A superior labrum anterior and posterior (SLAP) tear is an injury to the "cuff" of cartilage, called the labrum, in the shoulder joint. The injury is very common, especially among throwers and active athletes. Injuries either occur from repetitive activity such as throwing or serving in tennis, or from a fall onto the shoulder. Labral injuries are commonly seen along with shoulder separations as well.

Patients with labral tears often complain of pain with overhead shoulder movement, pain with lifting heavy objects and inability to perform well in sports.

Symptoms include pain deep within the shoulder or in the back of the shoulder joint. Some patients may feel pain in the front of the shoulder if the biceps tendon also is injuried.

The diagnosis of labral tears is made by the patient's medical history and physical exam. An MRI is often performed to confirm the diagnosis, and can be helpful in determining the type of cartilage injury. The MRI is usually performed with a small amount of dye placed into the joint (arthrogram).

The initial treatment of SLAP tears is usually with rest, ice and gradual resumption of activities with the assistance of physical therapy. Many people with SLAP tears get better with a period of rest and rehabilitation.

In those people who continue to have pain that limits their ability to do sports or interferes with daily activities, then surgery can be recommended.

Repair of SLAP tears is performed arthroscopically, and is performed on an outpatient basis. After surgery, the shoulder is placed in an immobilizer for about four weeks to allow the repair to heal. Physical therapy is started at this time, and return to sports takes approximately four to six months.

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