When Shoulder Pain Is A SLAP In The Face
No shoulder pain is ever welcome but there is a specific type of shoulder injury that’s a real slap in the face. Actually, it’s a SLAP in the shoulder—a Superior Labral tear from Anterior to Posterior—which means the top portion of the labrum is torn from the front to back. (The labrum is a thin ring of cartilage that deepens what is otherwise a very shallow bony surface on the shoulder blade side of the shoulder joint. It adds stability to the joint without being as rigid as bone.) The labrum is often torn as a result of trauma but can also occur as a result of repetitive motions (think overhead athletes).
When the labrum is torn, there is a loss of stability but not to the extent that the joint dislocates. People may often notice new or unwanted clicking or clunking of the joint, accompanied by a deep shoulder pain and difficulty performing activities in which the arm must be slowed down quickly (like the follow-through of a throwing or swinging motion). Sometimes, if the labrum is torn just so and slips into the joint, people can experience a sensation of joint locking. A frequent complaint is discomfort with lifting objects straight out in front of you or bending your elbow to lift objects as one of the two heads of your biceps begins right where this tear is and pulls on the tear—ouch!
We usually suggest some movement you can perform to see if this is what you might have, but there is no good self-test that is reliable. It’s a subtle thing even for us to try to provoke in the clinic. But, if you have symptoms similar to the above that are not debilitating, you can try to stabilize the shoulder by strengthening your rotator cuff with the exercises on page 3. If your symptoms don’t start to improve within 2-4 weeks, you may require professional help and need to come see us.