SLAP & Labral Tears
The labrum is the cartilage rim that deepens the shoulder socket. A SLAP tear involves the top of the labrum where the biceps attaches — a common source of deep shoulder pain in throwers and active adults.
What is a labral tear?
The labrum is a ring of cartilage around the socket that deepens it and anchors the biceps tendon. A SLAP tear (superior labrum, front-to-back) involves the top of the labrum at the biceps anchor. A Bankart tear at the front and bottom is linked to instability and dislocations. Tears can come from throwing, a fall or traction injury, or gradual wear with age.
Symptoms to watch for
- Deep shoulder pain, often with overhead or throwing motions
- Catching, popping, or a clicking sensation
- Loss of throwing velocity or control in athletes
- Sometimes a sense of looseness or instability
How it is diagnosed
Labral tears are notoriously hard to see on a standard MRI. An MRI with contrast (an MR-arthrogram) gives the clearest picture, combined with an exam using specific provocative tests.
Treatment
Many SLAP tears — particularly degenerative ones in adults — respond well to physical therapy that strengthens the cuff and shoulder-blade muscles, along with activity modification. When non-surgical care fails, or in younger athletes, arthroscopic treatment is effective: repairing the labrum, or in some cases securing the biceps tendon (tenodesis) depending on the tear and the patient. Bankart tears with instability are treated with labral repair.
Deep shoulder pain with overhead activity?
Learn about labral repair, or schedule an evaluation.
Common questions
A SLAP tear is at the top of the labrum where the biceps attaches; a Bankart tear is at the front-bottom and is associated with instability and dislocations.
It depends on age, activity, and the tear. Many degenerative SLAP tears do well with therapy; younger athletes and instability-related tears more often need surgery.
Many athletes return to throwing, though it takes a dedicated rehabilitation and throwing program. Return depends on the specific tear and how it is treated.
Recovery after labral surgery generally spans several months, with sport-specific return later. The recovery pathway lays out the timeline.
This page is for general education and is not a substitute for an in-person evaluation. Your specific diagnosis and treatment plan should come from Dr. Hachadorian based on your exam and imaging.