects the edges of the bone.
The buzz on SLAP Tears
- Shoulder damage accounts for 24% of sports injuries
- Pune: Slap tear and shoulder dislocation are emerging as prominent injuries among sportspersons. Whi...
- I Was Diagnosed With A S.l.a.p. Tear In My Rotator Cuff. I Am ...
- I Was Diagnosed With A S.l.a.p. Tear In My Rotator Cuff. I Am Faced With 2 Options, Surgery Or Physi...
- DoJoNa: Surgery Details & Recovery OR SLAP Tear Fixed!
- Surgery Details & Recovery OR SLAP Tear Fixed! Oct 6 at 10a I had surgery to repair the torn car...
- SLAP tear – examination by Dr Mark Hutchinson | Dr Penna
- This video from youtube by Dr Mark Hutchinson showing how to examine for SLAP tear. This video shows...
Sub-types of SLAP Tears ...
At least ten types of this injury are recognized with varying degrees of damage seven of which are listed here:
1. Degenerative fraying of the superior portion of the labrum, with the labrum remaining firmly attached to the glenoid rim
2. Separation of the superior portion of the glenoid labrum and tendon of the biceps brachii muscle from the glenoid rim
3. Bucket-handle tears of the superior portion of the labrum without involvement of the biceps brachii (long head) attachment
4. Bucket-handle tears of the superior portion of the labrum extending into the biceps tendon
5. Anteroinferior Bankart lesion that extends upward to include a separation of the biceps tendon
6. Unstable radial of flap tears associated with separation of the biceps anchor
7. Anterior extension of the SLAP lesion beneath the middle glenohumeral ligament
Symptoms of a SLAP Tear
A dull throbbing ache in the joint.
Difficulty sleeping due to shoulder discomfort.
For an athlete involved in a throwing sport such as baseball, pain and a catching feeling are prevalent.
Any applied force overhead or pushing directly into the shoulder can result in impingement and catching sensations.
Treatment of a SLAP Tear
Very few patients with SLAP lesion injuries return to full capability without surgical intervention.
Very rarely physical therapy can strengthen the supporting muscles in the shoulder joint to the point of reestablishing stability. For all other cases the choice is do nothing or have surgery to reattach the labrum to the glenoid.
While the surgery can be performed as a traditional open procedure, the recommended course of action is an arthroscopic surgery. This type of procedure is vastly less intrusive to the body and reduces chances of infection.
During the procedure the surgeon should check the general health of the shoulder joint. There are at least twenty different items of conditions that he/she should examine or look for. These include:
SLAP lesion - labrum/glenoid separation at the tendon of the biceps muscle.
Bankart lesion - labrum/glenoid separation at the inferior glenohumeral ligament.
Biceps Tendon.
Bone - glenoid, humerus - general surface condition.
Ligaments - check for tears and condition.
Books on shoulder surgery
Surgical Recovery
Trust me, this is hard to predict ...
Stage one - For the first four weeks the arm is typically kept in a sling. There are some surgeons only have the patient in a sling for a week. Patients may find themselves in an immobilizer sling, which adds in a waist support to prevent movement. Needless to say, the first stage of recovery is about not stressing the repair site. This is the initial healing phase of the recovery.
Stage two - Initial physical therapy. The goal here is to increase range of motion. Load bearing through the joint should be avoided to allow the repair to complete.
Stage three - Increased range of motion and initial strength training. At this point, about eight to ten weeks out, the repair should be complete but not ready for full loading yet. Return to day to day activities, but not strenuous activity.
Stage four - completion. At about six months out the repair should be strong enough for a return to full activity.
The timeline will vary according to surgeon preferences and the extent of damage.
More about slap tear surgery
- Shoulder damage accounts for 24% of sports injuries
- For both shoulder dislocation as well as slap tear, surgery has proved to have good results. ?In the modern era and with the advent of arthroscopy - a minimally invasive procedure is used and has proven acceptable to today's patient as ...
- I Was Diagnosed With A S.l.a.p. Tear In My Rotator Cuff. I Am ...
- I Was Diagnosed With A S.l.a.p. Tear In My Rotator Cuff. I Am Faced With 2 Options, Surgery Or Physical Therpy. It is a partial tear. SLAP refers to ?superior labrum anterior and posterior?. The doc says that a combination of physical ...
- DoJoNa: Surgery Details & Recovery OR SLAP Tear Fixed!
- Surgery Details & Recovery OR SLAP Tear Fixed! Oct 6 at 10a I had surgery to repair the torn cartilage in my right shoulder from a fall earlier in the year at work. Here I am being wheeled out of the hospital to the vehicle - obviously ...
- Alot Of Pain 4 Weeks After Shoulder Surgery?
- I had sub acromial decompression, clavicle resection, instability, and slap tear surgery on Nov. 5 07. I am still in alot of pain. I go to therapy 3x week. I also take 3 800mg ibuprofen 3x day. I ice several times a day. ...
P.S. How I am feeling since my SLAP Tear surgeries
A whole different story is my experience with 3 courses of PAIN management!
I've been hearing more and more from people who have also experienced a slap tear and want to know what to expect.
Similar shoulder injuries are more common than one might expect. In addition to my mother, I've now got 4-5 friends who have complained of the same types of shoulder pain common to a slap tear.
What is key to recovery is PT, physical rehabilitation and constant activity and exercise. As I was immobilized for 6 weeks, I had to deal with the buildup of scar tissue that was debrided in my second surgery. IMHO, I am not 'pain free' but am 'aware' that I had shoulder surgery.
Someone asked about activity AFTER surgery. Well, I was in a fully-restricting arm brace and experienced a fair level of pain. However, after 7 work days, I returned to work--one handed mind you--and was driving myself to work probably 2 weeks after surgery. But, I didn't need to shift or work a clutch thankfully.
P.S. Maybe someday I will take the time to talk about my experience with PAIN after being diagnosed with Reflex Sympathetic Disorder RSD after my shoulder surgery. I ended up have 3 courses of Pain Management which was NO fun!
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