SLAP Tears

What is a SLAP Tear?

The quick answer is that a SLAP tear is a tear in the labrum of the shoulder at the top that extends forward and backwards.  The tear may include the Biceps tendon of the long head of the Biceps.  S.L.A.P. stands for Superior Labrum, Anterior to Posterior.  To learn more about shoulder labrum injuries, please go to:

The labrum is the rim of the socket of the shoulder. It is made of cartilage. The labrum helps to deepen the socket and stabilize the head of the humerus in the socket. 

Image of shoulder bones with label pointing to the labrumGlenoid Labrum

What Causes SLAP Tears?

A SLAP tear can happen with:

  • Traumatic event; car accident or compression 
  • Repetitive motions; throwing or overhead lifting 
  • Excessive traction or motion of shoulder; hyperextension or peel back motion
  • Falling
  • Direct trauma 

image of a man after a bike wreck with shoulder injury slap tearMan with shoulder injury after trauma

How Do You Know If You Have A SLAP Tear?

There are Special Tests that help clinicians to tell if you have a SLAP Tear. Some Include the 

  • O'Brien's Test
  • Crank Test
  • Biceps Load Test II 

If these Special Tests suggest a SLAP tear, an MRI Arthrogram may be ordered to further diagnose the injury. 

The symptoms of a SLAP tear Include:

  • Instability
  • Popping or clicking
  • Pain at rest or with certain motions
  • Loss of strength 
  • Loss of sensation
  • Inability to lift arm 
  • Positive provocative testing 

Click HERE to learn about Labral Tears.

Image of the shoulder anatomy with labels on ligaments and biceps tendonsShoulder Anatomy

How are SLAP Tears Graded?

There are 4 grades of SLAP Tears.

  • Grade I - Mild Fraying, Common in Middle aged or older adults, No surgery typically.
  • Grade II - Labrum and biceps tendon detach from the socket, Usually requires arthroscopic repair
  • Grade III - Bucket handle tear of labrum that droops into the joint,  Usually requires Arthroscopic repair
  • Grade IV - Same as Grade III but the Biceps is involved as well, Usually requires surgical repair 

How Do You Treat a SLAP Tear?

Image of a man doing shoulder dumbbell exercises with his physical therapistPhysical therapy

Initially, a SLAP tear can be treated with physical therapy in most cases. Physical therapy can help to restore normal shoulder movement and range of motion. Physical therapy can also help to restore strength and muscular stability in the shoulder after a SLAP tear. 

If physical therapy does get you back to normal activity, surgery may be needed.  SLAP Repair surgery is an involved process.  It can typically be done arthroscopically or minimally invasive. The orthopedic surgeon anchors the labral cartilage back in place on the socket. 

After surgery, there is a lengthy rehabilitation process that can take 4 to 6 months. Most patients wear a sling for the first 2 to 6 weeks depending on the complexity of the repair. 

Click Here to learn HOW TO PUT ON A SLING.

How Do You Sleep with a SLAP Tear?

If you have a SLAP tear. avoid sleeping on the injured shoulder. Try sleeping on your back with the arm propped on a pillow or on the opposite side with  a pillow to support the arm.

Watch this VIDEO to learn how to put of a shirt with a SLAP Tear or other shoulder injury.

Do SLAP Tears Heal On Their Own? 

The quick answer is no, SLAP tears do not typically heal on their own. That does not mean that surgery is always needed though.  If the tear is mild, physical therapy may help to stabilize the shoulder and eliminate pain so that surgery is not needed.  But with larger tears, surgery is usually needed to return to sports or high functioning activity.

Click Here to learn the 5 worst shoulder exercises and SLAP tear exercises to avoid.

  Our website medical library has several articles on all of the injuries listed below.  Please go to JOI Library or JOI Trending.

To schedule an appointment for physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045.

By: Emily Kolar, PT, DPT with Ehren Allen, PT, DPT, COMT

To schedule an appointment with a JOI Shoulder Specialist, call 904-JOI-2000, schedule online, or click the link below

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