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 last 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.
Quick, cast your vote ...
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?
I had a SLAP repair in 6/2007 and I am still having pain from any sudden movements. Has anyone else had this issue? Certain movements will flare the pain up for days at a time. Driving even seems to irritate my left shoulder.
My SLAP was caused in a motor vehicle accidnent when a suburban ran a stop sign and pulled directly in front of my one ton dually on the snow and ice of January 2007. What a mess this has been and I am starting to feel depressed about the current pain I still have daily in the left arm and shoulder area on top of other injuries in my hip and knee. I braced myself against the steering wheel of my truck and never hit the seatbelt. Amen I was only going about 20 miles per hour when we hit. I am still doing physical therapy daily at my home and check in with my therapist once a month. No matter how much I stretch there are just certain motions that seem to set off the pain in my arm and shoulder. Massage therapy helped greatly, but now the PIP is all used up
Posted July 23, 2008
I'm going 7/25 for my second. The first was 8yrs ago on the right side, this is on the left. Not looking forward to it. I remember the first and swore I'd never do it again. But this is workers comp and need to have it done to contine my career in the fire service.
Posted July 23, 2008
Mine was a rather extreme type 2 slap tear with quite alot of bicep tear damage - i am now the owner of 5 anchors in my shoulder.. I injured it playing football(soccer) and falling on my elbow. I am 7 weeks post op and have to say i am really getting down about the amount of discomfort i am experiencing. The range of movement is getting better but i had expected to be on no pain relief and getting a full nights sleep. I have another 2 weeks before i can be considered fit to fdrive again and anything from 2-4 months before i can resume weight training again. I have had very invasive knee surgery and not had this much pain and frustration. Anyone with this really does have to keep positive and get ready for a long hard recovery road.
Posted July 22, 2008
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Dr_Joe
Very informative. Posted July 01, 2008 |
I had a SLAP tear and arthroscopic surgery. Rehab is tough!! I had surgery simply to continue pitching (I'm 40, And I love the game so much I will do most anything to continue playing). Recovery is longer than expected, though. Perhaps my age inhibits quick recovery, but, for pitchers, it's easily 1 1/2- 2 years to fully recover...lost speed on my fastball (not a lot but it's noticeable to me).
Posted June 23, 2008
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 (Superior Labrum from Anterior to Posterior) tear or lesion is an injury to the Glenoid labrum, a part of the shoulder joint.
More about the Glenoid labrum
:The Acetabular labrum is 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.
It is triangular on section, the base being 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.
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Sub-types of SLAP Tears ...
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 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
SLAP Tear videos
Surgical Recovery
Trust me, this is hard to predict ...
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.
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