Shoulder pain can be frustrating, especially when it limits daily activities such as lifting, reaching overhead, or playing sports. One common cause of persistent shoulder discomfort is a SLAP tear. SLAP stands for Superior Labrum from Anterior to Posterior, a type of injury affecting the ring of cartilage that lines the socket of the shoulder joint.

This blog explains what a SLAP tear is, its symptoms, causes, diagnosis, and the treatment options available for lasting relief.

What Is a SLAP Tear?

The shoulder is a ball-and-socket joint where the upper arm bone (humerus) fits into the shoulder blade (scapula). To keep the ball securely in place, the socket is lined with a rim of cartilage called the labrum. This labrum acts like a cushion, stabilising the joint and helping the ligaments and tendons attach properly.

A SLAP tear occurs when the top (superior) part of the labrum is torn, where the biceps tendon attaches. The tear runs from the front (anterior) to the back (posterior) of the socket, hence the name “SLAP.”

What Causes a SLAP Tear?

A SLAP tear may happen suddenly due to injury or gradually because of repetitive shoulder movements.

Common Causes Include:

• Sports injuries: Throwing athletes (cricketers, baseball players), weightlifters, and swimmers are at higher risk.
• Trauma: A fall onto an outstretched hand or a direct blow to the shoulder.
• Sudden pulling movements: Trying to catch a heavy object or sudden jerks during lifting.
• Repetitive overhead activity: Movements such as serving in tennis or overhead work.
• Ageing: With age, the labrum can naturally wear down and become more prone to tears.

Symptoms of a SLAP Tear

The symptoms of a SLAP tear may resemble other shoulder injuries, which is why proper diagnosis is important.

Common Signs and Symptoms:

• Deep shoulder pain, especially during overhead activities
• A feeling of catching, locking, or grinding in the shoulder
• Weakness or instability in the shoulder joint
• Pain while lifting objects or throwing
• Decreased range of motion
• Difficulty sleeping on the affected side

These symptoms often worsen with activity and improve with rest, leading many people to delay medical care.

Types of SLAP Tears

SLAP tears are classified into different types depending on the severity and exact location of the tear.

Type I

Fraying of the labrum, but the biceps tendon remains attached. Common in older adults.

Type II

The most common type. The labrum and biceps tendon detach from the socket.

Type III

A “bucket-handle” tear where a flap of the labrum gets caught in the joint.

Type IV

A tear that extends into the biceps tendon itself.

The type of SLAP tear helps determine the best treatment approach.

How Is a SLAP Tear Diagnosed?

Because shoulder pain can arise from many causes, accurate diagnosis is essential.

Physical Examination

The doctor will test shoulder strength, range of motion, and stability. Special tests such as the O’Brien test may be used to assess labral tears.

Imaging Tests

• MRI (Magnetic Resonance Imaging): With or without contrast dye, MRI can show labrum damage.
• CT scan or arthrogram: Sometimes used for detailed imaging.

Arthroscopy

In some cases, a minimally invasive procedure called arthroscopy is performed to directly view the inside of the shoulder joint and confirm the diagnosis.

Treatment Options for SLAP Tears

Treatment depends on the severity of the tear, the patient’s age, activity level, and lifestyle needs.

Non-Surgical Management

• Rest and activity modification: Avoiding painful overhead activities.
• Physiotherapy: Exercises to strengthen the shoulder and rotator cuff muscles.
• Medications: Anti-inflammatory drugs for pain relief.
• Injections: Corticosteroid injections may reduce pain and inflammation.

Non-surgical methods often work well for mild tears, older patients, or those who are not engaged in high-demand sports.

Surgical Treatment

If symptoms persist despite conservative measures, surgery may be recommended.

Arthroscopic SLAP Repair

• Performed through small incisions using a tiny camera (arthroscope).
• Torn labrum is reattached to the socket with sutures or anchors.

Biceps Tenodesis

• In some cases, the damaged biceps tendon is reattached to a different location on the arm bone to relieve strain on the labrum.

Debridement

• Trimming or removing frayed labral tissue in minor tears.

Recovery After SLAP Tear Surgery

Recovery from SLAP tear surgery is gradual and requires commitment to rehabilitation.

Immediate Post-Surgery

• Arm is usually kept in a sling for 2–4 weeks.
• Pain and swelling are managed with medication and cold therapy.

Physiotherapy

• Gentle exercises to restore mobility begin within weeks.
• Strengthening exercises are added gradually over 2–3 months.

Return to Activities

• Daily activities can often be resumed after 2–3 months.
• Athletes may need 4–6 months before returning to competitive sports.

Compliance with physiotherapy is crucial for a successful outcome.

Living with a SLAP Tear

Many people try to live with the pain of a SLAP tear, thinking it will heal on its own. Unfortunately, untreated labral tears can lead to chronic shoulder pain, reduced mobility, and even further joint damage. Seeking timely medical care not only prevents worsening but also improves long-term shoulder health.

Restore Shoulder Function with Dr. Martha Balakrishna

Shoulder pain should not hold you back from living an active, fulfilling life. A SLAP tear, if diagnosed and treated correctly, can be fully managed with excellent long-term results.

Dr. Martha Balakrishna, an experienced Orthopaedician and Joint Replacement Surgeon, specialises in the diagnosis and treatment of complex shoulder conditions, including SLAP tears. With expertise in both non-surgical and advanced surgical techniques, she provides personalised care to help patients regain strength, movement, and confidence.

Book your appointment with Dr. Martha Balakrishna today and take the first step towards a pain-free, stronger shoulder.