Shoulder Labral Tear (SLAP Tear)
Labral Tear (SLAP Tear)
A labral tear specifically refers to a tear of the Superior Labrum from Anterior to Posterior Lesion. Baseball players are prone to Type 2 SLAP caused by the late cocking phase of throwing, where the biceps anchor becomes overloaded due to maximum external rotation, or by the deceleration phase, where the biceps tendon is overloaded with extreme tension. According to the exact tear patterns, SLAP tears can be classified into four sub-categories. Some recent research has even classified SLAP tears into ten different sub-categories.
Rotator cuff tears are caused by a number of different reasons, including morphological abnormalities of the coracoacromial arch, impaired blood circulation, overuse, and degenerative changes to the ligaments and tendons. The supraspinatus is most vulnerable to tears caused by repeated physical pressure exerted between the acromion and the humeral head. (Typically this injury occurs to professional athletes who often overuse their shoulders) Symptoms include shoulder joint pain, muscle atrophy, limited range of motion, and nyctalgia (pain at night). In the case of a complete tear, patients can no longer lift their injured arm above their head.
Non-surgical treatment (exercise, injection, medication) /h5>
- Patients will be prohibited from any activities that involve excessive movement of the biceps brachii.
- Patients will be prescribed with progressive exercises to strengthen the rotator cuff.
- Patients will be prescribed with progressive exercises to strengthen the scapula.
- Patients will be prescribed with early proprioceptive exercises.
- Patients will be prescribed passive and active joint mobilization and movement exercises (acute pain controlled with medication, injection, physical therapy, thermal (ice) treatment, etc.)
Surgical treatment
+ Rehabilitation after SLAP tear surgery (for Type 2)
- Treatment will focus on reducing inflammation and pain immediately after surgery, and on protecting the anatomically restored ligaments/muscles near the surgical site
- Patients will be prohibited from contracting the biceps brachii immediately after surgery.
- Patients will be required to sleep with a protective sleeve on for the first four weeks.
- Patients will be prescribed joint mobilization and movement exercises after their SLAP tear surgery (active external rotation, extension, abduction prohibited).
- Patients will be prescribed with early proprioceptive exercises.
- Patients will be prescribed progressive muscle strengthening exercises.
- Patients will be allowed to begin sporting activities at a limited capacity (light swimming, golf half swing) four months after their surgery.
- Athletes who require overhead movements of their surgically repaired shoulder (baseball players), will begin Interval Throwing Programs (ITP) five months after their surgery.
