Shoulder injuries are common in people who lift, throw, or perform repetitive overhead motions. In some cases, damage to the cartilage in the shoulder joint may require surgical repair. SLAP repair surgery is one option when symptoms persist despite rest or physiotherapy.
What Is a SLAP Tear?
A SLAP tear is an injury to the labrum, a ring of cartilage that lines the rim of the shoulder socket. The term SLAP stands for Superior Labrum Anterior to Posterior, referring to the specific area of the labrum that is torn. This cartilage helps keep the ball of the upper arm bone securely in the shoulder joint, providing stability during movement.
Common Causes of SLAP Tears
Overhead activity: Repetitive throwing or lifting above shoulder level (e.g. in sports like baseball, tennis, or swimming) can gradually wear down the labrum.
Trauma: A sudden injury such as falling on an outstretched arm or lifting a heavy object may cause an acute tear.
Age-related wear: The labrum naturally weakens with age, making tears more common in people over 40.
Shoulder instability: Previous shoulder dislocations or chronic joint looseness can increase the risk of labral damage.
Symptoms of SLAP Tears
SLAP tear symptoms can develop slowly and are often mistaken for general shoulder fatigue or strain. Discomfort may worsen with specific movements, especially those involving lifting or reaching overhead.
Deep shoulder ache: A dull, persistent pain that feels different from typical muscle soreness often worse at night or when lying on the affected side.
Clicking or catching: A catching or popping sensation during arm movements, particularly when reaching overhead or behind the back.
Shoulder weakness: Difficulty lifting or throwing, sometimes accompanied by a feeling that the shoulder may “give way.”
Pain down the arm: Discomfort that may radiate into the upper arm, sometimes mistaken for nerve irritation or muscle strain.
Indications for SLAP Repair Surgery
Most SLAP tears are first managed with non-surgical treatment, such as physiotherapy, rest, and anti-inflammatory medications. Surgery is typically considered when these measures fail to relieve symptoms after several months.
SLAP repair may be recommended if you experience:
- Persistent pain that limits daily activities and does not improve after 3–6 months of conservative care
- Loss of function affecting work, sports, or essential movements like lifting or reaching overhead
- Active lifestyle demands, particularly in younger patients aiming to return to high-impact or overhead sports
- Tear patterns unlikely to heal on their own, especially in younger individuals with good tissue quality
The SLAP Repair Procedure
SLAP repair is typically performed using arthroscopic (keyhole) surgery, a minimally invasive technique that uses a small camera and specialised instruments to access the shoulder joint.
Minimally invasive approach: The procedure is done through 2 to 4 small puncture sites, avoiding the need for a large open incision.
Labrum reattachment: Small anchors with sutures are inserted into the bone to secure the torn labrum. These materials are usually absorbable and do not need to be removed.
Anaesthesia and pain control: The surgery is performed under general anaesthesia, often combined with a nerve block to reduce pain immediately after the procedure.
Same-day discharge: Most patients go home the same day, but you will need someone to accompany you and assist for the first 24 hours.
Recovery Timeline and Expectations
Recovery after SLAP repair is structured in phases to protect the shoulder and restore movement. Most people recover within 4 to 6 months, though this may vary.
Weeks 0 to 6: A sling is used to protect the shoulder. Gentle pendulum exercises may start around week 2 or 3.
Weeks 6 to 12: Passive range of motion exercises begin. A physiotherapist moves your arm without using your muscles.
Months 3 to 4: You begin active movement and strengthening exercises to rebuild shoulder stability.
Months 4 to 6: Sport-specific drills or physically demanding tasks are reintroduced. Most patients return to full function by 6 months.
Conclusion
Most people recover well after SLAP repair, with reduced pain and improved shoulder function. Returning to full activity takes time, guided rehabilitation, and consistency.
If you continue to experience shoulder discomfort or limitations, consult an orthopaedic and hand specialist for further evaluation and care.
