By ORA Sports Medicine Physician Waqas Hussain, MD
injuries are common in sports, especially in those athletes with high
demands for upper extremity use like pitchers, swimmers, throwers, and
volleyball players. One such problem includes tears to the labrum, which
is a soft tissue cartilage ring that surrounds the socket portion of
the shoulder and helps with stability of the joint, as well as serves as
an anchor to the biceps tendon. One labrum tear in particular called a
SLAP tear, or a Superior Labrum Anterior-Posterior tear, involves the
top of the labrum where the biceps tendon attaches.
can occur through stretching or pulling on the arm, direct loading or
compression of the joint with an accident like a fall, or repetitive
overhead activities such as throwing or shooting. Many times the reasons
for injury can be non-specific in onset, and this is especially true
for those in overhead sports.
Athletes most commonly experience
shoulder pain that can be sharp, aching, and located deep within the
shoulder. The pain can radiate across the joint and the upper arm and
can be worse with lifting or pushing. People with this problem can
notice giving way, clicking and catching, weakness, a decrease in
throwing velocity, and even what throwers call “dead arm syndrome.”
you are having problems, it is important to have a sports medicine
specialist examine you closely to take your shoulder through a series of
specific tests and ranges of motion that can help to diagnose the
It is important to start by checking X-rays, which are
usually normal, to make sure there are no other problems with your
bones. An MRI is the best study to examine for a SLAP tear, and the
accuracy of this exam is improved by placing a contrast dye in your
shoulder before the test.
Once the diagnosis is made, we can often
start with non-operative means to improve your symptoms including
focusing on shoulder flexibility and muscles to stabilize the joint.
Sometimes a cortisone injection in the shoulder joint can assist in
treatment as well.
If this treatment does not help, then there is an
option for a minimally invasive arthroscopic surgery to stabilize the
tear back to the bone through small incisions around the shoulder.
Patients usually go home the same day, wear a sling for six weeks, start
physical therapy immediately, and are able to resume throwing
activities once shoulder range of motion and strength is adequate, which
is usually at around four to six months.
The outcomes for isolated
SLAP tear surgery are generally good where most athletes are able to
return to sports. Athletes who have other ongoing structural issues with
the shoulder and patients of older age tend to not have as good of
outcomes and may be candidates for procedures other than direct repair.
you are having persistent pain in your shoulder, schedule an evaluation
with a sports medicine physician. Athletes are unique and return to
play is based on many factors. Athletes require individualized treatment
and therapy programs tailored to meet their specific needs, to
facilitate their quick, but safe, return to sports.
more about Waqas Hussain, MD, and ORA Orthopedics, visit qcora.com. Like
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