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SLAP Tear: Is this why my shoulder hurts?

A tear in the upper portion of the labrum where the biceps tendon attaches is known as a SLAP tear. SLAP stands for superior, labral, anterior to, posterior. A SLAP tear can result in shoulder pain, dislocations, and problems using your shoulder. It can be caused by repeated motions in sports or at work, a blow to the shoulder, and heavy lifting. Most SLAP tears happen when the labrum wears down over time. In fact, in people over 40 years old, a labrum tear is considered to be a normal part of aging. The top part of the labrum might also fray.



Will I need surgery for a SLAP tear?

MAXX Physical Therapy has a few orthopedic surgeons in the area who we highly recommend. These doctors will further assess your injury and likely suggest conservative treatments for you SLAP tear, depending on the severity of your injury. But surgery may be the best option in some cases if the injury is too severe or if conservative treatment does not work.


How does physical therapy treat a SLAP tear?

MAXX Physical Therapy can help reduce pain, improve mobility, and restore full use of your arm. The goal of physical therapy is to increase overall range of motion and mobility and strengthen the surrounding muscles in your shoulder. Sometimes physical therapy alone is enough to help your shoulder recover from a SLAP tear. Our team is prepared to set you up on a customized treatment plan so you can return to your daily activities as soon as possible.


What types of exercises and therapies will I need to do for my SLAP tear?

Your physical therapist may suggest a variety of methods to help you control your pain. They will also show you how to do strengthening exercises that will focus on rotator cuff and shoulder blade muscles. Strengthening these muscles will help support your shoulder and keep it more stable when you move your arm. This stability can help prevent future injury.

Some exercises your physical therapist will show you MAY include (please keep in mind these are not always appropriate for every patient and rehab):

  1. Arm bike and/or seated rowing

  2. Prone extension

  3. Forward flexion

  4. Cross-body stretch

  5. Sleeper stretch

  6. Internal and external rotations

The key to these exercises is to increase from low to moderate activity with instruction from your physical therapist. These exercises can also be done before injury for prevention.


Surgery

If you have a severe injury, or if nonsurgical treatments don’t work, you might need surgery.

The most common method is an arthroscopy. During this procedure, a surgeon makes small cuts in your shoulder. They insert a small camera, or an arthroscope, into the joint. The surgeon then uses miniature surgical tools to repair the SLAP tear.

There are many ways to repair a tear. The best technique depends on your injury.

Examples of SLAP repairs include:

  • removing the torn portion of the labrum

  • trimming the tear

  • stitching the tear together

  • cutting out the biceps tendon attachment

Recovery

With proper rehabilitation, you can expect to regain full range of motion after a SLAP tear surgery.

Recovery looks different for each person. It depends on many factors, including your:

  • age

  • type of injury

  • overall health

  • activity level

  • other shoulder problems

In general, here’s what recovery time looks like:

  • 0 to 4 weeks after surgery. You’ll wear a sling to stabilize your shoulder. You will also do gentle stretches with a physical therapist.

  • 5 to 7 weeks after surgery. As your shoulder heals, it might still feel somewhat painful. You may begin strengthening exercises with your physical therapist.

  • 8 to 12 weeks after surgery. You’ll continue doing moves to increase your range of motion and strength. You can also start biceps strengthening exercises.

  • 12 to 16 weeks after surgery. By this time, your range of motion should improve. If you’re an athlete, you can start sport-specific activity.

  • 16 to 20 weeks after surgery. You can slowly increase your physical activity. Many athletes return to their sport after 6 months.

If you work a physically demanding job, you may need to miss work for most of this time. Otherwise, you might be able to return to work within a few weeks.


Final Thoughts

While there are many types of SLAP tears, most can be treated by MAXX Physical Therapy or surgery. The best method depends on your age, overall health, and specific injury. You’ll likely need surgery if your tear is too severe. During the recovery process, be sure to continue physical therapy and follow your doctor’s recommendations. This will help your shoulder heal and regain its normal range of function.

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