SLAP Tears

slap tear anatomy shoulder

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

SLAP is an acronym for superior labrum anterior to posterior. The labrum is a rim of tissue that adds depth to the bony socket of the shoulder. The superior or « top » portion or the labrum is important and frequently injured because the biceps attaches to this region.

How

SLAP tears happens because of physical activity with repetitive overhead movements or physical shock. Tears created because of overhead movements are common among athletes as basball pitchers or tennis players. Tears created due to physical shocks are often a fall on a hand stretched with the arm over the head or fall directly on the shoulder.

Diagnosis

slap tear anatomy shoulder

SLAP tears are very difficult to diagnose only with a physical exam because of different shoulder problems. Using a MRI with or without contrast helps a lot.

Treatment

The first step is to do a nonsurgical treatment. While the SLAP tear likely will not heal, a study confirmed that many have improvement of symptoms and function. If nonsurgical treatment (such as physical therapy) isn’t successful, surgery is being considered.

Surgery is usually done arthroscopically and involves reattaching the torn labrum to the top of the cavity. Generally, bone anchors loaded with sutures are inserted into the top of the cavity. The sutures are passed through the torn area of the labrum. The sutures are tied, which brings the torn labrum to the bone.

Prevention

Although it’s difficult to avoir acute SLAP tears, it’s possible to prevent chronic tears, especially with athletes who make overhead movements, maintaining balance in the shoulder.

Exercices that strengthen the muscles around the shoulder blades and exercises that stretch posterior shoulders are recommended to reduce the risk of SLAP chronic tears.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Shoulder Impingement

shoulder impingement

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Impingement is the fact of having mechanical compression and/or tendon wear of the rotator cuff. Rotator cuff is composed of a serie of 4 muscles connected to the shoulder blade at the humeral head (upper part of the shoulder joint). The function of the rotator cuff is to maintain the humeral head within the glenoid (socket) during normal shoulder function and to participate in shoulder strength during activity. Normally, the rotator cuff glides gently between the inferior surface of the acromion, the bone at the point of the shoulder and the humeral head.

Causes

Any process that can interfere with rotator cuff being able to glide normally can cause impingement. The causes are :

  • Weakening

  • Degeneration of the tendon due to aging

  • Formation of the bone spurs

  • Inflammation of tissues on the space above the rotator cuff

  • Injury due to overuse

Overuse activities that can lead to impingement are most commonly seen in tennis players, pitchers and swimmers.

Diagnosis

shoulder impingement

Diagnosis can be made with the patient’s history and physical examination. Patients suffering impingement often complain of pain in the shoulder. This pain worsens with overhead activity and can be so strong that it causes an awakening during the night. Manipulation of the shoulder in a specific way by a doctor will usually reproduce the symptoms and confirm the diagnosis. X-rays are also useful for the evaluation of the presence of bone spurs and/or the narrowing of the subacromial space.

Treatment

The first thing to do is to eliminate identifiable causes or factor that contribute to the pain. This means temporarily avoiding activities like tennis, pitching or swimming. A non steroidal anti-inflammatory medication may also be recommended by your doctor. The treatment is based on exercises aimed at restoring flexibility and normal strength to the shoulder girdle, especially by strengthening the muscles of the rotator cuff and the muscles responsible for the normal movements of the scapula (shoulder blade). This program may be performed by a doctor, a certified athletic trainer or a qualified physiotherapist. Sometimes a cortisone injection may be helpful in the treatment.

Surgery

Surgery isn’t necessary in most case of shoulder impingement. But if the symptoms persist despite non-surgical treatment, surgical intervention may be beneficial. Surgery involves deriding or surgically removing, tissue that is irritating the rotator cuff. This can be done with open or arthroscopic technique. The result is favorable in about 90% of cases.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .