Symptoms of Labral and SLAP Tears
The primary symptom of a shoulder labral tear is pain in the area of the injury—most commonly—at the back on top of the shoulder or deep inside the shoulder. The pain usually is intense and may be associated with mechanical symptoms such as clicking or catching. Shoulder stiffness can also be a sign of or associated with a labral tear. In throwers, there is a specific type of tightness of the posterior capsule called GIRD (glenohumeral internal rotation deficit) that may also need treatment. Labral tears involving the bicep tendon anchor (SLAP tears) can make using the biceps painful such that even performing small activities such as using a screwdriver can be painful or difficult.
Treatment of Shoulder Labral
and SLAP Tears
Much can be done to help individuals who suffer from labral or SLAP tears, and the first approach usually consists of icing, physical therapy exercises, anti-inflammatory medications and rest. Some shoulder labral tears can become asymptomatic (painless) and therefore may not need further treatment.
If the conservative approach to managing these tears is not effective, surgery may be required to repair or remove the torn part of the labrum. These are almost exclusively treated with arthroscopic surgery. Arthroscopic shoulder surgery is the standard treatment for most labral injuries, even those associated with instability, GIRD, rotator cuff tears, or biceps problems. The majority of these can be treated with simple debridement (removal of abnormal, damaged, or excess tissue) although sometimes detachment and repair of the biceps tendon (biceps tenodesis) is the preferred method of treatment. Dr Millett has performed several thousand of these procedures.
SLAP Repair Video
In certain painful and unstable SLAP tears, in which the bicep anchor is detached, the labrum will need to be repaired (labral or SLAP repair). This requires meticulous surgery so as not to create too much stiffness in the shoulder. Sutures and anchors are used to firmly re-attach the labrum to the bone of the glenoid. Rehabilitation after surgery is critical and most people can resume full activities by 3 months, although overhead sports may take a bit longer.
For additional resources on labral and SLAP tears, please contact the orthopedic office of Dr. Peter Millett.