Sunday, September 7, 2014

SLAP Tear

SLAP Tear? What exactly is it? A SLAP Tear definitely can be a major slap as it was for me. If you're one of the many who have experienced a SLAP Tear, then you know that it can be quite painful. Speaking from personal experience, I've had a SLAP Tear in which the glenoid labrum of my left shoulder was torn along with a total detachment of the bicep muscle from the shoulder bone.

slap repair marks on left shoulder of jaguarjulie
Having 2 separate shoulder surgeries to repair my SLAP Tear injury, presented me with many challenges over the past several years. The first repair surgery lasted over 3-1/2 hours ... much longer than my surgeon expected! Wow, was that experience ever a nightmare!

After that surgery, I couldn't get past the high level of pain. I was subsequently diagnosed with Reflex Sympathetic Disorder or RSD. That meant 2 full courses of pain management which was totally another kind of major pain!

When I began my third course of pain management, the doctor hit a nerve that sent spasms down my right arm. I did not go back for the other two treatments.

Have you also experienced a SLAP Tear and had surgery? I'd love to hear from you! Please leave me a comment in my guestbook. It's definitely more than the name might convey -- for me it was a major S-L-A-P that SLAP Tear! P.S. Thanks to Google for including my pictures post-surgery on the first page of the image search.

Photo Credit: SLAP Tear repair surgery on JaguarJulie's left shoulder.


Quick, cast your vote about the SLAP Tear!
Have you experienced a SLAP Tear? Google "slap tear" and see what search results you get. Try web and image searches. So, have you had a SLAP Tear?
  1. Yes, and I had surgery!
  2. Yes, although I haven't had surgery.
  3. Well, I think I might have one.
  4. Nope, never had--lucky I guess!

What's SLAP?
What exactly is a SLAP tear? Well ... S-L-A-P stands for:
  1. Superior
  2. Labrum from
  3. Anterior to
  4. Posterior!

Sub-types of SLAP Tears
At least ten types of this injury are recognized with varying degrees of damage seven of which are listed here:
  1. Degenerative fraying of the superior portion of the labrum, with the labrum remaining firmly attached to the glenoid rim
  2. Separation of the superior portion of the glenoid labrum and tendon of the biceps brachii muscle from the glenoid rim
  3. Bucket-handle tears of the superior portion of the labrum without involvement of the biceps brachii (long head) attachment
  4. Bucket-handle tears of the superior portion of the labrum extending into the biceps tendon
  5. Anteroinferior Bankart lesion that extends upward to include a separation of the biceps tendon
  6. Unstable radial of flap tears associated with separation of the biceps anchor
  7. Anterior extension of the SLAP lesion beneath the middle glenohumeral ligament
slap tear symptoms

Slap Tear Symptoms

  1. A dull throbbing ache in the joint.
  2. Difficulty sleeping due to shoulder discomfort.
  3. For an athlete involved in a throwing sport such as baseball, pain and a catching feeling are prevalent.
  4. Any applied force overhead or pushing directly into the shoulder can result in impingement and catching sensations.

Heat Patches
Experiencing a lot of pain in my shoulder and back, I found that using heat patches seemed to provide some temporary relief. I have used a lot of heat wraps and patches like ThermaCare Lower Back & Hip Heat Wraps.

Slap Tear Treatment

No Intervention? Very few patients with SLAP lesion injuries return to full capability without surgical intervention.

Physical Therapy? Very rarely physical therapy can strengthen the supporting muscles in the shoulder joint to the point of reestablishing stability. For all other cases the choice is do nothing or have surgery to reattach the labrum to the glenoid.
accutex shoulder support
Oppo Medical AccuTex Specialist Shoulder Support
Arthroscopic Surgery? While the surgery can be performed as a traditional open procedure, the recommended course of action is an arthroscopic surgery. This type of procedure is vastly less intrusive to the body and reduces chances of infection.
  • Procedure: During the procedure the surgeon should check the general health of the shoulder joint. There are at least twenty different items of conditions that he/she should examine or look for. These include:
    • SLAP lesion - labrum/glenoid separation at the tendon of the biceps muscle.
    • Bankart lesion - labrum/glenoid separation at the inferior glenohumeral ligament.
    • Biceps Tendon.
    • Bone - glenoid, humerus - general surface condition.
    • Ligaments - check for tears and condition.

My First SLAP Tear Repair Surgery
I had 3 titanium anchors to reattach my biceps tendon to the bone along with the labral repair.

slap tear repair surgery surgeon marks of jaguarjulie
After my second SLAP surgery : surgeon's marks!
Photo of and by JaguarJulie.

The Surgical Procedure ...

  1. Glenoid and labrum roughened to increase contact surface area and promote regrowth.
  2. Locations for bone anchor are selected based on number and severity of tear. Bad tears involving SLAP and Bankart lesions may require 7 anchors. Simple tears may only require 1.
  3. Glenoid is drilled for the anchor implantation.
  4. Anchors are inserted in the glenoid.
  5. The suture component of the implant is tied through the labrum and knotted so the labrum is in tight contact with the glenoid surface.


Surgical Recovery

It is difficult to be precise when predicting a person's recovery from a SLAP Tear Repair Arthroscopy. You can generally expect to experience something of the following. The timeline can vary a bit according to your own surgeon's preferences and the extent of damage and repair.
  1. Stage one - For the first four weeks the arm is typically kept in a sling. There are some surgeons only have the patient in a sling for a week. Patients may find themselves in an immobilizer sling like the Corflex Neutral Abduction Pillow Sling for Shoulder Labral Tear-L, which adds in a waist support to prevent movement. The first stage of recovery is about not stressing the repair site. This is the initial healing phase of the recovery.
  2. Stage two - Initial physical therapy. The goal here is to increase range of motion. Load bearing through the joint should be avoided to allow the repair to complete.
  3. Stage three - Increased range of motion and initial strength training. At this point, about eight to ten weeks out, the repair should be complete but not ready for full loading yet. Return to day to day activities, but not strenuous activity.
  4. Stage four - completion. At about six months out the repair should be strong enough for a return to full activity.
Portable Dual Channel Tens Unit
Physical Therapy

Going through several courses of physical therapy, I got to know the Tens Unit really well. And, I liked it! My hubby, now the ex, actually bought one for me as a Christmas present.

I used my Tens Unit so many times that the electrode pads started to feel not so sticky.

Also, I found that my hubby liked using it too. Thankfully, there was a second pair of electrodes that he used for his hairy back.

Ultimately, when I was getting my divorce, I left him that former Christmas present. And, I got myself another Tens Unit. I've actually got the Drive Medical AGF-05 one.

My Second SLAP Tear Repair Surgery

After my second SLAP surgery : lots of bruising!!

slap tear repair surgery bruising of jaguarjulie
After my second SLAP surgery : lots of bruising!!
Photo of and by JaguarJulie.

I returned to my orthopedic surgeon for a second arthroscopy after the initial SLAP tear repair. I was experiencing limited motion in my left shoulder along with extreme, grabbing pain when I would reach out with my hand in a forward motion. You know as you reach across the table to grab the salt and pepper?

It was about a year later that I went back. Once the surgeon got in there, he found lots and lots of scar tissue. He said it was like a giant spider's web. He did a lot of cleanup and then it was recovery time again for me! You can see all the bruising I experienced after that second procedure!

P.S. How I am feeling since my SLAP Tear surgeries?
A whole different story is my experience with 3 courses of PAIN management! I've been hearing more and more from people who have also experienced a slap tear and want to know what to expect.

Similar shoulder injuries are more common than one might expect. In addition to my mother, I've now got 4-5 friends who have complained of the same types of shoulder pain common to a slap tear.

What is key to recovery is PT, physical rehabilitation and constant activity and exercise. As I was immobilized for 6 weeks, I had to deal with the buildup of scar tissue that was debrided in my second surgery. IMHO, I am not 'pain free' but am 'aware' that I had shoulder surgery.

Someone asked about activity AFTER surgery. Well, I was in a fully-restricting arm brace and experienced a fair level of pain. However, after 7 work days, I returned to work--one handed mind you--and was driving myself to work probably 2 weeks after surgery. But, I didn't need to shift or work a clutch thankfully.

P.S. Maybe someday I will take the time to talk about my experience with PAIN after being diagnosed with Reflex Sympathetic Dystrophy / Disorder RSD after my shoulder surgery. I ended up needing to have 3 courses of Pain Management which was NO fun! That included a series of 3 procedures for each course along with heavy duty meds and having a HUGE needle stuck in your spine!

Going Strapless!
When I first experienced the pain of my SLAP tear, I found wearing a bra with straps was unforgiveable. I went through a lot of bras before I found one that fit right.

Over the course of my treatment, I wasn't wearing any bras with straps.

Sometimes I would wear one of my tube tops as I didn't need to ask the hubby to hook me up! Later, when I was able to use both hands, I resorted to wearing strapless bras like the Wacoal Women's Full Figure Red Carpet Strapless Bra.

Thanks for visiting!
So, have you been diagnosed with a SLAP tear? I'd love to hear about your experiences as mine seemed to drag on for a few too many years. Had surgery or therapy? What worked for you ... or didn't?

History: SLAP Tear : What is it? was originally created on Squidoo by JaguarJulie on January 11, 2008. Highest lensrank ever achieved: #878 overall. Lens #236 in the quest for Giant Squid 300 Club.

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