SLAP Repair

A SLAP lesion is a tear of the labrum at the top edge of the shoulder socket, running from front to back (Superior Labrum Anterior Posterior). This area is also where the tendon of the long head of the biceps attaches to the shoulder, so SLAP tears can affect both shoulder stability and the biceps tendon.

How does it happen?

• Sports that use the arm repeatedly overhead, such as volleyball, handball, tennis, swimming and baseball
• Falling onto an outstretched arm
• Suddenly lifting a heavy load or having the arm pulled
• Shoulder dislocations
• Age-related wear

Symptoms

• Deep, poorly localised shoulder pain
• Pain that increases with the arm overhead or when throwing
• A catching, locking or clicking feeling
• Loss of throwing speed and power
• Weakness and a sense of instability

Diagnosis

SLAP lesions can be difficult to recognise on examination, and several specific tests are assessed together. MR arthrography is the most useful imaging test. The exact diagnosis and type of tear are often confirmed during arthroscopy.

Treatment options

Non-surgical treatment

Physiotherapy is the first choice, especially in older patients and in wear-related lesions. Exercises that stretch the back of the shoulder capsule and strengthen the shoulder blade and rotator cuff muscles can relieve much of the pain.

Arthroscopic SLAP repair

In young, active throwing athletes whose symptoms continue despite non-surgical treatment, the torn labrum is reattached to the rim of the socket with small anchors.

Biceps tenodesis

Especially in patients over about 35-40, or when the biceps tendon is also damaged, the tendon’s attachment inside the joint can be released and reattached to the upper arm bone. In some patient groups this gives a more predictable result than repair.

Recovery

After surgery the arm is kept in a sling for a few weeks, and movements that strain the biceps are avoided for a while. Range-of-motion exercises are progressed gradually, with strengthening and a throwing programme in the following months. A full return to throwing sports usually takes several months.

Prevention in throwing athletes

Tightness of the back of the shoulder capsule and weak shoulder blade muscles can increase the risk of SLAP injury. Regular stretching, rotator cuff and shoulder blade strengthening and controlling throwing volume help protect the shoulder.

The day of surgery

The operation is usually completed within a few hours and most patients go home the same day or the next. Because of the nerve block, the arm may feel numb for the first hours; this wears off on its own.

Frequently asked questions

Does a SLAP tear heal on its own?

Because the labrum has a limited blood supply, the tear usually does not heal on its own. Pain and function can improve with physiotherapy in many patients.

Is repair or tenodesis better?

The choice depends on age, activity level, the type of tear and the condition of the biceps tendon. Both have their place.

When can athletes return?

Returning to throwing sports is possible after a staged programme once the shoulder is strong enough, usually within a few months.

Can a SLAP tear cause dislocation?

Some SLAP tears can cause a feeling of instability and may occur together with dislocations. Associated lesions are looked for during assessment.

Will my shoulder stay stiff after SLAP surgery?

Shoulder movement may be limited in the first weeks. With regular physiotherapy, range of motion returns gradually in most patients. If stiffness lasts, additional exercises and check-ups are planned.

The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.