SLAP lesion - is an intervention beneficial?

SLAP lesion describes damage to the upper lip of the shoulder joint, which can affect the origin of the long biceps tendon and thus lead to pain.

It is caused by an injury, e.g. after a fall, or by chronic damage, e.g. overhead activity, tennis, etc. It can affect people of all ages and cause different symptoms.

In this guide, we discuss the typical symptoms of a SLAP lesion, diagnostic options, and best treatment options.

In this article you will learn:

Definition of the SLAP lesion
Typical symptoms of SLAP lesion.
This is how a SLAP lesion is diagnosed.
This is the typical course of the SLAP lesion.
These are the treatment options for SLAP lesions.

Definition of the SLAP lesion

The SLAP lesion is an injury to the glenohumeral lip, which surrounds the top of the shoulder joint and can thus disrupt the origin of the long biceps tendon.

This injury can cause pain, instability, and limited mobility.

SLAP lesions can be divided into different types, in which the long biceps tendon is more severely affected depending on the injury mechanism.

Symptoms of a SLAP lesion

Typical symptoms of a SLAP lesion can be:

Pain in the shoulder joint
Instability in the shoulder joint
Weakness in the arm
Limited mobility of the arm
A clicking or cracking sound in the shoulder joint when moving

In some people with SLAP lesions, the pain may radiate to the upper arm or neck area .

Symptoms may also worsen when the arm is raised above the head or placed in a certain position.

Diagnosis of a SLAP lesion

A SLAP lesion can be diagnosed through a thorough physical examination and imaging. The physical examination will determine whether there are any signs of instability or weakness and where the pain is specifically perceived.

An MRI scan may be performed to determine the exact location and severity of the injury and to detect associated pathologies such as a pulley lesion , rotator cuff damage, or labrum injuries.

Typical course of a SLAP lesion

In fact, the course of a SLAP lesion can vary greatly.

SLAP lesions often develop over the course of life without immediate, serious symptoms. Repetitive micro-movements cause small shear stresses on the tissue, which becomes more common with age due to decreasing tissue elasticity.

After an accident, a shoulder subluxation can cause the labrum, including the biceps anchor, to tear at the glenoid cavity. Pain and loss of function are typically immediately noticeable. Clinical examination typically reveals positive results on highly sensitive functional tests.

However, a SLAP lesion can also become present weeks after a fall or, for example, a blow during overhead sports. Often, the acute pain after the injury initially subsides or is not even recognized as an injury.

After some time, inflammation of the shoulder capsule may occur, necessitating MRI diagnostics. SLAP lesions are often detected in these studies.

Treatment options for a SLAP lesion

There are several treatment options for a SLAP lesion, depending on the severity of the injury and the individual needs of the patient.

Some of the proven treatment options for a SLAP lesion include:

Physiotherapy

Physical therapy can help strengthen the muscles in the shoulder area and improve mobility. Exercises can also help relieve pain and stabilize the joint.

Medications

Pain relievers and anti-inflammatory medications such as ibuprofen can help relieve pain and inflammation. Substances such as Wobenzym or Traumeel can help reduce inflammation-related pain and aid in the reduction of swelling after an injury.

Injections

Injections generally have the advantage of working where it's most needed. In addition to common medications such as triamcinolone and bupivacaine, Actovegin or autologous blood injections can provide relief from symptoms.

Radiation, shock wave and magnetic field therapy

Further device-based treatment methods can also be used to alleviate the symptoms of a SLAP lesion. While radiation therapy, for example, can provide symptom relief for shoulder inflammation, shock wave therapy and magnetic field therapy are more likely to be used in symptomatic treatment during the subacute phase.

operation

In the case of sports injuries or after a shoulder dislocation, it may be advisable to surgically repair the SLAP lesion early in order to restore the stability of the shoulder.

If the onset is delayed, it has proven useful to initially work with anti-inflammatory measures and to maintain shoulder mobility through physiotherapy.

If symptoms persist despite conservative treatment measures, a minimally invasive procedure is recommended to eliminate the cause of the pain.

The damage to the SLAP is repaired using keyhole surgery, allowing the shoulder to bear weight again. After a rehabilitation period of approximately six months, the shoulder can be used for overhead sports again.

Conclusion

A SLAP lesion can cause pain, instability, and limited mobility in the shoulder.
There are a number of treatment options that can help relieve symptoms and stabilize the joint.
If you notice pain or limitations in your shoulder, you should see a doctor to get a diagnosis and find the best possible treatment option for you.
Surgery is not necessary for every SLAP lesion.
A minimally invasive keyhole procedure is useful if conservative measures have not provided relief from the symptoms and the shoulder can no longer be used without pain, for example during sports or work.