Shoulder Labrum and SLAP Tear Specialist

Are you an athlete who participates in sports that involve throwing overhead? If so, you may be at risk of developing a shoulder labrum tear or a shoulder SLAP tear. A shoulder labral tear is a common injury sustained after a fall on an outstretched hand, from a sports injury or from natural degeneration of the labrum. Shoulder labral and SLAP tear specialist, Doctor Riley J. Williams, provides diagnosis and both surgical and nonsurgical treatment options for patients in Manhattan and New York City, NY who have sustained a shoulder labral tear. Contact Dr. Williams’ team today!

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What is a labral tear in the shoulder?

The labrum is located within the shoulder joint and is a fibrous, dense, and thick cartilage structure that surrounds the socket portion of the shoulder joint. The labrum is attached anteriorly (front) and posteriorly (back) to the glenoid socket. The labrum provides shoulder joint stability in conjunction with the joint capsule.  The labrum can be described as “bumper” that keeps the ball portion of the shoulder joint in place. A labral tear can occur in a number of ways. Labrum tears can occur in association with shoulder dislocation; such an event causes the labrum to be completely severed from the bone of the glenoid socket. Overhead athletic activities such as pitching/throwing can also cause tearing of the labrum from repetitive micro-trauma. The origin of the long head of the biceps tendon is also attached to the labrum. Disorders of the biceps tendon can result in a superior labrum tears (SLAP lesion) Due to the various mechanisms and degrees of labral tears, it is essential to seek medical care from an orthopedic shoulder specialist for appropriate treatment. Dr. Riley J. Williams, MD, an orthopedic shoulder specialist serving patients in Manhattan, New York City, and the surrounding New York boroughs, has the knowledge and understanding, as well as substantial training, in treating patients who have experienced a labral tear.

What is a SLAP tear in the shoulder?

The biceps tendon attachment site is at the top portion (superior end) of the shoulder labrum. When this area is injured, the biceps tendon attachment site, in addition to the anchoring points of the labrum cartilage, can be affected. This type of injury is known as a Superior Labrum Anterior and Posterior (SLAP) tear. The population most at risk of a SLAP tear are athletes that perform repetitive overhead motions like those in baseball, tennis, and weightlifting. However, a SLAP tear can also occur as a result of a traumatic injury such as falling on an out-stretched arm, bracing a fall, catching a heavy object, or a motor vehicle collision.

What are the symptoms of a labral or SLAP tear?

Because complaints of a labral, or SLAP, tear are typical of a number of other shoulder conditions, it is important to consult an orthopedic shoulder specialist for a proper evaluation. Shoulder pain is the most common symptom with a labral or SLAP tear. This pain is usually worse with overhead shoulder movement or lifting heavy objects. Other symptoms can include:

  • Shoulder instability or looseness
  • Decreased shoulder strength
  • Dislocation of the shoulder joint
  • Decreased range of motion
  • A clicking, popping, or grinding sensation within the shoulder joint

How are labral and SLAP tears diagnosed?

A thorough medical history and physical examination will be obtained by Dr. Williams. This includes an assessment of the injured shoulder’s range of motion, stability, and strength. Other labrum specific physical exam tests are also performed during the physical examination. To properly diagnose a labral or SLAP tear, diagnostic testing is also recommended. X-rays determine if any bone-related injuries, such as a fracture or dislocation, were also involved in the shoulder injury. Magnetic resonance imaging (MRI) is the gold standard for the detection of shoulder labrum tears.  Dr. Williams typically orders an MRI for patients suspected of having a labrum tear; the MRI also allows for an assessment of the rotator cuff and other structures in the shoulder. In addition to an MRI, an arthrogram may be requested by Dr. Williams if the MRI scan is not definitive in the diagnosis of a SLAP lesion.

What is the treatment for a labral or SLAP tear?

Dr. Williams will review the diagnostic imaging against important factors such as the patient’s age, activity level, and severity of injury to determine an appropriate treatment course.

Non-surgical treatment:

Labral and SLAP tears are often successfully treated with conservative therapy measures. To help alleviate the pain, anti-inflammatory medications, rest, and icing (cryotherapy) are utilized. Once the pain is reduced or completely eliminated, Dr. Williams will prescribe an appropriate physical rehabilitation program aimed at regaining shoulder strength and range of motion.

Surgical treatment:

When conservative therapy is unsuccessful, or in the cases of severe labral and SLAP tears, arthroscopy of the shoulder is recommended. This procedure is performed by introducing a small camera directly into the shoulder joint to view the labrum; shoulder arthroscopy is the preferred surgical method for this diagnosis as recovery time is remarkably decreased compared to open surgery. With a shoulder arthroscopy, Dr. Williams can determine which of the following techniques is the best repair option:

  • Debridement: This approach is utilized in SLAP tears that do not involve the biceps tendon. In this procedure, the torn or frayed portions of the labrum are removed.
  • SLAP or Labrum Repair: This method is routinely used in younger patients with symptoms of a SLAP tear as it allows them to remain physically active if they desire. This procedure reattaches the torn labrum to the shoulder joint socket (glenoid) with sutures.
  • Biceps tenodesis: This surgical approach is used in the cases of severe SLAP tears involving the biceps tendon. In this operation, Dr. Williams separates the biceps tendon from the labral attachment site, excises the damaged portion of the tendon, and then reattaches the tendon to the humerus (upper arm bone).

For more information on tears of the shoulder labrum or SLAP tears, or on the excellent treatment options available, please contact the office of Dr. Riley J. Williams, an orthopedic shoulder specialist serving Manhattan, New York City, and the surrounding New York boroughs, NY.

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212.606.1855
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Locations

HSS Sports Medicine Institute West Side
610 W 58th Street
New York, NY 10019

HSS Brooklyn
148 39th Street, 7th Floor
Brooklyn, NY 11232

Office Hours

Monday-Friday: 9:00 am – 4:30 pm
Fax: 212-774-2895