SLAP lesion

What is a SLAP fault?
A SLAP injury is a type of shoulder injury. It affects the humeral cartilage, which is a ring of connective tissue around the scapula that holds the head of the humerus in place. SLAP (Superior Labrum from Anterior to Posterior tear) stands for “tear in the superior labrum cartilage in the anterior to posterior direction”. The tear occurs in the upper region of the upper labrum where the long head of the biceps tendon takes refuge. In several cases the biceps tendon may be injured.

What symptoms do patients present with?
Patients with a SLAP lesion present with a wide range of symptoms. Many of these are similar to other types of shoulder injuries.

Symptoms mainly include:

Shoulder pain (on certain movements, or when lifting objects, especially above head height)
A feeling of “locking” or friction
Muscle weakness.
What are the causes of SLAP damage?
The causes of SLAP lesion are traumatic, degenerative or due to hyperextension. Most SLAP tears occur in patients older than 40 years of age. This is because with age the upper part of the cartilage of the operculum can gradually degenerate. Usually, traumatic SLAP tears can be caused by a fall on a stretched arm, in car accidents and after shoulder dislocation. SLAP tears can also occur after repetitive shoulder movements. This occurs most often in athletes in throwing sports, weightlifters, professionals who perform repetitive heavy physical tasks involving shoulder movements.

What is the process of diagnosis?
Diagnosis of SLAP injury involves a clinical examination and taking a detailed medical history that highlights the type of activity that caused the injury. MRI allows for accurate visualization and staging of the lesion as well as highlighting concomitant lesions.

What does the treatment involve?
Conservative treatment
Treatment of SLAP lesion depends on the location and severity of the injury. If the injury is not severe, it can heal with conservative treatment including:

Ice therapy
Immobilization – Treatment with non-steroidal anti-inflammatory drugs
Physical therapy.
Physical therapy includes specific exercises that focus on improving the flexibility, motion, and strength of the shoulder.

Surgical intervention
If the injury is more severe and conservative methods do not work, the patient will need surgery. The most common method is arthroscopy. During arthroscopy, a camera and special surgical instruments are inserted into the joint, where the damage is repaired and disconnected with the biceps process. With proper rehabilitation, after arthroscopic SLAP lesion repair, full range of motion is usually regained. Rehabilitation is different for each patient and depends on many factors, including age, type of injury and overall health. Usually postoperative immobilisation of the shoulder for 4 weeks is needed and then gradual initiation of physiotherapy. Return to sport is usually at 6 months.


The orthopaedic surgeon, Dr. Antonios Pettas, was responsible for the foot and ankle surgeries at Norrtälje Hospital in Stockholm. He has many years of experience, with a high success rate of operations. Contact him for a detailed diagnosis and consequently an individualized treatment and rehabilitation plan.