Biceps tendon disorders: SLAP (Superior Labrum Anterior Posterior) tears

Biceps tendon disorders: SLAP (Superior Labrum Anterior Posterior) tears

If you are unable to perform everyday movements such as taking the milk out of the fridge or lifting a water bottle without pain, you may have a SLAP lesion. If you can’t throw a stone or you can’t serve playing tennis you might have a SLAP lesion. This is a rupture or tear of the glenoid labrum in the glenoid cavity.

Our experts at Schoen Clinic specialise in treating SLAP lesions. They will find the cause and the right therapy for you.

What do we understand by a SLAP tear?

The glenoid cavity is surrounded by a fibrocartilaginous tissue (glenoid labrum). SLAP is an abbreviation and stands for a Superior (topmost) Labral tear from Anterior (front) to Posterior (back). In simple terms, this is a tear or rupture at the upper edge of the joint socket. The long tendon of the biceps muscle is attached to the upper edge of the glenoid labrum. The area of the upper glenoid labrum and the attachment of the long head of the biceps tendon is called the labrum-biceps tendon complex. Damage and tears in this complex are called a SLAP lesion (labral tear).

A SLAP lesion occurs when the upper labrum (superior labrum) is torn at or near its attachment with the biceps.

How we diagnose a SLAP tear

The diagnosis is made from the history and findings at an initial consultation. The patient can present with pain or mechanical symptoms in the joint. If associated with an anterior labral tear, they may present with a history of shoulder instability or dislocations. In addition, special imaging such as an MR-Arthrogram help in confirming the diagnosis however, in the absence of findings on examination or MR, a diagnostic arthroscopy may sometimes be performed.

Symptoms indicating a SLAP lesion

Patients with a labral tear typically have little pain at rest and during simple everyday activities however, movements of the shoulder over the head are very painful. Rotating the arm behind the back e.g. when reaching for a car seatbelt, can also lead to pain. Some patients complain about a loss of strength in the shoulder, athletes lose speed when throwing and some patients feel movements accompanied by a “cracking” sound.

Causes of a SLAP lesion

  • A SLAP lesion can occur due to a chronic overload
  • A SLAP lesion can occur due to accidental injury, traction or fall on an outstretched arm