SLAP Tear

A SLAP (Superior Labrum Anterior to Posterior) tear is a tear of the labrum at the top of the glenoid socket where the long head of the biceps tendon attaches. Type II SLAP tears — where the biceps anchor is detached — are the most clinically significant. They occur from a fall on an outstretched arm, sudden traction on the arm, or repetitive overhead activity in throwing athletes (the "peel-back" mechanism in pitchers).

Deep shoulder pain with overhead activity, clicking, and a sense of catching. Provocative tests (O'Brien active compression, Biceps Load II) are moderately sensitive. MRI arthrography with intra-articular contrast is the best imaging study, though SLAP tears remain challenging to diagnose confidently without arthroscopy.

Younger throwing athletes with a Type II SLAP tear confirmed on MRI arthrography who have failed a structured rehabilitation program are candidates for repair. Older patients with SLAP tears are more often treated with biceps tenodesis rather than labral repair.

External patient-education references and related OSI pages for additional background:

• Britannica — Shoulder (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language