What is SLAP Tear and Labral Tear?

The labrum is a rim of cartilage that lines the shoulder socket and makes it deeper, which helps hold the ball of the joint in place.

A SLAP tear affects the top part of this rim, where the biceps tendon attaches. SLAP stands for superior labrum anterior to posterior, meaning a tear at the top that runs from front to back.

These tears come from different causes. Some follow a single event, such as a fall onto an outstretched arm or a hard pull on the arm. Others build up over time from repeated overhead motion, which is why they are seen in throwing athletes and people who work overhead. Wear with age also plays a role.

Signs include a deep ache in the shoulder, a catching, locking, or popping feeling with certain motions, pain when reaching overhead or across the body, and a loss of strength or throwing speed in athletes.

How is SLAP Tear and Labral Tear diagnosed, and what does the visit involve?

A SLAP tear is diagnosed with an exam and imaging.

Dr. McMillan will ask how the pain started and test the shoulder with specific movements that stress the top of the labrum. Because these tears can be hard to see, an MRI with contrast, called an MR arthrogram, in which dye is placed in the joint to outline the cartilage, is often the most useful scan. Plain X-rays are taken to check the bones and rule out other causes. In some cases the tear is confirmed and treated during arthroscopy, when the joint is viewed directly with a small camera.

What can I expect over time?

Many SLAP tears improve gradually with the rest, therapy, and activity changes described above, especially strengthening of the muscles that support the shoulder.

The natural course varies: some shoulders settle with non-surgical care, while others stay painful, particularly in athletes whose sport depends on overhead motion. It helps to check back with Dr. McMillan if catching, pain, or loss of strength continues after a few months, since that is when arthroscopic repair may be considered.