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  • Writer's pictureJay Kasthuriarachchi

What are SLAP tears and how do we manage them?

Shoulder injuries are common, and among the types of shoulder injuries that an individual may experience, SLAP tears stand out as a challenging and intricate problem. A SLAP tear, short for Superior Labrum Anterior to Posterior tear, affects the labrum in the shoulder joint, potentially causing pain, instability, and limited range of motion. In this blog post, we will delve into SLAP tears and explore how we aim to restore function if you have a SLAP tear in your shoulder.

What is a SLAP tear?

The shoulder joint is a complex structure, and the labrum plays a vital role in stabilizing it. A SLAP tear occurs when the upper part of the labrum is damaged, usually as a result of repetitive overhead motions (such as in overhead sports), trauma (from a shoulder dislocation for example), or degeneration over time. This is also related to the long head of the biceps tendon, as this attaches to this region of the labrum. Individuals with SLAP tears often experience pain, a clicking or catching sensation with overhead movement, and reduced strength in the affected shoulder.

Assessment and Diagnosis:

The journey to recovery begins with an accurate diagnosis. This involves a thorough physical examination, often including specific tests such as the O'Brien's Test and the Speed Test, as well as imaging studies like MRI if necessary to visualize the labrum and surrounding structures. Specialist opinion may also be necessary for SLAP tears that are unstable, or where function is significantly compromised.

Phase 1: Pain Management and Protection:

The initial phase of physiotherapy focuses on managing pain and protecting the injured shoulder. Treatment during this initial phase is often focussed on manual therapy techniques to reduce pain and aid in restoring range of motion, as well as graded range of motion exercises and gentle strengthening exercises to maintain strength in the shoulder. Relative rest and activity modification are essential during this stage to prevent further damage and reduce pain.

Phase 2: Range of Motion and Strengthening:

As pain subsides, the emphasis shifts to restoring the range of motion and strengthening the shoulder muscles. The focus of rehabilitation shifts more towards exercise in this phase, with motor control and graded strengthening exercises becoming the primary part of the program. Strengthening exercises often target the rotator cuff and shoulder blade stabilizers, aiming to enhance shoulder stability. Testing strength and control in this phase acts to dictate what exercises take priority within the program.

Phase 3: Functional Training and Return to Activity:

The final phase of rehabilitation focuses on functional training and preparing the individual to return to their regular activities. This involves sport-specific exercises, proprioceptive training, and a gradual progression towards more complex movements. Return to sport testing also takes place during this phase, to ensure the person is safe to return to their chosen activity.

Prevention Strategies:

To reduce the risk of SLAP tears and similar shoulder injuries, physiotherapists educate individuals on proper shoulder biomechanics, load management strategies, and other risk reduction strategies. This may include specific warm-up exercises, a regular strengthening program, and guidance on proper technique during activities.

Recovering from a SLAP tear requires a comprehensive approach, and physiotherapy plays a pivotal role in guiding individuals through each phase of rehabilitation. From pain management to functional training, physiotherapists tailor their interventions to the unique needs of each patient, aiming not only to facilitate healing of the injury but also to prevent future recurrence. If you suspect a SLAP tear or you have shoulder discomfort or pain, consulting with a physiotherapist early on can make a significant difference in your journey to a pain-free and fully functional shoulder.

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