13 Mar SLAP tears and lesions a common cause of shoulder pain and how best to manage them!
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Ever thrown a ball and felt a sudden discomfort or gone up to take that speccy in the dying minutes of a game, only to feel your shoulder slide in and out when falling to the ground? Or has your shoulder just started getting sore when trying to lift heavier items into shelves above your head.
Shoulders are extremely unstable joints, they need to be, so we can move our arm in all different directions. The definition, that I’m sure you can all remember from grade 10 physical education is a “ball and socket joint,” or you might have heard your physio say imagine a golf ball sitting on a tee. I’m ok with this definition, however, I’d prefer to say, “imagine a golf ball sitting on a saucer!!” because the socket of the shoulder is really not that deep at all.
To help with stability of the shoulder joint we have passive structures such as the rotator cuff muscles, and the labrum, which is a piece of cartilage that helps deepen the socket.
SLAP (Superior Labrum, Anterior, Posterior) tears occur when the biceps (beach muscles) tendon tears away from the cartilaginous labrum that it attaches to. They can be happen in acute traumatic mechanisms such as high speed throwing or shoulder dislocations, as well chronic overuse mechanisms such as repetitive throwing (baseball pitcher).
Depending on their severity, SLAP tears can be managed conservatively by your physiotherapist through an extensive strength and plyometric gym program. The aim of rehabilitation is to build up capacity in the surrounding muscles such as the rotator cuff and scapular muscles, before progressing into more sport specific exercises.
So what should you do if this happens to you? Well, a SLAP tear is usually accompanied with a sharp pain at the front of your shoulder, which inhibits your range of motion. When the pain first appears whether it be traumatic or not, you should ICE the area and make an appointment with your physiotherapist. From here, depending on the suspected severity, your physio may send your for an MRI to examine the extent of the damage. No matter the grade, you should leave that first physio appointment with a comprehensive home exercise program, as well as a well thought out rehabilitation plan tailored to your goals.
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In some cases, surgery is required to repair the cartilage, however if this is the case your physio should guide your through an extensive prehabilitation program that focuses on regaining full range of motion and building muscle strength and capacity as soon as possible!
Chris and Jackson have conservatively managed numerous patients in both the athletic and general population who have suffered SLAP tears, and helped them get back to doing the things they love!