Treatment Orthopedics

SLAP Tear
Treatments

Many people with SLAP tears get better with a period of rest and rehabilitation. A physical therapy program can strengthen the muscles surrounding the shoulder and improve control of the shoulder joint. Nonsurgical treatment may include:

Rest: If overuse led to inflammation, resting the shoulder may help.

Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications such as ibuprofen help control pain by decreasing the inflammation around the labrum and biceps tendon.

Strengthening and stretching exercises: A structured physical therapy program may be recommended to strengthen the muscles around the shoulder and address any accompanying issue with the labrum and biceps tendon. Physical therapy can be done at home, at UCSF or at other licensed facilities.

Corticosteroid injections: Corticosteroids can reduce pain by decreasing inflammation. Ultrasound imaging may be used to guide the injection.

Surgery

For patients who continue to have pain that limits their ability to play sports or perform daily activities, we may recommend surgery.

SLAP tear surgery is a minimally invasive procedure performed with an arthroscope (an endoscope for joints), and patients typically go home the same day. They are under general anesthesia (completely asleep) and usually given a nerve block (an injection to stop pain signals in the specific area), which lessens post-op pain. The surgeon uses multiple small incisions to pass a camera and small, specialized instruments into the shoulder joint. This visualization allows the surgeon to confirm the tear pattern and determine the best treatment. Techniques include repairing the tear (such as by suturing the labrum to the shoulder socket bone) and removing damaged tissue from the labrum. For some patients, the best approach is a biceps tenodesis, in which one of the biceps tendons is attached to a different point to stop it from pulling on the injured labrum.

Recovery from SLAP tear surgery takes time. Patients typically use a sling for four to six weeks to allow healing. During that period, they shouldn't drive, and physical therapy is limited to passive range-of-motion exercises, which will keep the shoulder from getting stiff while protecting the repair. People who sit at their jobs can usually go back to work one to two weeks after surgery, but people with strenuous jobs may need to wait until they have completed three to four months of physical therapy.

After the sling is removed, physical therapy begins, focused on active range-of-motion exercises without the use of weights. Jogging and other lower body exercises can also be introduced. At week 12, physical therapy starts to focus on strengthening. A full return to activities is generally allowed between five and six months post-op, and at six months, the repair is considered completely healed.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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