A SLAP lesion (Superior Labrum from Anterior to Posterior tear) generally occurs as result of overuse injury to the shoulder in overhead athletes or traumatic falls in older patients and can result in deep shoulder pain and biceps tendonitis.
mechanisms of injury
repetitive overhead activities (often seen in throwing athletes)
fall on outstretched arm with tensed biceps
traction on the arm
History
feeling “pop” sensation in shoulder during overhead activity or traumtic event
Symptoms
vague deep shoulder pain
often a lag between the time of injury and the onset of symptoms
mechanical symptoms of popping and clicking
weakness, easy fatigue, and decrease athletic performance
Physical exam
bicipital groove tenderness
pop may be reproduced during overhead range of motion
biceps provocation tests
Speed’s test
Yergason’s test
Kim biceps load test
SLAP lesion tests
active compression test (O’Brien’s test)
Diagnosis generally requires MRI studies to assess the superior labrum and the integrity of the biceps tendon.
Treatment may be nonoperative or operative depending on patient age, activity levels, severity of symptoms and associated instability.
