What is Superior Labral Anterior Posterior Lesion?
A superior labral anterior posterior lesion, also known as SLAP lesion, can be the cause of pain or instability at the shoulder joint. The labrum is a tough, flexible structure that acts as a shock absorber and stabilizer for your arm bone where it attaches to your scapula. It also acts as an anchor for other structures in your arm, most notably the long head of your biceps. When this area becomes damaged, you might experience shoulder instability, clunking, and a deep aching feeling. These symptoms are usually aggravated by overhead movements. Physiotherapy is often the first line of treatment for this type of shoulder injury.
Why does it happen?
In the general population, SLAP lesions are often caused by a fall onto an outstretched hand. In athletic populations, repeated throwing or other overhead movements like swinging a tennis racket can also cause a similar injury. SLAP injuries can also occur with chronic, repetitive strain in the area due to abnormal mechanics or rotator cuff damage. In mild SLAP injuries, physiotherapy treatment is aimed at decreasing pain, improving mobility, and retraining muscles. In more advanced SLAP injuries, arthroscopic surgery may be necessary to repair the damage. If your injury needs to be surgically managed, then the goals of physiotherapy will likely be very similar, while also taking into account the additional pain which may be experienced immediately after the surgical intervention.
The role of Physiotherapy
It is important to remember that pain and injuries often have many contributing factors. Your Physiotherapist will perform a thorough assessment and work with you to find the most effective treatment strategy. Some approaches for treating SLAP lesions are:
- Stretching and strengthening exercises
- Manual therapies such as mobilization with movement
- Deep and superficial massage
- Modalities such as ultrasound and acupuncture
- Education for self-management
Often a combination of techniques will be performed to treat the underlying cause(s) and to reduce your pain. Some postural advice and task modification may also be appropriate, such as reducing frequency and intensity of overhead movements during recovery.
Popp, D. (2015). Superior labral anterior posterior lesions of the shoulder: Current diagnostic and therapeutic standards. World Journal of Orthopedics, 6(9), 660. https://doi.org/10.5312/wjo.v6.i9.660