Understanding SLAP tears
After appearing in just two games for Sussex, Bangladesh fast bowler Mustafizur Rahman’s England cricket season came to a premature end in July with a shoulder injury that saw him undergoing surgery last month with Mr Andrew Wallace of the London Shoulder Specialists at Fortius Clinic to treat a SLAP tear.
SLAP tears are diagnosed when the top part of the labrum becomes torn due to injury. Responsible for stabilising the shoulder, the labrum is made up of strong tissue which runs in a ring around the shoulder’s socket. SLAP is an abbreviation for Superior Labrum, Anterior to Posterior, and refers to the area of the shoulder that’s been injured.
There are actually various types of SLAP tears a patient can experience, all relating to the severity of the tear. It’s most common in those who play contact or overhead sports and is therefore a common injury suffered by fast bowlers like Rahman.
Understanding the different types of SLAP tears
When a SLAP tear is diagnosed, it is classified as a specific type:
Type 1: A partial tear, including degeneration of the superior labrum. The edges of the free margin are frayed and rough, but the actual labrum itself is still attached. Treatment typically includes cleaning the edges, a process known as ‘debride’.
Type 2: Diagnosed when the labrum has totally come away from the glenoid, this is the most common type of SLAP tear. It tends to occur after an injury such as dislocation and a gap is left between the labral attachment and articular cartilage.
These types of tears are also commonly broken down into sub-categories such as posterior, anterior and a combined posterior/anterior tear. To treat it, the labrum will need to be reattached via keyhole surgery. The slap repair is carried out arthroscopically with suture anchors.
Type 3: In some cases, the tear in the labrum causes it to hang down into the joint, causing it to frequently pop and lock. Treatment is similar to a type 2 tear, using the same keyhole surgery technique. The only difference is the hanging section of the labrum, commonly referred to as a bucket-handle tear, is eliminated before the remaining labrum is repaired.
Type 4: A severe tear which extends within the long head of the biceps tendon. SLAP repair surgery will need to be carried out to reattach the labrum, as well as potentially repair the tear in the biceps.
How do I know I have a SLAP tear?
The first sign of a SLAP tear is pain, ranging in severity, throughout the top section of the shoulder. This will largely present itself when you’re performing overhead activities. Mustafizur Rahman noticed his SLAP tear after his second game of the season, experiencing significant pain when bowling.
The pain experienced is sometimes assumed to be associated with AC joint issues. A good way to establish whether you’re experiencing a SLAP tear or AC joint issue is to do a bench press. If you experience a lot of pain while going down into the press, it’s a SLAP tear. AC joint issues commonly cause more pain as you press out of the bench press.
As well as pain, clicking is another common symptom, along with weakness in the shoulder. You may also feel like the shoulder is going to pop out of place and there could be a deceased range of motion.
Depending on the type of tear and how it is affecting you – whether that’s your performance as a top-flight cricketer or your ability to discharge day-to-day activities – the London Shoulder Specialists can offer a range of non-surgical and surgical treatments.
