What is a SLAP tear? Should you get it fixed? Surgeon explains

[@shoulderarmhealth]

Hi user gt! I grew up in Auburn Washington but now I’m in Orange County california. I recommend Dr. Tyler Nathe in the Seattle area. He is top notch.

[@diegoescalante8792]

excellent! thank you a lot from a radiologist in Perú

[@johnmacdonald5767]

Thanks for the info Dr. Sohn. I'm as old as the hills and not in pain so it sounds like I would be a poor candidate for repair. Sure would be able to raise my hand over my head though for things like brushing my hair or storing luggage in an overhead compartment on a plane.

[@shoulderarmhealth]

That just means you don’t need a slap repair. However, if the pain gets significant, a bicep tenodesis is the way to go.

[@johnmacdonald5767]

Thanks very much for the response. I'll be meeting with my Dr. next month and be interested to see what he recommends.

[@Mangop7q]

Hello, DR. Sohn! I got shoulder injured from head first sliding during baseball game. I'm wondering if you ever plan to have practice in Seattle area or WA area. Or eould you please recommend someone who is in Seattle area and a great shoulder doctor like you? Please help me out. I really wish to push up and pull up exercise again 🙏 😢

[@michaelmcw111]

Hello Dr, thank you for your educational video. I'm a 62yo,male in otherwise good health.Just had MRI for (r) shoulder pain and below is the impression. Is your practice in the southern California area ? Thanks ! IMPRESSION: 1. SLAP tear extending to the bicipitolabral anchor. Mid anterior-inferior labral tear extending from 3 o'clock to 6 o'clock. 2. Borderline subacromial impingement with mild anterolateral downsloping of the acromion causing trace subacromial/subdeltoid bursitis and tendinosis of the distal supraspinatus myotendinous junction. 3. Distal supraspinatus, infraspinatus and subscapularis tendinosis. Low-grade interstitial delamination of the distal supraspinatus fibers. 4. Severe acromioclavicular osteoarthritis. 5. Mild to moderate glenohumeral osteoarthritis. 6. Trace subacromial/subdeltoid bursitis. 7. Tendinosis of the intra-articular long head of the biceps tendon 8. Tenosynovitis of the extra-articular long head of the biceps tendon

[@shoulderarmhealth]

Hello. Yes. Our office is in Orange County. You can learn more or request an appointment at www.sohnortho.com. based on the report, I think we can help you.

[@22prince22billups1]

I have shoulder pain, and had a MRI without the fluid so doctors aren't sure if it's a SLAP tear forsure. However, including my shoulder pain my bicep is also in pain, what do you think I should do? I used to be a heavy lifter but haven't been able to do any activity because of it

[@shoulderarmhealth]

Hi. Thanks for the question. It really depends on the factors I mentioned (age, bicep involvement, etc). If you haven’t already tried physical therapy, that’s always a good place to start. If you have and it still hurts, you may consider other options such as an injection under your doctor’s guidance and recommendations. For long standing cases in people over 30, I usually recommend a bicep tenodesis surgery. Of course, depending on what your mri shows, you may also need other areas addressed at the same time. Good luck and please make your decisions with your treating orthopaedic surgeon. This channel is for general information and not medical advice.

[@TAF27-o2s]

Hi Dr, firstly thank you for sharing your knowledge online. I had a fall injuring my shoulder 9 months ago, the pain is still at the same level as it was when I had the fall. I currently use heat & ice packs & paracetamol to get some mild relief from the ongoing pain. I’m allergic to NSAIDS so they are not an option for me. The MRI showed a small SLAP tear, early features of adhesive capsulitis, bursitis, Bicep tenosynovitis , supraspinatus tendon shows tendinopathy. My issue now is that I have been sleeping on my uninjured side that has aggravated my hip pain from a bursa I had yers ago . I’m 62 and was hoping surgery to be an option as my life is on hold due to the pain and loss of function & mobility in my L shoulder . Can you recommend anything else I could do for some relief and improve movement? I have also had 2 injections that unfortunately did nothing

[@shoulderarmhealth]

Hi Tracy. Sorry to hear about your pain. One thing I forgot to mention is that most everyone gets a type one slap tear as they get above the age of 60. It’s just a normal part of aging. The bicep is the main issue and this is why it is called the bicep labral complex. If you also have adhesive capsultitis, you will be very stiff as well. If you haven’t tried physical therapy yet, you should definitely start with that. I’m my practice, when I have patients who don’t improve with those measures, I usually recommend a surgery called a bicep tenodesis and rotator cuff collagen augmentation patch.

[@shoulderarmhealth]

Also, see my video called “side sleepers do this”.

[@TAF27-o2s]

@@shoulderarmhealth thank you for your response I really appreciate it. I have been seeing to a physiotherapist in the hopes I don’t end up with a frozen shoulder. I will go back to see my Orthopedic surgeon to see if he does surgery using collagen augmentation. I’m in Australia so fingers crossed 🤞🏻

[@FalconsRaptor]

Hi, The video is a great help. I want to ask that Is it normal to have a door hinge type of squeaking sound in the shoulder after a slap repair with knotted suture anchors ? Does that painless squeaking sound mean a failed surgery ? If so do you recommend a recovery surgery? If yes when would be the optimal time for it ? Thank you doctor

[@shoulderarmhealth]

Hello. While I’m not able to offer medical advice on this channel, it does sound like you may have some abrasive rubbing coming from the knots (if they indeed used knots). Lately, most companies have gone to a completely knot less technology so as to avoid that situation. I’m some cases, the noises may dissipate as the body covers the knots with scar tissue. If there is pain, you may need to consider a surgery to remove the knots after the slap has healed. If they are going back to look at the knots, they will also see if the slap healed (and to consider bicep tenodesis if needed).

[@FalconsRaptor]

Thank you for your response! I really appreciate it.

[@trendtrader8074]

Sir can slap tear be detected on 3 Tesla MRI scan or we require Mr arthrogram for diagnosis

[@shoulderarmhealth]

Yes. A slap can often be seen on a regular mri. However, some can be missed. An arthrogram is still the gold standard test.

[@karthikeyankabilan8752]

Does a grade I SLAP tear require a surgery?

[@shoulderarmhealth]

Not always. If it causes enough pain, a bicep tenodesis surgery can often help.

[@joshuaroberts6891]

Just got a MRI with Fluroscopy. Just curious as to what this means and how bad is my shoulder is. I can still lift Ths is just the impression: Hill-Sachs deformity with nearly circumferential tear of the labrum. SLAP tear extending to an anteroinferior labral tear and chronic tearing of the posterior labrum. Tear extends to the biceps anchor. Mild bursitis and tendinopathy. It also says my posterior labrum has blunting, fraying and peeling on ABER view ?

[@shoulderarmhealth]

Hi Joshuaroberts6891. Looks like a pretty bad injury of the entire rim of the socket. that is much more than a slap tear (although it includes a slap tear). I often see this type of result in my patients. It may be possible to rehab the shoulder a bit and avoid the things that hurt. However, if the pain persists, you may need to have a surgery to repair the damage. Good luck on your recovery from this shoulder injury.

[@joshuaroberts6891]

Thank you for your reply! I’m a young very active person but haven’t been in pain. It just with certain exercises it pops out and then it’s really bad pain. So basically my entire labrum isn’t attached to the bone? Should I be worried about the tear extending to by bicep anchors ? Trying to see if surgery can be avoided. Tried pt but didn’t work. But I want to resume my usual activities such as bouldering

[@Bigglionnnn]

@@joshuaroberts6891u might need surgery bro mg doctors told me a torn labrum don’t jus heal on it own if it does it takes a very while

[@shoulderarmhealth]

Hi Joshua. Without seeing your mri images, I can’t answer your question or give good advice. Please seek the help of a shoulder specialist near you and I’m sure they can offer you options to get back to bouldering and all the things you love.

[@shwartzkatt4695]

What if it is a "complex" superior labral tear and I'm 34. I was told my bicep tendon is fine and my rotator cuff is mildly frayed. I also have great range of motion, but I can still tell something isn't right although my trainer and PT have said they don't believe I need surgery. The yhing is I power lift, Olympic lift and do martial arts. So in terms of longevity I am trying to figure out if I should get surgery or just stick with conservative treatment

[@shoulderarmhealth]

When you hear “complex tear” it is usually not a good thing. That usually means there is a disorganized tear pattern seen on the mri. The only repairable type is a type 2 tear which is a clean and “simple” tear. However, it is hard to advise you just based on the information you gave me. Ultimately, you have to decide if this nagging pain is bad enough to warrant the down time and recovery period needed with surgery. Your surgeon can help you make this decision. If it comes to surgery, the repair vs tenodesis decision is often a decision that has to be made when the camera is in the joint. Good luck. Please share what you end up doing.

[@Bigglionnnn]

I jus got an mri a week ago I found out I I have a type 2 slap tear with a proximal humerus fracture with a little fluid in my shoulder I been in pain ever since it happened on new years a month later I still can’t raise my arm or put my arm in certain positions doctors said physical therapy is not going to help😢. Does my tear sound bad ? and does it sound surgical ?

[@shoulderarmhealth]

Hi biglionnnn. This channel is for general information. It’s hard to give you specific advice based on your question. However, a humorus fracture is a much more acute and important problem to heal from before addressing any problems with the labrum. It takes about six weeks for the bone to heal and then after that, it probably takes another month or two to get your flexibility back. It’s too soon to make any decisions about surgery unless the fracture itself requires surgery. I recommend seeing a shoulders doctor near you to monitor healing.