What Is a SLAP Tear?
A SLAP tear (Superior Labrum Anterior to Posterior) is an injury to the superior labrum of the shoulder — the ring of fibrocartilage that deepens the glenoid socket and anchors the long head of the biceps tendon. SLAP tears are complex shoulder injuries requiring careful diagnosis because not all require surgery, and aggressive conservative care produces excellent outcomes in many cases — particularly in the active adults and recreational athletes we serve from Shadyside, Lawrenceville, Bloomfield, Squirrel Hill, Oakland, Highland Park, Point Breeze, and Regent Square.
How SLAP Tears Happen
Acute Trauma
- Falling on an outstretched arm (FOOSH) — the most common acute mechanism
- Sudden traction on the arm — catching a heavy falling object
- Shoulder dislocation or subluxation
Repetitive Overhead Loading
- Throwing athletes — from the peel-back mechanism during late cocking phase
- Swimmers — from repetitive overhead pull-through
- CrossFit athletes — from kipping pull-ups, muscle-ups, and overhead pressing
- Overhead workers — painters, electricians, drywallers
Symptoms
- Deep, aching shoulder pain that is difficult to localize
- Painful clicking or catching with overhead movements
- Pain and weakness overhead, particularly at end range
- A sense of instability or "dead arm" in throwing athletes
- Pain with biceps loading (supination against resistance)
SLAP vs. rotator cuff: SLAP tears more commonly produce a deep catching sensation with overhead movement and pain with the O'Brien test. Rotator cuff pathology more commonly causes lateral shoulder and upper arm pain with resisted abduction.
Conservative vs. Surgical Treatment
Not all SLAP tears require surgery. Key factors: age (older patients respond better to conservative care), activity demands (recreational athletes often avoid surgery), tear type (Type I fraying rarely needs surgery), and associated pathology. Multiple studies show non-operative management succeeds in the majority of patients who are not competitive overhead athletes.
Our Conservative Treatment Approach
Dr. Crockatt's PT program restores dynamic shoulder stability through rotator cuff and periscapular strengthening, reduces provocative biceps anchor loading, and progressively reintroduces sport-specific demands. Dr. Foltz and Dr. O'Mara address cervical and thoracic dysfunction contributing to abnormal shoulder mechanics.
We provide clear guidance on safe activities during rehab and when surgical consultation is warranted. Serving Pittsburgh's active community from Shadyside, Lawrenceville, Bloomfield, Squirrel Hill, Oakland, Highland Park, Point Breeze, and Regent Square.
Treating Patients from Across Pittsburgh's East End
Pittsburgh Physical Medicine is at 5916 Penn Ave in East Liberty — minutes from Shadyside, Bloomfield, Lawrenceville, Squirrel Hill, Oakland, Highland Park, and Point Breeze. We're in-network with UPMC Health Plan, Highmark BCBS, Aetna, and United Healthcare.
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