SLAP Tears
What is the shoulder labrum?
The shoulder labrum is a ring of tough, fibrous cartilage that surrounds the edge of the shoulder socket, known as the glenoid. The glenoid on its own is relatively shallow—more like a saucer than a deep cup—which allows for the shoulder’s incredible range of motion but also makes it less stable. The labrum acts as a stabilizing structure that deepens this socket and helps keep the head of the upper arm bone (the humerus) securely in place.
In addition to enhancing joint stability, the labrum serves as an attachment site for several important structures, including the ligaments that support the shoulder and the tendon of the biceps muscle, which anchors at the top portion of the labrum.
Functionally, the labrum:
- Deepens the socket by up to 50%, allowing for both greater stability and smoother movement.
- Acts as a cushion, absorbing forces during motion and helping protect the bone surfaces.
- Provides attachment points for ligaments and tendons that control shoulder movement.
- Maintains joint integrity, preventing the shoulder from slipping out of place during rotation, lifting, or throwing.
The labrum can tear in several ways: it may separate entirely from the bone from a shoulder dislocation, tear within or along its rim often due to degeneration, or rupture at the point where the biceps tendon attaches.
When the labrum is torn or damaged—as in a SLAP tear or a Bankart lesion—the shoulder can become painful, unstable, and prone to dislocations or mechanical symptoms such as catching and clicking. Because the labrum plays such a crucial role in both stability and motion, injury to this structure can significantly impact shoulder performance in sports and daily activities.
A SLAP tear is an injury to the superior labrum of the shoulder joint. The term SLAP stands for Superior Labrum Anterior and Posterior, describing a tear that occurs where the biceps tendon attaches to the top of the labrum and extends both in front (anterior) and behind (posterior) this attachment point. This type of injury can range from a small fray in the cartilage to a complete detachment of the labrum from the bone.
SLAP tears can develop from either acute trauma or repetitive shoulder stress. Traumatic injuries that can lead to a SLAP tear include falling on an outstretched arm, a sudden pull on the arm (such as when lifting a heavy object), or a direct blow to the shoulder. These injuries can cause the labrum to tear away from the bone.
In athletes and active individuals, repetitive overhead motions—like throwing a baseball, serving a tennis ball or performing heavy weightlifting—can gradually wear down the labrum over time. As the cartilage weakens, small tears can develop and progress, eventually leading to pain and instability. Degenerative SLAP tears may also occur as part of the natural aging process, as the labrum becomes less resilient over time.
The symptoms of a SLAP tear can be subtle at first and may resemble other shoulder problems such as rotator cuff injuries or tendonitis. Patients often describe a deep, aching pain within the shoulder joint that worsens with overhead movements or lifting.
Other common symptoms include:
- A catching, locking, or popping sensation in the shoulder during movement
- Pain with certain activities, especially throwing, lifting, or reaching overhead
- A feeling of weakness or instability in the shoulder
- Decreased range of motion, particularly when rotating or reaching behind the body
- Pain at night, especially when lying on the affected side
Because these symptoms can overlap with other shoulder conditions, a precise diagnosis is important for determining the most appropriate treatment plan.
Diagnosing a SLAP tear begins with a thorough medical history and physical examination. During the evaluation, your orthopedic specialist will ask about how the injury occurred, what activities worsen your symptoms, and any history of shoulder injuries.
Physical tests may include gentle manipulation of the arm and shoulder to reproduce the pain or catching sensation characteristic of a labral tear. However, because the labrum is deep within the joint, imaging studies are often needed for confirmation.
An MRI with contrast dye (known as an MR arthrogram) is the most accurate imaging test for detecting SLAP tears. The dye outlines the structures inside the shoulder joint, making any irregularities in the labrum more visible. In some cases, an arthroscopic examination—a minimally invasive surgical procedure that allows direct visualization of the joint—may be used to confirm the diagnosis and, if necessary, repair the tear at the same time.
At Ortho Illinois, part of OrthoMidwest, we provide advanced care for SLAP tears and other shoulder injuries. Our experienced orthopedic specialists utilize the latest diagnostic imaging, conservative treatments such as physical therapy and activity modification, and, when appropriate, minimally invasive surgical repair to restore stability and function.
Our goal is to help each patient regain comfort, confidence, and mobility in their shoulder so they can resume the activities they enjoy most. With convenient clinic locations in Rockford, Algonquin, Elgin, and McHenry, we make expert orthopedic care accessible throughout northern Illinois.
If you are experiencing persistent shoulder pain, clicking, or instability, contact Ortho Illinois today to schedule an evaluation. Early diagnosis and treatment can make all the difference in restoring full shoulder function and preventing long-term complications.
