Shoulder injuries , while common , can be particularly complex . One such intricate injury that affects the shoulder joint is known as a SLAP lesion .

Its complexity underscores the importance of seeking professional guidance .

SLAP refers to a specific type of tear or injury to the labrum in the shoulder joint .

The labrum , a ring of fibrous cartilage surrounding the shoulder socket , plays a crucial role in stabilising the joint . A SLAP lesion occurs when there is a tear or injury at the point where the biceps tendon attaches to the labrum , compromising the stability of the shoulder joint .

Among the reasons why a SLAP injury can be a pain to both doctors and patients is because this type of injury can be challenging to diagnose and treat due to its location and the range of symptoms it can produce .

SLAP lesions can result from a variety of causes , including :

• Trauma : Direct impact or force to the shoulder , such as a fall onto an outstretched arm or a sudden pull .

• Repetitive overhead movements : Athletes involved in sports like baseball , tennis , or volleyball that require repetitive overhead motions are at higher risk .

• Age-related degeneration : As people age , the labrum can weaken and become more susceptible to tears .

MAXIMAL EXTERNAL ROTATION

This injury is peculiar to athletes who perform repetitive overhead activities because of the way the head of the humerus head rotates on the glenoid ( the shoulder joint is a ball and socket joint ; the humerus head is the ball and the glenoid is the socket ).

When the shoulder is placed in a position of maximal external rotation , the rotation produces a torsional force to the base of the biceps anchor .

It is commonly referred to as the peel-back mechanism , whereby , with repetitive movement , the labrum is peeled away from its site of attachment .

Among the symptoms experienced by patients is pain , which worsens , especially with overhead activities or

when lifting objects .

Occasionally , a catching or popping sensation could be felt deep within the shoulder joint . Other symptoms may include a reduction in shoulder movement and feelings of weakness .

These could lead to a reduction in shoulder movement and feelings of weakness .

Diagnosing this lesion could be challenging . It involves targeted patient history and physical examination to try and elicit the pathology .

Magnetic resonance imaging ( MRI ) is necessary to confirm the diagnosis , as it provides detailed images of the shoulder joint , allowing for a more accurate assessment of the injury .

Treatment for a SLAP varies . It depends on several factors , including the severity of the injury , the patient ’ s age , and activity level . Standard treatment options include either conservative or surgical intervention :

• Conservative treatment : Initially , rest , ice , physical therapy , and antiinflammatory medications may be recommended to reduce pain and inflammation .

• Surgical intervention : If conservative measures do not alleviate

symptoms , surgery may be necessary . Arthroscopic surgery is often performed to repair or stabilise the torn labrum and biceps tendon attachment . Occasionally , the biceps tendon may have to be cut .

TRAUMA OR OVERUSE

A SLAP lesion is a specific type of shoulder injury that requires early recognition and prompt management . Whether caused by trauma or overuse , the urgency of addressing these injuries cannot be overstated .

By understanding the causes , symptoms , and treatment options available , individuals can take proactive steps towards recovery and prevention of future shoulder injuries .

Seeking prompt medical attention and committing to a comprehensive rehabilitation plan is critical to successfully overcoming a SLAP lesion and returning to an active lifestyle . This commitment is key to a successful recovery .

Because this pathology can often be challenging to diagnose and symptoms may sometimes continue to persist , the SLAP lesion can feel like a “ slap in the face ”. – The HEALTH

BONE TO PICK

Dr Jonas Fernandez is an Orthopaedic Surgeon at Putrajaya Hospital . He is also a member of the Malaysian Arthroscopy Society ( MAS ).