SLAP Tears of the Shoulder: What They Are and How They're Treated

SLAP tears refer to injuries of the superior labrum of the shoulder, where the long head of the biceps tendon attaches to the glenoid. These tears are commonly identified on imaging, particularly in overhead athletes and aging populations, but their presence does not always explain pain or dysfunction. The shoulder relies heavily on soft tissue structures for stability, and the biceps–labral complex is exposed to significant load during overhead and deceleration activities. Importantly, labral changes are frequently seen in asymptomatic individuals, highlighting that structural findings alone do not equate to symptoms.

Clinically, SLAP tears may present with deep shoulder pain, discomfort during overhead activity, clicking sensations, or fatigue with repeated use, though symptoms often overlap with other shoulder conditions. Diagnosis is challenging, as no single clinical test is highly accurate and imaging frequently reveals incidental findings. Meaningful diagnosis requires correlating symptoms, functional limitations, and activity demands rather than relying on imaging alone.

From a treatment standpoint, conservative management is the first-line approach for most individuals. Rehabilitation focuses on restoring shoulder strength, scapular control, and load tolerance rather than "fixing" the labrum itself. While surgery may be appropriate in select cases, many people experience meaningful improvement with well-structured physical therapy. This episode explores how education, progressive loading, and evidence-based rehab strategies can help individuals return to function, even in the presence of a diagnosed SLAP tear.

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