How does a SLAP (Superior Labral Anterior Posterior lesion) lesion occur:
- Fall on your outstretched arm.
- Fall on your shoulder.
- Brace yourself with your outstretched arm in a car accident.
- Lift heavy objects repeatedly or too suddenly.
- Do a lot of overhead activities, such as throwing a ball (cricket, baseball) or hitting a ball (volleyball).
- Painful popping, clicking, or catching in the shoulder.
- Pain when you move your arm over your head or reach back.
- Pain when you throw a ball.
- An ache often described as being deep inside the shoulder.
Types of SLAP tears: (Lennard Funk)
If you have been diagnosed with a SLAP tear, your surgeon may have called it a ‘Type 1 or 2 or 3, etc’. SLAP tears have been classified according to their severity of tear. Please note that it does not mean that the outcome of surgery is worse, it just gives us surgeons a guide to management and a form of communication. The common types are types 1 to 4. There are other types, but these are rare.
SLAP Type 1
Treatment is usually to ‘debride‘ (clean) the edges.
SLAP Type 2
Type 2 is the comonest type of SLAP tear. The superior labrum is completely torn off the glenoid, due to an injury (often a shoulder dislocation). This type leaves a gap between the articular cartilage and the labral attachment to the bone. Type 2 SLAP tears can be further subdivided into (a) anterior (b) posterior, and (c) combined anterior–posterior lesions.
Treatment is reattachment of the labrum. This is done arthroscopically using anchors.
SLAP Type 3
Treatment usually involves removal of the ‘bucket-handle’ segment and then repair of any remaining detached, unstable labrum.
SLAP Type 4
Treatment is reattachment of the labrum and repair of the biceps tear, or a biceps tenodesis.