SLAP Lesion (Superior Labral Anterior Posterior)
Written and edited by Aruna Seneviratne, M.D
SLAP lesions are common injuries among athletes and some non-athletes. It can result in a painful shoulder and may cause a significant loss of power with throwing a ball or overhead motions such as a tennis serve or volley.
Biology: Why does it occur?
The labrum is a soft tissue structure that goes around the rim of the shoulder socket (the glenoid) like a rubber O ring. It serves to deepen the socket and provide stability to the shoulder. The long head of the biceps tendon is attached to upper part of the labrum, and if there is traction on it, it can tear the labrum off the bone in the upper part of the socket. If you think about a clockface, the SLAP lesion represents a tear of the labrum from 10 o’clock to 2 o’clock. A second mechanism is repetitive trauma that causes the labrum to tear.
Click to read Dr. Seneviratne’s published research on SLAP lesions.
Common Diagnostic Techniques
Physical Exam: A thorough physical examination is then conducted by your surgeon.
X-Rays: Plain radiographs (X-Rays) are the most important diagnostic study that is performed initially. Several views will be obtained to diagnose the condition.
MRI: Allows the visualization of the damage to the soft tissues about the shoulder.
Older patients can be treated non-operatively with a sling for a few weeks followed by physical therapy. On going pain may warrant surgery.
There are several different ways to treat SLAP lesions, but the most common technique used by Dr. Seneviratne is the arthroscopic method. Arthroscopic SLAP repairs are reserved for patients under the age of 36. Those who are older, are treated with a procedure called biceps tenodesis, where the long head of the biceps is released from the labrum and transferred to the upper part of the humerus via a small incision. Thus, the operation that is chosen to treat the problem at hand is personalized to each patient.
The postoperative course
- Can I drive?
Usually in 6 weeks, but as early as 3 weeks.
- Can I return to work?
About 1-2 days depending on your occupation, but a week off is recommended.
- Can I shower?
Yes – in 48 hours.
- Can I resume sexual activity?
Yes – within a day or two.
- Can I fly in an airplane?In about 1 week – you must arrange for an aisle seat, have your bags handled by someone else, and you MUST do ankle pumps every 15minutes, as DVT is a major concern. You must also take Aspirin to prevent DVT.