Understanding SLAP Lesions

Labrum is the ring of cartilage that surrounds the shoulder socket, and helps in keeping the arm bone in the socket. The biceps tendon attaches to the Labrum at its top or the superior part. A SLAP Tear refers to an injury to this superior part of the Labrum. The tear occurs in the anterior as well as posterior of the attachment point.  Overhead and high-contact sport players are at a greater risk of SLAP Lesions.Causes Risk factors associated with SLAP Lesions are as follows:

1. Motor vehicle accident
2. Falling on the shoulder or outstretched arm
3. Lifting heavy objects
4. Rapid or forceful movement of arm above shoulder level
5. Repetitive overhead activities
6. Shoulder Dislocation

Signs and Symptoms The common symptoms of a SLAP Tear may include:

1. Clicking, popping, grinding, or catching sensation in the shoulder
2. Pain while carrying out overhead arm movements
3. Pain while moving the shoulder in specific positions
4. Weakness or Instability in the shoulder
5. Pain while lifting objects
6. Reduced range of motion
7. Decreased shoulder strength

Specialist One should consult an Orthopedic for SLAP Tears. Diagnosis Shoulder Pain can occur for various reasons and hence it is difficult to identify a SLAP Tear. The doctor will undertake the following steps to diagnose the disorder: History: The specialist will analyze information of the patient's symptoms, previous injuries, treatment taken, activities that aggravate shoulder pain, and exact location of the pain. Physical Examination: The doctor will check the strength, stability, and range of motion of the shoulder, by moving the arms in different positions. He may also examine the patient's neck and head to ensure that the pain is not a result of a pinched nerve. Tests: Imaging Tests, such as, X-Rays and MRI (Magnetic Resonance Imaging) provide information on bones and soft-tissues. The doctor may suggest a MRI Arthrogram wherein he injects a dye in the patient's shoulder so that the tear is clearly visible in the MRI. Treatment Modalities Available for Management of the Disorder Initial treatment options for SLAP Tear are mostly non-surgical, and may include the following:

1. Non-steroidal anti-inflammatory drugs to alleviate pain and swelling.
2. Physical therapy to restore movement and flexibility. Exercises suggested by the therapist include stretching the shoulder capsule and strengthening the rotator cuff muscles.

If non-surgical options fail and pain persists, the doctor may resort to Arthroscopy, a minimally invasive surgery, which involves inserting a small camera in the shoulder joint to get a clear picture of the injury. The surgeon uses instruments and makes small incisions to repair the SLAP Tear by removing the torn part of the labrum or re-attaching the torn section with the help of stitches. Post surgery, the surgeon may wrap the patient's arm in a sling to protect the labrum. Known Complications Shoulder Arthroscopy is a safe surgery and does not impose any major complications. However, there are always few potential risks associated with any surgery, such as, Excessive Bleeding, Infection, Shoulder Stiffness, Blood Clots, and Damage to Blood Vessels or Nerves. Precautions Patients suffering from a SLAP Tear should undertake the following precautions:

1. Do not lift heavy-weight objects.
2. Avoid or modify activities which provoke pain to the shoulder.
3. Do not indulge in over-head or contact sports

Dietary and Physical Activity Requirements Patients suffering from a SLAP Tear should not indulge in lifting heavy objects, overhead arm activities, and other repetitive movements, which might create stress and abuse on the injured shoulder. If the doctor recommends wearing a sling, then the patient should not lie down on the operated arm. Instead, the patient should lie on his back or on the opposite side. Prevention of the Disorder from Happening or Recurring One should follow the below-mentioned steps to prevent occurrence or recurrence of a SLAP Tear:

1. Strengthen muscles surrounding the shoulder joint as it helps in maintaining shoulder stability.
2. Before starting a sport, carry out proper warm-up and stretching exercises.
3. Use proper techniques while playing sports, particularly falling techniques.
4. Avoid walking on slippery surface to lessen the risk of a fall.

Support and Help given by the Caregiver A SLAP Tear can induce severe pain while carrying out simple activities, such as, dressing, cooking, and several other daily life tasks. Caregivers should provide ample support and assistance in helping the patient to cope with the changed lifestyle, particularly if the patient has undergone surgery.