- 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.
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