Slap Lesion


 

The labrum is a thin ring of tissue that surrounds the rim of the shoulder socket, deepening the socket and increasing the stability of the shoulder joint. At the top of the socket, or ’12 o’clock’ position, the biceps tendon also inserts into the labrum. A SLAP lesion stands for a tear of the superior labrum, from anterior to posterior.

 

Common Causes

A traction injury, such as catching oneself falling, is a common cause. A fall on the outstretched arm, or repetitive activities such as pitching may predispose to this injury.

 

Symptoms

Pain in the shoulder, occasionally radiating down the arm. A sense of catching may be felt, or deep aching that persists.

 

Physical Findings

Difficult to diagnose on physical examination. Must have a high degree of suspicion.

 

Workup

X-rays are rarely helpful. MR scans are frequently inaccurate. A well-placed injection of local anesthetic into the shoulder joint will temporarily relieve symptoms, suggesting the diagnosis.

 

Non-operative Treatment

Anti-inflammatory medication and rest may reduce symptoms.

 

Surgical Treatment

Arthroscopic surgery, with either repair of the torn tissue, or removal of the torn piece, depending on the injury.

 

Injury Comment

This injury is often seen with other shoulder injuries, such as shoulder instability, or a rotator cuff tear.