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Shoulder

SLAP Tears

What is the shoulder labrum?

The shoulder labrum is a ring of cartilage that surrounds the socket (glenoid) of the shoulder joint. It deepens the socket, helping to keep the ball of the upper arm (humerus) in place and providing stability during motion.

The superior labrum is the upper part of the labrum, where the biceps tendon attaches. It helps stabilize the shoulder during overhead activities and resists traction forces from the biceps, especially in throwing or lifting movements.

A SLAP tear is an injury to the top part of the labrum, where it peels or pulls away from the socket. The tear often extends from front to back (“anterior to posterior”) and may involve the attachment of the biceps tendon.

Symptoms include deep shoulder pain, especially with overhead activity or lifting. You may feel clicking, popping, or a catching sensation in the joint, along with shoulder weakness or fatigue during repetitive use.

SLAP tears can result from acute trauma (like a fall on an outstretched arm) or repetitive overhead motions, such as throwing or swimming. They’re also more common in aging shoulders, where the labrum may weaken over time.

Diagnosis starts with a physical exam to check for pain with specific shoulder movements. An MRI or MRI with contrast (arthrogram) is often used to visualize the labrum and confirm the presence and extent of the tear.

Treatment depends on age, activity level, and severity of the tear. Many SLAP tears improve with rest, physical therapy, and anti-inflammatory medication. If symptoms persist, surgery may be recommended — usually either a SLAP repair or biceps tenodesis.

A SLAP repair is an arthroscopic procedure that reattaches the torn labrum to the socket using sutures and anchors. It aims to restore normal anatomy and stability, particularly in younger or high-demand patients.

In a biceps tenodesis, the biceps tendon is detached from the torn labrum and reattached lower on the humerus. This relieves tension on the labrum while preserving biceps function.

Recovery takes about 4 to 6 months. You’ll wear a sling for several weeks, then start physical therapy to restore motion and strength. Return to sports or overhead activity is usually allowed around 5 to 6 months, depending on healing.

Recovery after biceps tenodesis is similar, though often slightly faster. Most patients regain function within 3 to 5 months, with a focus on gentle motion early and strengthening later. Full return to overhead activities may take 4 to 6 months.

At a Glance

Sachin Allahabadi, MD

  • Board-Certified & Fellowship-Trained Sports Medicine Surgeon
  • Expertise in Minimally Invasive Knee & Shoulder Surgeries
  • Assistant Professor of Clinical Orthopaedic Surgery, Houston Methodist Hospital & Weill Cornell Medical College
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