A superior labral anterior-posterior or S.L.A.P. lesion is a tear of the cartilage ring, called the glenoid labrum that cushions the head of the humerus or upper arm bone in the shoulder socket.
The main culprit of S.L.A.P., lesion is often said to be overhead throwing motions such as those common to baseball, volleyball, football, swimming or tennis. However, S.L.A.P. lesion can also come from other mechanisms including:
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Falling onto the shoulder
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Lifting heavy
objects
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Experiencing a traumatic dislocation
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A forced abduction (severe muscle pull) with external rotation
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Falling onto an outstretched arm
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Repeatedly lifting and throwing
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Having an unstable shoulder joint
Athletes may experience these symptoms if S.L.A.P. lesion has occurred:
- Dull throbbing ache in the joint - This may be brought on by strenuous exertion or simple household chores. Sufferers often turn to ice packs more frequently for relief.
- Difficulty with sleeping due to shoulder discomfort - This may occur because S.L.A.P. lesion decreases the stability of the shoulder joint. When lying in bed the shoulder drops which in turn pulls on the muscles and ligaments causing discomfort.
- Catching feeling - This may be prevalent for an athlete involved in a throwing sport, such as baseball, volleyball or tennis. These athletes may also complain of a loss of strength or velocity in throwing.
- Impingement and catching sensations - This can result from any applied force overhead or pushing directly into the shoulder.
Diagnosis of S.L.A.P. lesion is made usually through magnetic resonance imaging (M.R.I.) or an arthroscopic examination. Treatment options include physical therapy, modification in the sport activity, anti-inflammatory medications, or if needed, surgery. Because S.L.A.P. lesion is an injury to the cartilage ring, it will not usually heal on its own. Most S.L.A.P. lesions need surgical repair. The torn part of the cartilage is removed or smoothed and is reattached to its location before the tear. This arthroscopic procedure requires six to eight weeks for rest and recovery. Physical therapy follows the surgery.
Preseason conditioning and learning proper sport techniques may prevent S.L.A.P. lesion:
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Complete a good warm up with stretching before starting your activity.
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Strengthen muscles surrounding the shoulder joint, especially rotator cuffs to help create shoulder stability.
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Avoid walking on slippery surfaces to decrease the chance of a fall.\
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Learn proper falling techniques while playing sports like volleyball or when walking on ice in the winter.
Share comments or questions on this information email: sports.medicine@marshfieldclinic.org.
