Shoulder pain can present itself in many ways. You can experience numbness, along with dull, achy, tingling, electrifying sensations that radiate into your shoulders (left, right, or both), and sometimes your scapula. (See articles for more information: Other Forms of Nerve Pain, Are you experiencing neck pain, and Fibromyalgia). You may also have problems lifting or raising your arms above your head. You may be a side sleeper and have shoulder pain every morning. You may have injured your shoulder throwing a ball or trying to prevent yourself from falling. (See other shoulder pain articles for more information: Rotator Cuff Tendonitis, Rotator Cuff Tears, Shoulder Dislocation, Shoulder Impingement, Shoulder Separation, Shoulder Sprain and Strain, and SLAP Tear (Superior Labrum Anterior Posterior Tear, Shoulder Fracture, and Shoulder Cartilage Tear)). Your shoulders may ache before and during a rainstorm, orduring colder weather. (See articles on Arthritis, Osteoarthritis (OA), and Rheumatoid Arthritis (RA)).
In this article, I will discuss a SLAP tear (Superior Labrum Anterior Posterior Tear). A SLAP tearis an injury to the labrum of the shoulder. Some causes of a SLAP tear are motor vehicle accidents, a fall onto an outstretched arm, a forceful pulling down of the arm by an opponent, a shoulder dislocation, and repetitive overhead movement during activities such as weightlifting and painting. With this type of shoulder injury, patients have reported experiencing their shoulder locking, popping, or grinding. They experience pain with movement of the shoulder when lifting heavy objects overhead. In addition, they experience decreased shoulder strength, decreased throwing velocity, and decreased range of motion.
SLAP tears canbe acute or chronic. Chronic SLAP tears occur from the wearing down of the labrum that slowly occurs over time. The labrum is a thick ring of cartilage that surrounds the socket of the shoulder. Thelabrum’s main functionsareto deepen the socket so the ball stays in place and to attach the outer structures and tissue around the joints. The labrum can tear in different ways. A complete labrum tear results in the labrum being torn from the bone. The shoulder is either subluxated (occurs when the ball slides partially out of the socket) or dislocated (when the ball slides all the way out of the socket). Tears within the labrum are typically seen in older patients. The edges of the labrum are frayed, and pain is minimal. SLAP tears occur when the labrum is torn where the biceps tendons attach to the upper end of the humerus head and bend into the labrum (the anterior and posterior labrum attachment). The injury can be mild to severe. The best treatment for a SLAP tear is arthroscopic surgery.
If you are having unrelieved shoulder pain and a decline in mobility and function, please follow-up with your healthcare provider for physical assessment, a shoulder X-ray to assess the bone structure, and an MRI/CT with and without contrast to assess tissue and ligaments. It’s important to use contrast dye because it allows the tears to be more visible on the MRI/CT. Treatment depends on severity, type, and location. Initial treatment includes NSAIDS and physical therapy for 3 to 6 months to help restore movement and to strengthen the muscles. Surgery may be required if pain has not improved with NSAIDS and physical therapy. Please follow-up with an orthopedic surgeon to discuss possible surgery options.
References
American Academy of Orthopedic Surgeons. (2019). SLAP Tears. Retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/slap-tears/
John Hopkin Medicine. (2019). Shoulder Labrum Tear. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-labrum-tear
Udaix. (2019). Shoulder Joint of Human Body Anatomy infographic diagram with all parts including bones ligaments muscles bursa cavity capsule cartilage membrane for medical science education and health care.Retrieved from https://www.shutterstock.com/image-vector/shoulder-joint-human-body-anatomy-infographic-699043855?src=library