Shoulder Injuries and SLAP Lesion Labral Tears

The SLAP lesion is a shoulder injury that is short for Superior Labral Anterior Posterior. It is an injury to the cartilaginous labrum in the shoulder joint, which is a structure that provides enhanced stability to the joint. It helps the shoulder to have its incredible range of motion that it enjoys. Without the labrum intact, the patient’s shoulder would be significantly unstable analogous to a golf ball on a tee. It has minimal coverage! In conjunction with muscles of the rotator cuff, stability is provided by the labrum which allows the shoulder to maintain an immense range of motion. If the injury happens to the labrum, it involves detachment of the top part (superior) labrum along with part of the biceps tendon. A lot of people don’t realize that part of the biceps tendon originates right off of the shoulder capsule. These injuries typically occur in overhead throwing athletes because of the exceptional motion extremes seen in these repetitive activities. There are several proposed theories of how these injuries happen, but what is known for certain is that the greatest strain on the superior labrum occurs during the late cocking phase of throwing. When it comes to the biceps tendon, the largest stress occurs during the throwing deceleration phase once the ball is released secondary to the large forces seen. Unfortunately, making the diagnosis of a SLAP tear may be tough due to the individual having non-specific pain. Throwing athletes will typically tell their Phoenix orthopedic surgeon that they have deep seated shoulder pain during throwing and the pitching velocity may be reduced. There are several physical examination tests used by Scottsdale orthopedic surgeons to test for SLAP lesions. The most accurate method of diagnosing a SLAP lesion is arthroscopy, which is obviously not the primary step. MRI may show the tear, and it may necessitate contrast material with the MRI to see the tear best. The initial treatment prescribed by Arizona orthopedic surgeons focuses on Phoenix physical therapy and rest. The physical therapy should consist of muscle strengthening around the shoulder, referred to as the dynamic stabilizers. If this treatment is failing and a SLAP tear is highly suspected, an arthroscopic surgery is in order. There are 4 different variants of SLAP tears, which involve labral tears/fraying along with either a stable biceps tendon or biceps tendon tearing. If the labrum and biceps are completely unattached, they can be surgically reattached with suture anchors. After an operation, physical therapy involves restoring range of motion but allowing 6-8 wks for healing of the tissues while avoidaning extreme rotational movements. At the three to four month point, sport specific training can be started but not throwing just yet. Progression of throwing is avoided until the five to six month post-operative time frame, at which point it can be started. The results of SLAP repair with an arthroscopic shoulder surgery has shown good to excellent results in 85-90% of cases. After the shoulder surgery, three fourths of individuals are able to return to their pre-tear level of competitive sports. FXRX is the premier practice of orthopedic surgeons Phoenix AZ in the state and also has Arizona Orthopedic Surgeons. FXRX has Sumit Dewanjee, MD, Board Certified, Fellowship Trained Sports Medicine surgeon specializing in the treatment of shoulder, knee, and hip disorders. FXRX also specializes in treating fractures along with orthopedic bracing, treating each patient like family! Call (480) 449-3979 to make your appointment TODAY!

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