- SPECIALIST ORTHOPAEDIC SURGEON | MELBOURNE, VIC | ALBURY, NSW | MORNINGTON, VIC |
- 03 9421 6133
- Melbourne & Mornington VIC |
- Albury, NSW
Labral tears or SLAP lesions
Injuries to the shoulder's stabilising cartilage that can cause pain, clicking, or instability
Your shoulder joint is surrounded by a ring of cartilage called the labrum. It helps to stabilise the shoulder by deepening the socket and keeping the ball of your upper arm bone in place. It also serves as the attachment point for several important structures, including the ligaments and one of your biceps tendons.
If this cartilage is torn, whether from an injury, repeated overuse, or wear over time, it can lead to a range of symptoms, including pain, catching or clicking in the joint, weakness, or even a feeling that your shoulder is loose or about to dislocate.
There are different types of labral tears, two common ones include:
- SLAP tears – where the tear occurs at the top of the labrum near where the biceps tendon attaches (SLAP stands for Superior Labrum Anterior to Posterior)
- Bankart tears – usually caused by a shoulder dislocation and occur in the front part of the labrum
These injuries can affect people of any age but are especially common in athletes who use their arms overhead (such as swimmers or throwers), as well as people who have had a shoulder dislocation or trauma.
What causes labral tears?
A labral tear can occur suddenly from a single injury or gradually over time due to repetitive strain. Some common causes include:
- A fall onto your outstretched arm
- Lifting or pulling something heavy
- A shoulder dislocation or partial dislocation
- Repetitive overhead motion, such as in tennis, swimming, or throwing
- Natural degeneration from ageing
In many cases, people can’t recall a specific incident but notice increasing pain, weakness, or a clicking sensation over time.
What symptoms should I look out for?
A torn labrum can cause a variety of symptoms, depending on the location and severity of the tear. These may include:
- A deep ache in the shoulder
- Clicking, catching, or grinding inside the joint
- Shoulder weakness or fatigue
- Feeling like the shoulder is unstable or “slipping”
- Pain when lifting, reaching, or doing overhead activities
- Decreased performance in sport or daily activities
SLAP tears can sometimes mimic other shoulder conditions, such as biceps problems or rotator cuff injuries, which is why a careful assessment is important.
How are labral tears diagnosed?
Dr Jason Hockings will start by discussing your symptoms, medical history, and how the injury happened (if known). He’ll then perform a physical examination to assess your shoulder’s range of motion, strength, and stability.
To confirm the diagnosis, you may be referred for imaging tests such as:
- MRI with contrast (arthrogram) – This is the most reliable way to see a labral tear and assess the surrounding soft tissues.
- Standard MRI or X-ray – These may help rule out other causes of shoulder pain, like arthritis or bone damage.
In some cases, the diagnosis is confirmed during an arthroscopy, a minimally invasive procedure using a small camera to look directly inside the joint.
Can a labral tear heal without surgery?
Some labral tears, especially small or degenerative ones, may settle with non-surgical treatment. If your shoulder is stable and your symptoms are manageable, Dr Hockings or your GP may recommend a period of physiotherapy and activity modification before considering surgery. If the tear is large, causing instability, or not improving with time however, surgical repair may be the best option, particularly for younger patients or those who wish to return to sport.
What are the non-surgical treatment options?
For milder cases, or when surgery isn’t needed, treatment may include:
- Physiotherapy – to strengthen the muscles that support and stabilise your shoulder
- Activity modification – avoiding movements that aggravate your symptoms
- Anti-inflammatory medications – o reduce pain and swelling
- Cortisone injections – occasionally used to relieve pain and allow physiotherapy to progress
Your response to non-surgical treatment will help guide the next steps in your care.
When is surgery recommended?
Dr Hockings may recommend surgery if:
- You have ongoing shoulder instability or repeated dislocations
- The tear involves the biceps tendon or causes significant pain
- Non-surgical treatment hasn’t helped
- You’re an athlete or active individual with symptoms affecting performance
The goal of surgery is to reattach the torn labrum and restore shoulder stability.
If you’re experiencing ongoing pain, stiffness, or reduced movement that is affecting your daily activities or quality of life, a thorough orthopaedic assessment can help determine the cause and guide the most appropriate treatment options for your situation.