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Instability & Sports

SLAP Tears

Superior labral tears and treatment in athletes

Understanding SLAP Tears

SLAP lesions involve the superior labrum where the biceps tendon anchors to the glenoid. They commonly occur in overhead athletes (baseball, tennis, volleyball) due to repetitive stress, or from acute trauma like falls or traction injuries.

Snyder Classification:

Type I
Labral fraying, biceps anchor intact. Most common. Usually managed conservatively.
Type II
Biceps anchor detached from glenoid. Most surgically significant. Requires repair in symptomatic patients.
Type III
Bucket-handle tear, biceps intact. Can cause mechanical symptoms. Excision of unstable fragment.
Type IV
Bucket-handle tear extending into biceps. May need repair or tenodesis depending on biceps involvement.

Treatment Algorithm

Conservative First (3-6 months)

• Activity modification (avoid aggravating movements)

• Scapular stabilization exercises

• Rotator cuff and core strengthening

• Posterior capsule stretching

Surgical Options (If Conservative Fails)

Age <35, Active Overhead Athlete: Arthroscopic SLAP repair with suture anchors

Age >35-40 or Low-Demand: Biceps tenodesis (excellent results, more predictable)

Degenerative/Type I: Debridement alone

1. Snyder SJ, et al. SLAP lesions of the shoulder. Arthroscopy. 1990

2. Boileau P, et al. Arthroscopic treatment of isolated type II SLAP lesions: biceps tenodesis as an alternative to reinsertion. AJSM. 2009

Last Updated: January 2025 | Content reviewed by Dr. Deepthi Nandan Reddy, FRCS (Ortho)

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