Should you try surgery or rehab for a SLAP tear of the shoulder?

Many people suffer injuries where there are several treatment options, and the patient must decide what is best for him or her. In this Ask Dr. Geier video, I discuss a specific injury in which surgery isn’t always the only treatment option – a SLAP tear, or superior labral tear, of the shoulder.

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Nick asks:
What do you think about an athlete that has a labrum tear of his shoulder? Would you suggest to a player to have the surgery, or is rehab a better option? It seems that the opinions I receive are mixed.

The labrum is the cartilage bumper along the rim of the glenoid, or the socket, of the shoulder. It helps to provide stability to the shoulder. It can be injured when a young athlete suffers a shoulder dislocation. Pitchers and other overhead athletes often injure the superior labrum as well.

SLAP tears are also common findings in adults that have shoulder pain. Sometimes these labral tears can cause pain or catching deep within the shoulder. Other times, they are incidental findings. MRI can demonstrate a SLAP tear of the shoulder, but as I discuss in this video, these can be common findings in adults with no shoulder pain at all. Therefore, a trial of physical therapy can often be a good first step for many patients with shoulder pain.

Please remember, while I appreciate your questions, I cannot and will not offer specific medical advice by email, online, on my show, or in the comments at the end of these posts. My responses are meant to provide general medical information and education. Please consult your physician or health care provider for your specific medical concerns.

[DrDavidGeier]

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[ionzaifu]

I was diagnosed with a SLAP tear and got only surgery as an option from the doc. Toughed it out for 3 months, got full mobility, and after 6 months was in the gym lifting weights, as I was pain free. I sometime get slight pain when training hard chest or shoulders. I get popping noises in the bad shoulder in certain movements. Hope i don't agravate the injury, i'm not afraid of the surgery, but the recovery.

[DelDrew]

Injured my shoulder 3 months ago doing Hammer Strength rows at the gym. I tried rest & inactivity for 6 weeks but the pain/discomfort/loss of mobility/instability didn't get any better. Decided to finally see an orthopedist and get a MRI which revealed a type II SLAP tear from 10 o'clock to 1 o'clock. He suggested surgery (biceps tenodesis due to my age, I'm 46) as an option if PT doesn't help. My followup appt with the doctor is in 4 weeks. A seasoned PT at my job has SLAP tears on both shoulders and told me that under no circumstances should I consider surgery for it. I've read so many articles, testimonials, message boards etc over the past week that I don't know if I'm coming or going. This has all gotten so confusing. All I know is that I just want back normal (or as close to normal as I can get) use of my right shoulder and give zero shits about being able to lift weights again at this point. But I don't want to go under the knife unless I absolutely have to. So I'm going to take the trainer's advice and be patient & consistent with PT using fitness bands & doing range of motion work to strengthen the shoulder and see how it goes. He told me it can take 6 months or longer. If he could do it then I guess I can too. Everyone else who's suffering with this has my sympathies.

[neilkirst]

I suffered a shoulder injury playing tennis. Had som pain and discomfort. Enough to visit the Dr. Dr gave me a choice of MRI or PT. The cost was $2, 600 for MRI due to equipment compatibility with stents (another story altogether). So I am trying PT. Exercises helping with strength and range of motion. Too early to tell if this is the "solution" but it is certainly worth trying before MRI and or surgery.

[ms-hihs]

Great video, I'm going to live with my slap tear (type 2)for as long as I can. I'm a 52 y/o Male been karate, boxing, lifting, running and worked hard since I was a teenager. You said what my doctor said to day, , , , It's not going to get worse so I will get fixed when I cant do what I'm doing now

[riteshtandon]

I was diagnosed with SLAP injury 10 months ago. I did PT for about 2 months, it alleviated the pain to some extent but it came back to the prior-PT levels within a month. The MRI showed inflammation in labrum but no clear tear (they did not use the dye). Based on the movement tests, the surgeon thinks it is a labrum tear and is suggesting surgery. I am not sure if I should go for surgery but there doesn't seem to be any better options. Honestly, the pain is not too bad and doesn't interfere with my daily life (not an athlete). It's bad on some mornings and having an ice pack on the shoulder for 10 min relieves it to the level that I don't feel it at all that day. After reading about the possible complications (or no benefits) after surgery I am thinking of toughing it out without surgery. The surgeon himself indicated about 60% chance of reduction in pain after SLAP surgery.

[JayJay-nhch]

Did physical therapy for my SLAP tear, helped a bit but pain is still there. Im 24, athlete in great shape, and a correction officer - furthering my career to be a police officer, therefore I chose to go with surgery for fixing my SLAP tear. A week out from surgery today and all I am nervous about is the physical therapy afterwards... i want to progress the best I can so I can pass my fitness tests!

[cindykey]

I had rotator cuff repair and slap repair about 7 years ago. I recently injured the same shoulder. I had an arthro MRI yesterday. Still don’t know the results. My pain is worse since the MRI. How common is it to reinsure the same shoulder after previous surgery

[RichRobinson]

I partially subluxed my right shoulder behind my back in a weird gym incident 3 years ago. I did extensive rehab and it slowly improved but mundane incidents (putting on a backpack) would set me back months of progress and the pain gradually got worse. Following an MRI, I've just been told that I have a LARGE SLAP tear of of my lebrum and the letter I've received from the Orthopaedic Surgeon says they are looking at "arthroscapy +/- labral repair stabalisation". No wonder it's been such a struggle to rehab! I've not been able to train even remotely as hard as I used to. Can't wait to get my shoulder back!

[deborahturner]

I'm 54 and very fit and active. Based on my physical exam and xrays, my doctor believes I have a labral tear in my right shoulder. He initially wanted to order and MRI coupled with a sonogram and inject dye to confirm his diagnosis. I asked if we could try something less radical to start with. So, he gave me a steroid injection yesterday and a therapy band with prescribed exercises. He said we might get lucky and this problem could only be tendonitis. I have had this problem for 1 1/2 years. I will go back in six weeks and we will reassess. My question is if I do have a tear and I do have surgery, will someone like me at my age really benefit and be able to go back to my regular arm and shoulder workouts with further problems? Or, if my best bet just to continue substituting bothersome exercises with ones that do not aggravate my condition. Thanks.

[cichlidfrontosaguy]

I'm currently going through my second week of PT. It seems it may be working just a little. My shoulder pain wakes me up about 4, 5, or 6am. There's not any position that I can put my arm. That's even with PT. I'm scheduled to see my doctor in a few weeks. If PT doesn't work after next week I may discontinue services until my doctor visit. There's no need to waste money if it's not improving or the pain is still there.

[Mcleod]

I was diagnosed with mri with having a slap tear in my shoulder from weightlifting in the gym.. I have been training even with the injury I must admit certain exercises are out of the question, but when this happened I couldn’t do push-ups due to the pain... Without any kind of therapy other than my weight training I can now do push-ups again with no pain and it seems some of my strength is coming back.. This has been over the course of about 3 months so we’ll see if time will heal it!! I’m also 48 yrs old and have become a gym rat.. My Dr suggested no weight training but that was out of the question, but in fact I feel better after a good workout over not having workout at all!!

[michaeldooley]

Please point me to any source that might help! I had both shoulders with Slap repairs over one year ago (four months apart) I struggled with escalating pain and impingement issues which I did not have before surgery. I am far worse off now than before. A recent contrast MRI shows tendonosis of each rotator cuff tendon as well as a significant Slap tears and moderate glenohumeral arthritis in both shoulders. I believe there was something about the capsules which were not dealt with that led to a struggle with everything prescribed to me including PT. I now cannot feel stable in any position and do indeed feel constant pain, especially if I do anything other than rest all day. The surgeons don't seem to want to acknowledge anything missed on their behalf. In addition I also received three corticosteroid shots in each shoulder over a one-year period. Each time I had any local anesthetic with lidocane, xylocaine or buprivicvane I have experienced increased pain and a sense that my shoulders are falling off. I was an active happy person all my life, and now I consider more unacceptable options to finish this nightmarish ordeal.

[harshal]

I had a fall last November and my should was injured after MRI following are the analysis : I have a Glenoid Labrum torn from 1 to 4 o'clock position. Hyperintense singal is also noted i superior Labrum-SLA2-tear The long head of biceps tendon is normal. Rest of Glenoid labrum and articular cartialage is intact. Cortical irregularity is noted in naterior aspect of glenoid without significant flattering. The acromion is of Type II. Mild acromioclavicular arthrosis is seen. There is mild glenohumeral effusion. Visualised bones appear normal.
I have taken physiotherapy for 3 months and some of the pain is some positions have gone. but now the remaining pain still exits. My Physio have told me that I cannot push anything above my shoulder by I can puul. I can do anything below shoulder level.
I want to know if I join GYM and exercise, which exercises are not to be done and which are to be done on light weights until other muscles get strong and support the shoulder.
OR
Surgery is required?

[trucksdeluxe]

I’m FREAKING OUT! I’m a 45 year old surfer and I’ve had shoulder pain for 18 months and it just keeps getting worse. If I try to rest my shoulder gets worse, if I go to the PT or try to rehab it my shoulder gets worse faster.

Atm I can’t sleep or do any kind of exercise. My arm locks up with a pinching pain right on the top of my shoulder which radiates into my arm and neck.

I had a MRI which revealed a fairly large SLAP tear. I’ve seen 3 shoulder surgeons who tell me that SLAP tears are fairly normal in someone my age and that it’s likely that the tears is not the cause of my pain. I have booked in with the top surgeon for shoulder surgery in which he’ll go into my shoulder to have a look and potential repair the tear.

Has anyone else has a similar experience with shoulder pain?

I have the surgery booked for a week from today but I don’t want to do it if it’s going to be a waste of time or potentially make my shoulder worse.

[familyguyrocks]

I was diagnosed with a slap tear, and I haven't had an MRI done, the Army doesn't want to waste the money, I'm in physical therapy, no improvement. should I push the docs to do surgery?

[namansapra]

Hi David,
I probably have a slap tear. I got MRI done but still it's not clear. I'm very confused whether to go for a surgery or not. I can even send you my MRI report. Please suggest.
Thanks!

[kpbergey]

I had SLAP tear surgery and it ruined my shoulder permanently, wished I never did it. Had it done 6 yrs ago and had to have 2 more to fix that horror surgery. AVOID SURGERY AT ALL COSTS!

[smashu]

If my Shoulder is constantly poping out of the socket and I manually place it back in the socket does it damage the labrum ?? because I may do this 30 time in a day...Second Question do you tink prp or Stem cell could rebuild the labrum ??

[vinasmj]

I'm 52 years old I just had a bucket tear It's only been 5 days Very little pain I can move my shoulder Around 70% Waiting to start physical therapy next week...thank for the information...🇺🇲👍🏻