SLAP Tear Treatment Options

Nonoperative treatment is often the first approach for SLAP tears. This strategy is especially suited for older patients or those with low-demand physical activities.

This approach typically includes rest, ice application, and nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation. Physical therapy can also play a key role in this stage. It aims to improve the range of motion, strength, and functionality of the shoulder by focusing on exercises that boost rotator cuff and scapular muscles. However, if nonoperative treatments fail to provide adequate relief, surgical options may be explored.

Lifestyle Modification

In lifestyle modification, the patient adjusts their daily activities to avoid or limit movements that aggravate the SLAP tear symptoms. This treatment option is particularly beneficial for those who can adjust their occupational demands or daily routines to lessen shoulder strain. The modifications might include avoiding overhead activities, changing workout routines, or altering the way they carry heavy items.

However, for younger, active individuals or those with severe SLAP tears, lifestyle modifications may not offer sufficient symptom relief.

Physical Therapy

Physical therapy is a crucial part of treating SLAP tears. The focus is to strengthen the muscles around the shoulder, especially the rotator cuff and the scapular muscles. This not only improves the stability of the shoulder joint but also enhances its functionality and range of motion.

Despite its benefits, in some cases of severe SLAP tears, physical therapy might not yield the desired outcomes, and surgical intervention might be required.

Injections

Corticosteroid injections can provide temporary relief from pain and inflammation caused by a SLAP tear. They are usually administered alongside physical therapy. However, they do not repair the labral tear and so may not be the best solution for those with continued shoulder instability or those requiring a high degree of shoulder function.

Bracing

A shoulder brace or sling can offer short-term relief and support, primarily following an acute flare-up of symptoms. It offers stability to the shoulder joint and restricts certain movements that may exacerbate the tear. However, bracing is generally not a recommended solution as it will cause the shoulder to become stiff.

Surgery becomes an option when nonoperative treatments fail to relieve symptoms or in cases of severe SLAP tears. Let’s explore these surgical options in greater detail:

Arthroscopic SLAP Repair

In this procedure, your shoulder surgeon Dr. Mayo uses a small camera (arthroscope) and tiny instruments inserted through small incisions. The torn labrum is reattached to the bone using sutures and anchors. This procedure is typically indicated for younger or active individuals who need to maintain a high level of shoulder function. Post-surgery, the patient typically undergoes physical therapy to restore shoulder strength and mobility. Full recovery can take several months.

Biceps Tenodesis

For older patients or those with degenerative SLAP tears, biceps tenodesis might be an option. This procedure involves detaching the long head of the biceps tendon from its original attachment in the shoulder and reattaching it to the upper arm bone. This can alleviate pain and maintain the biceps’ function without putting strain on the labrum. Postoperative rehabilitation includes a period of rest and immobilization, followed by a range of motion and strengthening exercises.

Labrum Debridement

In some cases, especially for those with fraying or degenerative SLAP tears, Dr. Mayo may simply smooth or trim the torn area rather than trying to repair it. This is generally used for older patients, or when the tissue quality is poor. Recovery is typically quicker than a repair, but some patients may have persistent symptoms if the instability isn’t fully addressed.

Surgery for SLAP tears is typically considered when conservative treatments fail to relieve symptoms, or in cases where the SLAP tear is causing significant shoulder instability. The decision for surgery is individual and depends on the patient’s personal needs and lifestyle. Surgery can often be delayed until it fits with the patient’s schedule, as it is not typically an urgent procedure.