In short: A SLAP tear is an injury to the ring of cartilage (the labrum) that surrounds the shoulder socket, and it often causes pain, clicking, and reduced strength, especially with overhead movement. A SLAP tear affects the upper portion of the labrum where the biceps tendon attaches. This area helps keep the shoulder stable during lifting, reaching, and rotation, so even a small injury can interrupt day-to-day activities. Many people notice pain when reaching overhead, rotating the arm, or performing sports that rely on quick, repeated shoulder motion. Early evaluation helps determine whether the tear can improve with rest and therapy or if more targeted treatment is needed. TSAOG’s shoulder and elbow specialists treat all types of labral injuries and offer a wide range of care options, including procedures performed at TSAOG’s accredited surgery centers.
Understanding SLAP Tears
“SLAP” stands for Superior Labrum Anterior to Posterior, which describes the location and direction of the tear. This part of the labrum anchors the biceps tendon and supports the ball-and-socket structure of the shoulder. When it’s damaged, the joint loses some of its stability and smoothness. That’s why many people report catching, popping, or “loose” sensations.
SLAP tears are often categorized into several types, ranging from minor fraying of the labrum to complete detachment of the biceps tendon anchor. Each type affects shoulder stability differently, which can influence the severity of symptoms and the best approach to treatment. Some tears remain relatively stable and cause mild discomfort, while others can progress over time, increasing pain and limiting overhead or rotational movements. Understanding the specific type of tear can help guide treatment decisions and improve outcomes, particularly for athletes or individuals whose work relies heavily on shoulder function.
Common Causes of SLAP Tears
SLAP tears can occur from a single traumatic event or gradually from repetitive movement over time. One frequent cause is repetitive overhead motion. Athletes who play baseball, tennis, volleyball, or swimmers and weightlifters often place ongoing stress on the top of the labrum. Over months or years, this repeated strain can weaken the tissue and eventually lead to a tear.
Falls and impact injuries are another common source. Landing on an outstretched hand, taking a hard hit, or experiencing a sudden pull on the arm can generate enough force to detach the labrum from the shoulder socket. Similarly, sudden lifting or jerking motions, such as trying to hoist a heavy object quickly or catching something unexpectedly, can place intense stress on the biceps anchor and surrounding labrum.
Age-related changes also play a role. As people get older, the labrum naturally becomes thinner and more fragile, which can make even ordinary activities enough to create small tears that gradually worsen. Work-related strain can contribute as well. Jobs that involve frequent overhead activity or heavy lifting increase the risk of labral injury over time.
Regardless of the cause, the outcome is often the same: pain, instability, and difficulty using the shoulder at full strength, which can impact both daily activities and athletic performance.
Signs and Symptoms of a SLAP Tear
SLAP tear symptoms can vary, but certain patterns appear frequently. Many people describe a deep, hard-to-pinpoint ache at the top or front of the shoulder that becomes more noticeable with overhead movement. Some experience clicking or popping during daily tasks, especially when raising the arm, reaching behind the body, or rotating the shoulder. Others notice weakness, a sense that the joint might “give out,” or a gradual decline in strength and endurance during sports or exercise.
These changes often stand out most during activities that rely on forceful or repeated shoulder motion. Athletes, in particular, may notice a drop in power or precision when throwing, swimming, or swinging.
Because these symptoms are similar to those seen in rotator cuff or biceps tendon injuries, a medical evaluation is the most reliable way to determine whether the underlying issue is a SLAP tear or another type of shoulder problem.
Diagnosis and Evaluation
Accurate diagnosis begins with a detailed medical history and physical exam. During the exam, a specialist checks shoulder strength, range of motion, and joint stability. Certain movement tests help determine whether the pain stems from the labrum, the biceps tendon, the rotator cuff, or a combination.
Imaging studies can provide further clarity. X-rays rule out bone problems, while MRI or MRI arthrograms offer a clearer view of the labrum itself. In some cases, the full extent of the tear becomes most apparent during arthroscopy, a minimally invasive procedure where a camera is inserted into the joint. Early diagnosis allows you to start treatment sooner, which often leads to a smoother and quicker recovery.
Some SLAP tears can improve without surgery, particularly mild fraying or small, stable tears. Rest, activity modification, and structured physical therapy help strengthen the muscles surrounding the shoulder, which improves stability and reduces pain. However, deeper or unstable tears often do not heal completely on their own because the top of the labrum has limited blood supply. If your symptoms interfere with daily activities, continue for several months despite conservative care, or prevent you from performing your sport or job safely, more specialized treatment may be recommended. Once a SLAP tear has been diagnosed and conservative measures alone aren’t enough, several treatment approaches can help relieve pain, restore function, and support recovery.
Physical Therapy
Therapy focuses on strengthening the rotator cuff and stabilizing muscles, improving shoulder mechanics, and reducing strain on the labrum. Many people see significant improvement with consistent therapy.
Activity Modification and Rest
Avoiding painful overhead activities or high-force movements gives the shoulder time to recover. Adjusting athletic training or work routines may help reduce irritation.
Anti-Inflammatory Medication
Short-term use of anti-inflammatory medication can reduce pain and swelling during the early phase of recovery.
Injections
In some cases, injections may help calm irritation in the joint and provide relief that allows you to progress with physical therapy.
Arthroscopic Surgery
For persistent symptoms or more advanced tears, minimally invasive surgery may be recommended. Options include repairing the torn labrum with sutures or performing a biceps tenodesis, which repositions the biceps tendon to relieve tension at the labrum. These procedures are typically performed in outpatient settings like TSAOG’s surgery centers, where patients receive efficient, specialized care.
Recovery and Rehabilitation
Recovery and rehabilitation is not just about returning to activity but also maintaining long-term shoulder health. Continuing exercises and good movement habits after rehab can help prevent reinjury and support lasting mobility. Following the rehabilitation plan carefully, listening to your body, and gradually increasing activity intensity are all key components of successful recovery. Many patients find that a consistent routine of strength, flexibility, and stability work helps maintain optimal shoulder function and reduces the likelihood of future labral or tendon injuries.
Surgical recovery takes longer but is highly structured. Early stages focus on protecting the repair, followed by gradual strengthening and range-of-motion work. Full return to overhead sports or demanding activities may take several months, but most patients regain strong, reliable shoulder function with proper rehabilitation. Regular communication with your physical therapist and orthopedic specialist ensures each phase of recovery progresses safely.
You should consider seeing an orthopedic specialist if shoulder pain lasts more than a few weeks or if you notice clicking, catching, or a sense of instability in the joint. Difficulty performing overhead movements, weakness that limits daily activities, or a decline in athletic performance are also signs that professional evaluation may be needed. Additionally, any sudden shoulder injury that causes pain or discomfort warrants a specialist’s assessment. An orthopedic expert can determine whether your symptoms indicate a SLAP tear or another shoulder condition and guide you toward the treatment plan most likely to restore strength, stability, and comfort.
SLAP Tear FAQs
Is a SLAP tear worse than a rotator cuff tear? – They are different injuries, and one is not automatically worse than the other. A SLAP tear affects the labrum, while a rotator cuff tear involves the shoulder’s muscles and tendons. Severity depends on the specific injury and how much it limits movement and function.
What does a SLAP tear feel like? – Many people report deep pain, clicking, or catching in the shoulder, especially with rotation or overhead activity.
What happens if you leave a SLAP tear untreated? – Some mild tears improve with rest and therapy, but others can lead to ongoing pain, instability, or decreased strength if not addressed.
Is SLAP tear surgery worth it? – Surgery can be very effective for people whose symptoms persist despite conservative care, especially athletes or individuals who rely heavily on overhead motion.
Can you worsen a SLAP tear? – Yes. Repetitive overhead activity, heavy lifting, or sudden forceful movement can increase the severity of the tear.
If shoulder pain is limiting your daily routine or making overhead movement difficult, help is close by. TSAOG’s specialists offer thorough evaluations, clear guidance, and personalized care plans designed to support long-term shoulder health. Whether you need focused therapy, advanced imaging, or surgical expertise, a visit with a TSAOG provider can help you understand your options and move toward comfortable, confident shoulder function again.
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