Slap Lesion (labrum injury)

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INJURY TITLE

Slap Lesion  (labrum injury)

 

INJURY OVERVIEW

Injury to the cartilage of the actual shoulder joint.

 

INJURY IN-DEPTH INFORMATION

The labrum is an attachment site for a lot of different structures in the shoulder (ligaments, joint capsule, Biceps tendon).  The function of the labrum is to increase the stability of the joint so if it gets injured there are obvious consequences for the stability of the shoulder joint.

 

Because of a relatively poor blood supply, the part of the labrum where the biceps tendon attaches is prone wear and tear type injuries.  That said, injury is usually coupled with a memorable event, carrying or catching a heavy object or lifting a heavy object over head.  The biceps tendon is important in providing support to the front of the shoulder and this is detrimentally affected if the labrum is injured.

 

The labrum can tear in any direction but some tears are more common than others.  It is common for the Superior (upper part) Labrum to be torn from Anterior (front) to Posterior (back).  This is catergorised as a SLAP lesion.  This can be further catergorised into stable and unstable (if the tear is large enough to remove a lot of the tissue and the bicep tendon away from the joint).

 

COMMON SIGNS & SYMPTOMS

  • Poorly localised pain in the shoulder
  • Pain on overhead lifting
  • Pain on placing hand behind back
  • Can be associated with other injuries like dislocation.

 

HOW IS IT ASSESSED

There are a number of clinical tests for this injury.  None of them in isolation are good enough for a firm diagnosis but are reasonably reliable when used in conjunction with a thorough verbal assessment and other clinical tests.

 

MRI is the imaging of choice but some evidence has found the clinical tests to be more accurate in this diagnosis.

 

 

 

GENERAL TREATMENT

Conservative management is only good for the minor labrum tears.  Usually an arthroscopic surgery is needed to correct the fault and rid the joint of any further irritants.

 

Because of its association with poor shoulder stability, a good rehabilitation program is key here.  Basic shoulder exercises to strengthen the rotator cuff and readdress bicep strength without placing too much stress on the injured site is needed.

 

Exercise Videos: i.e.

  • Rotator cuff strengthening
  • Pec stretch
  • etc

 

WHICH HEALTH PROFESSIONAL TO CONSULT

PHYSIO     X

MEDIC     X

PODIATRY     

 

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