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SLAP Tears Specialist In Singapore
SLAP tears are a shoulder injury affecting the labrum, a ring of cartilage surrounding the socket of the shoulder joint. This injury involves the top (superior) part of the labrum and is an acronym for Superior Labrum Anterior and Posterior.
- Are your symptoms affecting your quality of life? Consult our MOH-accredited shoulder specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
Causes of SLAP Tears
The causes of SLAP tears are broadly categorized into two main types: acute injuries and repetitive stress injuries.
Acute Injuries
These are sudden, traumatic events that can lead to a SLAP tear. Common scenarios include:
- Falling on an outstretched arm, where the sudden force pushes the upper arm bone into the labrum.
- Direct blow to the shoulder, which can occur in contact sports or accidents.
- Rapid or forceful movement of the arm when it’s extended above the head, as seen in certain athletic activities.
Repetitive Stress Injuries
Repeated motion can lead to wear and tear of the labrum. This includes:
- Overuse of the shoulder joint, especially in sports requiring overhead motion.
- Chronic wear and tear due to age-related degeneration is often seen in older adults.
- Occupational activities that involve heavy lifting or repetitive shoulder movements.
Symptoms and Signs
Individuals with a SLAP tear can experience a variety of symptoms, depending on the severity of the injury and their activity level.
- Pain: This is the most common symptom, often described as a deep ache in the shoulder. The pain may worsen with overhead activities, lifting objects, or certain movements.
- Popping or Clicking Sounds: Some may notice a popping, clicking, or grinding sensation in the shoulder joint. This is due to the irregular movement of the shoulder joint and labrum.
- Weakness: There may be a noticeable weakness in the shoulder, especially when lifting objects or performing activities that involve raising the arm.
- Decreased Range of Motion: The injury can lead to a reduced range of motion in the shoulder, making it difficult to perform certain movements.
- Difficulty with Specific Activities: Tasks that require lifting the arm overhead, throwing, or other specific shoulder movements may become challenging or painful.
- Instability: The shoulder may feel loose or as if it might “give out”.
Diagnosis
Diagnosing SLAP tears involves a detailed medical history, physical examination, and imaging studies. Physicians typically use MRI, sometimes MR arthrography, to visualize the soft tissues of the shoulder, including the labrum. X-rays may also be used to rule out other conditions. In some cases, a diagnostic arthroscopy, a minimally invasive procedure, is performed for a definitive diagnosis.
Non-Surgical Treatment Options
Non-surgical treatment can be an effective approach for those with less severe injuries or for whom surgery is not an ideal option.
Physical Therapy
A tailored physical therapy program is central to the non-surgical treatment of SLAP tears. It involves:
- Exercises to strengthen the muscles around the shoulder, improving stability and function.
- Stretching exercises to maintain or improve the range of motion.
- Specific techniques to address any biomechanical issues contributing to the injury.
Rest and Activity Modification
Limit or avoid activities that exacerbate symptoms. This may involve modifying work tasks or adjusting sports techniques.
Ice and Pain Management
Applying ice can help reduce inflammation and pain. Over-the-counter pain relievers like ibuprofen or acetaminophen may also be recommended to manage discomfort.
Corticosteroid Injections
In some cases, corticosteroid injections may be used to reduce inflammation and pain within the joint.
Surgical Treatment Options
When non-surgical treatments do not provide adequate relief, surgery may be recommended.
Arthroscopic Repair |
This is the most common surgical procedure for SLAP tears. The surgeon makes small incisions around the shoulder and inserts an arthroscope (a small camera). The torn part of the labrum is reattached to the bone using anchors and sutures. |
Labrum Debridement |
In some cases, particularly for older patients or where the tear is frayed, the surgeon may clean up (debride) the torn area rather than reattach it. |
Biceps Tenodesis |
If the SLAP tear is associated with problems in the biceps tendon, a procedure called biceps tenodesis may be performed. This involves detaching the biceps tendon from its original attachment in the labrum and reattaching it to the upper arm bone. |
Prevention Strategies
Preventing SLAP tears involves measures that protect the shoulder joint from injury and reduce the risk of developing these tears.
- Proper Training and Technique
Athletes should focus on proper techniques, especially in sports involving overhead motions like throwing or swimming. Coaches and trainers can guide the correct form to minimize stress on the shoulder. - Strength and Conditioning
Strengthening the muscles around the shoulder joint, particularly the rotator cuff and scapular stabilizers, helps provide better support and stability to the shoulder. - Flexibility and Range of Motion
Maintaining good shoulder flexibility and range of motion through regular stretching exercises can prevent tightness and imbalances that may contribute to injuries. - Gradual Increase in Activity
Avoid sudden increases in the intensity or duration of sports activities. Gradually increasing the load gives the shoulder time to adapt and strengthen. - Rest and Recovery
Adequate rest between training sessions and competitions is necessary to allow the shoulder to recover and prevent overuse injuries. - Ergonomic Adjustments
For individuals in occupations involving repetitive shoulder movements or heavy lifting, ergonomic adjustments to the work environment can help reduce strain on the shoulder.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
Insurance
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
Can SLAP tears heal on their own?
Some minor SLAP tears may improve with non-surgical treatments like physical therapy and rest, but many require surgical intervention for complete healing, especially in active individuals or athletes.
How long is the recovery period after SLAP tear surgery?
Recovery time can vary, but it typically takes several months. The exact duration depends on the severity of the tear and the individual’s adherence to rehabilitation.
Are there any long-term effects of a SLAP tear?
If properly treated, most individuals recover fully. Untreated or severe SLAP tears can lead to chronic shoulder pain and instability.
Can I return to sports after a SLAP tear?
Yes, with proper treatment and rehabilitation, many individuals can return to their previous level of sports activity. This may take several months.
How can I prevent a SLAP tear?
Prevention strategies include proper sports techniques, shoulder strengthening and flexibility exercises, gradual activity progression, and listening to your body to avoid overuse.