An injury that affects both skilled athletes and the accident-prone alike, a SLAP tear is a specific type of shoulder injury.  SLAP (Superior Labrum Anterior to Posterior) refers to the part of the labrum that is damaged, or torn.  The labrum is a ring of firm tissue surrounding your shoulder socket that helps to keep your shoulder stable and in place.  In  plain English:  the “top part of the labrum, from front to back” where the biceps tendon attaches to the shoulder socket.  In essence, the labrum keeps the arm bone connected to the shoulder bone.  People with SLAP tears often have other shoulder injuries as well, such as a torn rotator cuff.

Although SLAP tears are relatively uncommon, certain types of people commonly present with pain from SLAP tears.  Baseball or volleyball players complain of pain from SLAP tears.  The repetitive overhead throwing motion common to both sports can result in trauma and tearing.  SLAP tears also occur from a traction injury to the arm, such as lifting a heavy object off of the ground too quickly. Or, for the clumsy among us, a slip and fall onto an outstretched arm, or falling on a shoulder may cause a SLAP tear.  Even bracing oneself, with arms outstretched, in a car accident can fray, or tear, the labrum.

There are also types of SLAP tears that are specific to the area involved and severity of the tear.  Basic types are Type I-IV.
Type I –     fraying/degeneration of labrum edge
Type II –   defect (fray/degeneration) into the labrum; commonest type; requires surgical repair

Type III –   bucket handle tear; uncommon; requires surgical repair
Type IV –    bucket handle tear AND biceps tendon tear; uncommon; requires surgical repair

Symptoms of a SLAP Tear

  • Painful popping, clicking, or “catching” in the shoulder
  • Pain when attempting to extend the arm overhead or reach behind the back
  • Pain when throwing a ball
  • An aching pain felt deep in the shoulder

Diagnosis of a SLAP Tear

Typically, doctors do not see SLAP tears with great frequency, making diagnosis difficult. Many other potential sources for shoulder pain, such as arthritis, tendonitis, or rotator cuff disorders, show up more often, causing the physicians to overlook a possible SLAP injury when diagnosing the injury.

If you suspect that you, or a client, may have suffered a SLAP tear, don’t panic.  Consult a physician and find an orthopedic specialist to ascertain a proper diagnosis. Orthopedic specialists know to look for SLAP tears as well as other sources for the pain. They have more experience interpreting x-rays and MRI images than the typical primary care physician.

Patient outlook varies with the severity of the tear and treatment ranges from physical therapy and medication to surgery.  Recovery success correlates directly with the diligence he or she puts into rehabilitation.  If patients treat the injured shoulder with care and follow all physician and physical therapist instructions properly, they should recover fully within a few months. Once recovered, they should feel comfortable participating in their favorite activities and work just as rigorously as they did prior to the injury.

Photo credit: Image courtesy of