LABRAL/SLAP TEARS

The labrum is a triangular soft tissue structure that surrounds the socket (glenoid) of the shoulder, acting like a bumper. The labrum deepens the shoulder socket, which provides additional stability to the shoulder joint. The long head of the biceps inserts adjacent to the labrum on the top of the glenoid. The labrum is usually damaged following an injury or trauma to the shoulder joint. Superior labral tears (SLAP tears) are most common in competitive throwing and overhead athletes, such as pitchers and volleyball players. However SLAP tears can also occur in patients who overload the biceps/labrum complex with work (e.g. a lifting injury) and in recreational athletes. Labral tears on the front of the glenoid (anterior labral tears or “Bankart” tears) occur most commonly during a shoulder dislocation.

Symptoms

• A sense that the shoulder may dislocate
• Weakness/pain with throwing
• Pain with rotating the shoulder or lifting

Diagnosis And Treatment

Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination and x-rays to make the diagnosis. Dr. Welch usually orders an MRI if he is concerned about a labral tear. Patients who sustain superior labral tears (SLAP tears) often recover with a targeted physical therapy program. Other non-surgical options include guided injections (such as a steroid injection) and activity modification. In those patients who do not recover with physical therapy, Dr. Welch may recommend surgical intervention. Surgery involves either repair of the torn labrum or release of the biceps insertion on the labrum and re-insertion of the biceps into the humerus bone (biceps tenodesis). High-level athletes typically require surgical repair of a SLAP tear in order to return to competitive play.

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