Superior Labral Anterior Posterior Tears | Everything you need to know about SLAP tears!
ฝัง
- เผยแพร่เมื่อ 29 พ.ค. 2024
- In this educational video we take you through what SLAP tears are using our 3D anatomy model, explore mechanisms of injury, discuss how SLAP tears are managed and how Physio rehab can help.
References:
Scott E. Powell, Keith D. Nord, Richard K.N. Ryu. (2012). The Diagnosis, Classification, and Treatment of SLAP Lesions, Operative Techniques in Sports Medicine, Volume 20, Issue 1, Pages 46-56. doi.org/10.1053/j.otsm.2012.0...
Clark, R. C., Chandler, C. C., Fuqua, A. C., Glymph, K. N., Lambert, G. C., & Rigney, K. J. (2019). USE of CLINICAL TEST CLUSTERS VERSUS ADVANCED IMAGING STUDIES in the MANAGEMENT of PATIENTS with a SUSPECTED SLAP TEAR. International journal of sports physical therapy, 14(3), 345-352. doi.org/10.26603/ijspt20190345
Papadopoulos Pericles, Karataglis Dimitrios, Boutsiadis Achilleas, Charistos Stavros, Katranitsa Lamprini, and Christodoulou Anastasios. (2012). SLAP LESIONS. EPIDEMIOLOGICAL STUDY, Orthopaedic Proceedings 2012 94-B:SUPP_XXXVII, 558-558
Ahsan, Z. S., Hsu, J. E., & Gee, A. O. (2016). The Snyder Classification of Superior Labrum Anterior and Posterior (SLAP) Lesions. Clinical orthopaedics and related research, 474(9), 2075-2078. doi.org/10.1007/s11999-016-48...
Brockmeyer M, Tompkins M, Kohn DM, Lorbach O. (2016). SLAP lesions: a treatment algorithm. Knee Surg Sports Traumatol Arthrosc;24(2):447-55.
doi.org/10.1007/s00167-015-39...
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![SLAP Tear Rehab Explained [WORKOUT INCLUDED]](http://i.ytimg.com/vi/Z2agRYd6FFE/mqdefault.jpg)
![SLAP Tear Rehab Explained [WORKOUT INCLUDED]](/img/tr.png)
Dude, you are an incredible teacher! I'm a long time athlete who played at pretty high levels and you explained these details better than any of the trainers I had in my career. Thank you!
Thank you so much John-Carlos! That’s very kind of you 🙏🏼 Hope we can keep helping you!
😂
جزاك الله خيرا دكتور خالد
Thank you for the detailed video with the visual representations. Your video was much more useful than any other videos out there. Please continue your great work.
Glad it was helpful! Kusunum Balázs!
As a very new physio still trying to put everything together, your videos are an absolute life-line. Thank you so so much for taking the time to make them!!!
You’re so welcome Rebecca! I’m so glad you are enjoying them! We have loads as well on instagram @clinicalphysio if you want to follow us there!
I'd like to thank you from the bottom of my heart for your wonderful videos. I had an MSK exam today, and because of your content, I was able to pass. MSK is my weakest subject and has been a major source of anxiety for me, but everything you release is so easy to disseminate. I was given a shoulder scenario where I had a SLAP tear as my differential and was able to talk at length about it thanks to you. You're an absolute star, and I hope this channel continues to grow.
Congratulations Lisha!! This is absolutely wonderful news and I’m so pleased to hear how well you did! Huge credit to you and we are very grateful to have played a small part in your journey! Well done!!
Thoroughly and engagingly explained! Thank you!
You’re very welcome!
Thank you. Rare to get quality posts like yours.
Thank you so much for your kind words!
Thank you so much for the detailed explanations, along with the evidence-based findings!
You’re very welcome!
Most helpful video on this subject I've seen to this point---thanks!
Thank you so much!
You have the gift of teaching. Very structured thinking.
Thank you so much!
Awesome video, people pay for this level of education, thanks for delivering such a great lecture!
Thank you so much Adam that’s very kind of you!
Just got my MRI indicating Superior labral tear, extending into anterior labrum.
Thank you for the neat explanation! 🙏🏼
i just got today my mri scan same as you superior labral tear how is your shoulder now?
@@mustimustafa3759did you get into PT?
@@mustimustafa3759Is surgery required?
Excellent explanations and appreciate the references to academic papers.
Glad it was helpful! Thank you for watching!
Wow, these videos are so good. Thank you for sharing
You are so welcome! Thank you so much for your kind words!
Fantastic video and great review.
Thank you so much! Very kind words!
Keep Going Khalid One of my favorite Physio Channel.
Thank you so much for your kind words!
Great video for revision. Your condition specific n differential diagnosis video are really helpful.
You’re very welcome! Thank you for watching!
great information
Thank you so much!
Very well presented!
Thank you so much!
This lecture was really really informative 😃 Thank you so much 😊😊
Most welcome 😊 thank you for watching!
My compliments Sir 👏 Not only are you knowledgeable, but you also know how to teach and explain. A very rare combination. Once again, well done 👍
So nice of you! Thank you for watching!
Awesome information. Currently working on my third rotator cuff surgery.
Thank you so much for your kind words! Wish you all the best with your surgery!
thanks for the video, it is very informative without being too technical. I will pass this on to patients suffering from a SLAP lesion.
Thank you so much Dr!
Hi,I've had an X-ray and ultrasound of my right shoulder, then 12 months later, a mri the ultrasound showed two small tears in my rotator cuff however did pick up a labral slap tear until i had the mri scan done then the slap tear was seen so I have type 3 tear. I've had symptoms over the past 15 months, and I've gradually gotten worse. I've had rotator cuff repair on my left shoulder, too.
I've been doing exercise physiotherapy since surgery back in February 2022 and before that and developed capsulitis, which has put recovery back a bit. However, now the right shoulder issue my specialist surgeon has recommended surgery to repair the labram. However, the bicep tendinitis, hasn't been mentioned when I've spoken to my surgeon, so I'll definitely talk to my doctor about this. Your video explains this quite clearly. Oh, and my background. I'm 51 and have been working in a truck parts warehouse for the past 20 years now, and there's a lot of heavy repeative lifting.
Great video cheers, Col 👍
Thank you for the video. I appreciate your time and effort putting into these videos. I recently have been reading some studies as they relate to the treatment of SLAP tears. There was a small RTC study using bone marrow concentrate (BMC) and platelet-rich plasma (PRP) as a treatment modality. It's potentially a safer and more robust way to address the injury compared to the standard treatment we currently offer.
Thank you so much for your messages and interesting to hear about these options!
Really excellent
Thanks a lot! Very kind of you!
Very informative! Thank you so much!!
You’re very welcome!
Really good video. Thank you
Thank you so much!
Brilliant channel.
Thank you so much!
Best explanation I’ve come across. I don’t have an official diagnosis yet as my mri is in several weeks, but I’m in agony. Suffering since October. Can barely move my arm. It feels as tho it’s coming off of my body when I do move it. I can feel it subluxing 😢 lots of expletives to describe it but I never fell on it extended. I did however slam right in it from falling on ice about 12 years ago. Went to PT then and it healed nicely. Didn’t have any tears back then. This is awful and I’m going out of my mind. Interrupted sleep… tried PT and can’t do it. I do not know what I did. Just woke up in pain. And it hasn’t stopped.
Fantastic video, thankyou so much. I've had this for 10yrs, and only one dr is now diagnosing it. Have always been told it's impingement.
🙏🏼🙏🏼🙏🏼 wish you all the best!
Great informative video.
Thank you so much!
Geez, so in-depth, but also digestible and easily applied. Out of all the tests, I had no pain, though I still have rear delt pinching after a meso of upper body training. I'm going to work with the suggested band exercises at the end of the video. Thanks for your help!
Thank you so much for your kind words!
@@ClinicalPhysio Anytime.
what do you mean by rear delt pinching?
@@sonic-fm1gw sharp muscle pain in rear delt in abduction
Great video you are very articulate. I'm a young athlete who's experienced dull but deep shoulder pain for almost two years. It has prevented me from playing tennis and other shoulder intensive activities in any significant capacity. I am excited to start my journey to repairing my shoulder.
Thank you so much John! Wishing you all the best in your recovery!
THE most comprehensive video on SLAP tears I've seen to date. You've reassured me that there are things I can do whilst awaiting further diagnosis. Thank you so much!
Thank you so much for your kind words my friend!
Is surgery required?
Great video
Thank you so much!
Thank you Khalid
You are the best 😇
Thank you so much for your kind words!
thank you, very helpful video 👏
You're welcome!
12-14-22. Best vid so far!! Mot my injury but very informative!! and EXCELLENT SPEACH with fantastic explanations!!
Had stage 3 Acronium separation!
Surgeon was worthless-physio people WERE WORTHLESS!!
Can’t anyone DO ANYTHING CORRECT!!??
Thanks for a good vid!
Thank you so much my friend for your kind words! Wish you all the best with your shoulder 🙏🏼
Great stuff. Thanks.
Glad you enjoyed it! Thank you!
Thank you for this
You are very welcome!
Thank you so much....such a great video.....I love Clinical Physio.....can you pls make some videos on lumbar / thoracic / cervical spine....I have some difficulties to really understand some of the nerve related pathologies and how to gradually treat/mobilize them right.....that would be so cool.....
Hi! Thank you so much for your message! Absolutely we have lots of assessment videos on this in our TH-cam channel, but also we have LOTS of webinars on our website at clinicalphysio.com with even more info on those kind of subjects and more!
Wow, good lecture.👌
Thank you so much!
Thank you for this throughout explanation. I suffered a stage 2 SLAP tear to my left shoulder in summer of 2017 from trying to start a VERY stubborn lawnmower. I did some shoulder stretches afterwards to see if it would improve my pain. It only increased my pain by 100%. I felt a spider web of pain to the front of my shoulder. Then afterwards I couldn't raise my arm up above my head. I spent 3 months in an arm sling. Every step I took KILLED my shoulder. Riding in a vehicle was also extremely unbearable. I later developed long head bicep tendinitis due to the SLAP tear. I've had nearly 6 years of on and off extreme pain. Then had surgery late January for another issue. It was mandatory that the BP cuff be placed on my left arm dispite my pleas of having bicep tendinitis. My BP was taken 5x that day for surgery. Been living with level 8-10 front shoulder pain since then. Can anyone explain why having a BP taken 5x cause injury to an already damaged and repaired tendon?
Great Great Video! Thank you 🙏
Thank you so much for watching
What a fantastic video, Khalid, thank you!! After over-use at the gym (likely doing Arnie presses!) 6 months ago, and ignoring it, I was recently diagnosed with SLAP lesion by my orthopedic surgeon and had many visits at my physio. After about 6 weeks (and prescription anti-inflammatories), the constant pain has been slowly subsiding - but every now and then it will flare up again. I'm 40.
One thing I noticed was the three preferred tests for high degrees of diagnosis. In each of them (except the supinated O'Briens test) I felt almost no discomfort (like 1 out of 10). MRI however has shown it as a slap lesion - Type 1 or 2, the doctor said. I will be going in for a contrast MRI to better show any lesion in the area. My strong preference is not to get surgery, so I'm trying to rehab as much as possible.
I'd love to get any further recommendations for rehab exercises (including good form) that you can think of. I often find myself needing to mentally engage the right muscles as using the resistance bands sometimes causes me to just use my bicep/tricep instead of posterior rotator cuff.
Once again thank you so much for this video, it really helps spread the knowledge and clearly articulates the terminology!
Hi Mark! Thank you so much for your message! I’m really pleased to hear that all tests gave almost no discomfort! I must admit I would be a hypocrite if I was to give clear advice over the internet as a therapist/doctor/clinician who is able to see you in person and assess you is much better than me guessing over messaging… but a few things to think about, 1) SLAP lesion on a scan can be an incidental finding I.E. it is on the scan, but is it actually causing the symptoms?…… 2) You can absolutely avoid surgery if you it isn’t causing a huge issue to you and your pain levels ….. 3) once again, to prevent hypocrisy, please may I recommend you get specific exercise advice from someone who can fully assess you for the right exercises. Sorry to not give specific advice, but I would much prefer, for your sake, that you get advice specifically from someone who can assess you rather than me guessing at exercises over the internet 🙏🏼 wish you all the best!
@@ClinicalPhysio is the superior and posterior labrum at the posterosuperior aspect of the humerus? what are the structures commonly involved there?
also what are the symptoms the slap should be producing?
Informative vid!!! Hope you can get to radial head fracture soon!!! Keep it up!!!
Thank you!
Informative. Nice video :)
Thank you so much!
Thank you!
Thank you so much!
Amazing Video, very informative and perfectively presented. Love it. (Just had a SLAP repair myself, 8 weeks post surgery)
Thank you Rob! Wish you all the best for your recovery!
Is the operation laparoscopic?
Thank you for the great video! I just had our athletics PT tell me I injured my labrum and gave me most of the exercises to do that were listed here. This video helped me understand and made me feel a lot better about it.
🙏🏼🙏🏼🙏🏼 very kind thank you!
Is surgery required?
Excellent video, any update on the research regarding stem cell therapy for these injuries?
Wow, this video is such a great help and so informative. Thanks a lot. At least I have no problems with the first two biceps exercises, but pain within the third test. But the other way round, no pain while thumb goes down, but deep pain, while palms show up. 🤷🏻♂️
And also deep pain while reaching the arm in front and than rotating it in both directions like holding a bottle and kipping it out and than turning in the other direction.
You’re very welcome! Wishing you all the very best with your shoulder 🙏🏼
Much Gratitude
Thank you so much! Glad you enjoyed it!
Thank you.
You’re very welcome!
Brilliant!
Thank you so much!
Wow! Awesome breakdown. Articulate, precise and very easy to understand. Subbed immediately.
Just what I needed after my type 2 SLAP Tear and biceps tendinitis diagnosis today!
Thank you so much! Wish you all the best!
How are you now?
Excellent video! Very thorough, very clear, evidence based, very well explained.
Glad you liked it! Thank you so much!
What an incredible and clear description!! Subscribe!
Thank you so much!
I need your advice :)
A week ago I was doing pec cable flies from slightly below shoulder level, lightweight (12 kg either side) really slowly, controlled, focusing on the stretch.
I was allowing my arms to go back a lot at the end of the eccentric.
And, third set, 12th rep, I heard a subtle pop.
Accompanied by a strange sensation.
Not pain, or very little pain.
It was more like a sensation of ease.
As if my right shoulder joint had found a better location and it could move more freely.
I have always had limited mobility in my right shoulder accompanied by pain both on internal and external rotation limits.
So yes - first I thought it was a “good pop”…
But when it came to train the biceps, I realised a strange gap between my felt and the long head of my biceps.
I could still contract it, but it felt out of place so I stopped. I also noticed a slight yellowing right under my front delt where my bicep used to start, but now there is a slight gap.
Went to emergency room and was told it’s a tear but it would heal on its own.
Dismissed in 10 minutes.
Having replayed it in my mind, what I believe happened, was a shift of the upper tendon. It simply feels as if that long tendon no longer runs in the groove at the top of my humerus, instead it moved a couple of centimetres forward and internally.
What do you think,
And what should I do?
I really want to keep my functionality of my body, you know… I’m quite worried.
Theodor
i give this lesson a 10/10!
Thank you so much for your kind words!
what do you think about the recent studies that came out explaining how the labrum has a rich blood supply?shouldnt this result in a greater healing capability?@@ClinicalPhysio
Nice video 🎉
Thank you so much!
I got a slap tear and can’t get the surgery since I can’t miss the amount of work to recover. The doctor said I could live with it but it was an option. Great video!
Same here
Insane to live in a world where you cant get sick leave to fix a damn shoulder
Cheers man, great teacher. Helped me understand what my specialist was saying lol.
You’re very welcome! Thank you so much for watching!
This vid is amazing 👏
Thanku sir 🙏 👍
Most welcome! Thank you!
Great video! Would you ever consider making a video on FAI and labral tear conservative physio management?
Hi Amy! Thank you so much for your message! Yes absolutely, we have a long list of things to do and certainly hip related stuff is one of them!
Thank you for this video! I'm curious, what's the reasoning for the Arnie press?
I’m really adverse to the western medicine idea or just doing surgery for every injury. Are there any types of treatments like acupuncture or something that have been effective for this injury?
Thank you for this full explanation 👍 If I understood well, the pain is on shoulder, if I have only pain on the biceps this is probably not a SLAP. I feel pain and weakness on one biceps and after mri the doctor thinks it's a slap tear, I will see a shoulder specialist soon.
Wish you all the best Pedro!
Hey thanks for the superb detail.
The start of my shoulder injury started from one tennis session after not playing for a long while. Started booming serves because i just missed it so much haha. Next few days had the normal soreness around the teres area but once that soreness went away, a dull ache kicked in (infra area. Pec area only when i do runs). I reduced my arm activity a lot to not aggravate it but the dull ache continued and I started to notice i get a painful shoulder clunk when i bring my arm down from a fully flexed position (arnold press hurts from end positions to initial). Its been a year already now. Both of that symptoms are still there but with physio i dont limit my arm movement as much anymore and my strength definitely came back. Have yet to take an MRI but do you think the two symptoms i have is related to over doing it on the tennis serves during that session? Technically is not a traumatic one but a tennis serve can be considered traumatic haha. But anyway, just from this explanation alone, do you think there's definietly a tear?
Hi Pascal - to answer your question, “No, I’m not totally convinced you have a SLAP tear”. But also, it’s important for me to say that it’s wrong to give you a diagnosis over the internet… please please seek advice with an assessment with a local clinician so you can get more accurate information 🙏🏼
Hi Doc. Awesome video. I have a question. What about PRP treatment for a grade 1 tear? Thanks
Hi John! Thank you so much for your message… Honest answer I haven’t seen many successful or evidenced based research suggesting that PRP is a good option
I had an injury wake boarding. Being pulled while my wake board was dragging. I think I over did the bicep muscles. I have been dealing with some pain for 5 months when I finally went in to the doctor to really figure it out. Got an MRI and doctor said I had a SLAP tear. He recommended tenodesis surgery. I basically have full range of motion but I do feel pain in extreme positions and I feel a bit of soreness still on the top of my bicep. Seemingly coming from the tendons. I tried to do the tests you showed on your video to myself and didn't experience pain. After what you stated about MRI tests I'm now a little sceptical that I have a SLAP tear. This injury has been more annoyance with sharp pains but it has gotten better over the 5 months. My surgery is scheduled in 5 days. And now I'm conflicted whether it's necessary. Would you recommend a second opinion or physical therapy before I do the surgery? I tried to do some of my own physical therapy after my injury but never did completely heal. Hard to know what to do.
What about lifting weights again without undergoing surgery, I have no pain while sitting , only a slight discomfort while I do some specific mocment of my arm in a specific angle, I was diagnosed with slap type 2 lesion a year ago, can I go back to to lift heavy weights without surgery and also do weight body excerszies (pull ups , push ups) Thanks
Thank you for detailed break down. I have two questions please. 1. If someone has a bicep tenodesis done, the labrum is still torn correct? if so, what happens to the labrum? Is there an issue having it still torn after a bicep tenodesis? 2)I am 40 yr old male with slap tear (grade 2?). I dont have much pain, my only issue is I probably have about ~90% arm strength, is it worth having surgery for this? I like to go to the gym and do karate.
Sir excellent 👍
Thank you so much!
Big Fan of your Channel Khalid! Kindly make a video on Paediatric MSK conditions..Thanks!
Thank you so much for your kind words! We actually have a full webinar run this month by a specialist orthopaedic consultant and specialist Paeds physio! This can be found at clinicalphysio.com/live-webinars
@@ClinicalPhysio Thanks!
hi can you please tell me if we have slap tear or THROWERS SHOULDER R POST LABRAL R SHOULDER without operation ?
Can you make a video on how to understand biomechanics and apply it on patients by showing us the exact mechanism what happens in the body
Thankyou and great videos 🔥
Thank you so much!
Thank you for your analytical explanations!
One question: when someone is clinically diagnosed with a slap tear but the MRI doesn't show it, is it possible that this type of tair is type I or II, excluding the types III and IV?
Thank you
Doc how about nerve entrapment due to slap tear suprascapular nerve
This is so helpful thank you! Please what would you expect to see during the objective AROM, PROM and resisted tests? Would SLAP patients show weakness or any pain during particular PROM? Thank you
Hi Louisa! If a lower grade then mild restriction in AROM and potentially PROM, and I would expected resisted biceps to be sore. In more higher grades or severe cases I would probably expect more restriction and potential for other resisted tests including rotation to be sore, particularly if rotation is tested in outer ranges 😊 However, there isn’t necessarily a “one size fits all” with this and so would focus on subjective + tests as able 🙏🏼
I had reparative surgery for this. It was endoscopic. But the imaging was the most painful thing I’ve encountered thus far in my life. The imaging was unbearable the length and positioning they had me in. And the contrast dye seemed like it was making my entire joint expand.
I also had a distal biceps tendon rupture on that same side. It was repaired with an endobutton surgery. This happened before my slap tear.
Now I have awful forearm and hand pain numbness and burning in both hands.
Wishing you all the very best my friend
Thank you, Doc. I passed those tests. This isn't my problem. I think I have bicep's tendinitis
No problem! Wish you all the very best!
I'm positive for the first and third test.
Oh man, I'm 30 and have been struggling with a bad shoulder for the past 7 years.. had to give up muay thai and cant lift heavy like I used to. Been to some physio and was given some pointers, but over the years I've also explored my body with movement. Some of the movements you recommended I intuitively incorporated, like the straight arm pull down and Arnie press. I also like to lie on my back and with even just 5lb dbs do a lat pull over. But I'm going to I corporate the other motions you suggested, hoping they help!
Wishing you all the best!
You are awesome. Thank u.
I got my shoulder dislocated during football i fell down was in sliding motion on chest, i placed my hand to stop but it got internally rotated and pressed by my bodyweight since then whenever i throw something really hard it again gets dislocated and recovers automatically after 5 min.
Pain was strong .
Also since then i lifted shoulder pressed really heavy but having no problem only when i throw something or get jerk the shoulder again gets dislocated. Is there any permanent solution ?
Great video. I’m currently in physical therapy for a suspected slap tear of my left shoulder. What a “wonky” feeling! Clicking and clunking was pretty bad but seems to be lessening with treatment. I’m 52 and pretty active. My biggest concern is the possibility of a full long bicep tendon rupture occurring.
Wishing you all the very best with your physio! One step at a time 🙏🏼
Hello, how is the treatment going?
Hello Doc, I have hypermobility joints and 3 dislocation(Bankart Lesion) on right and 2 on left mainly due to rugby and my just profound condition , I am now 21 and have decided to retire from rugby, I am not fond of surgery, can I know whether the shoulder labrum tear can heal on its own by time?
Need help can i avoid surgery?
RI of the shoulder was performed, using axial volumetric GRE or CISS, axial fat-saturated proton density; coronal oblique T1, fat-saturated T1, and fat-saturated T2; and sagittal fat-saturated proton density.
FINDINGS:
Labrum: There is a labral tear extending from the superior labrum into the posterior and posterior inferior labrum. There is a 4 x 5 mm defect in the posterior to posteroinferior glenoid articular cartilage consistent with a reverse GLAD type
injury.
Along the mid and superior margin of the posterior labrum there is contrast curving posteriorly along the glenoid which may reflect a component of reversed Perthes-type injury. The remainder of the anterior and inferior labrum is maintained. As
suggested previously, there is a small posterior
Hey - question: I was at a physical therapy session getting treated for some underarm pain. One of the initial stretches I did made a very loud pop in my shoulder. No pain was associated with it but my shoulder has been popping 4-5 times per day since, and this was over 2 months ago. I got an MRI which found a SLAP tear. I don't know if I am type 1 or 2. Do you? I don't truly have pain in my shoulder by the popping concerns me and makes me limit what ways I move my shoulder. Let me know!
How long after your injury should you start exercising?
Hi Khalid I have a question and I'm not sure if you'll see this but I'm gonna give it a shot anyway. Have you found if there is a greater risk for SLAP or Rotator cuff injuries in patients that have Ehlers Danlos syndrome or those that have a hypermobility syndrome? And what did the recovery look like with them if you have encountered them?
This was incredibly informative and well done, thank you. What is your opinion on using mesenchymal stem cells for SLAP tears?
Very kind of you! Thank you 🙏🏼 my honest answer is I don’t have much of an opinion on them but I very rarely see this being used in practice, which I suppose just suggests to me that they may not have a lot of evidence behind them
I had an MRI and Dr. told me there was Increased labral signal which may represent a tear. I have a weird nerve sensation across my pec muscle now too when I move it certain directions. Thoughts?
Could snapping in the shoulder be caused by biceps tendon being inflamed? The 3 tests presented in this video were negative however I feel discomfort when I do standing internal rotation with a band. Also raising the injured arm straight up in an attempt to make my biceps come in contact with the ear causes pain (impingement?)
is doig bicep curls in an externally rotated, supinated position a common way for slap injury?
Do you know where in Type 1-4 the following tear would grade? From the MRI report:
Mild joint arthrosis seen acromioclavicular joint.
Mild tendinitis/tendinopathy is seen supraspinatus and infra spinatus tendons.
Long head of the biceps tendon and biceps labral anchor are intact.
There is an anterior superior labral tear from 1:00 to 4:00 position.
There is a small posterior labral tear identified.
The middle glenohumeral ligament shows abnormal signal intensity compatible with tear.
No articular cartilage thinning is seen in the glenohumeral joint.
The inferior glenohumeral ligament is intact.
I think this occurred 4-5 months ago when I did a creative pushup against the corner of a bookcase, and then I tried to do pushups again that night normal on the floor and pain started. Took 2 weeks off then pain again when I tried to do pushups. Then a month later still pain only during pushups. Switched to only swimming and that worked for a while but by November I was getting dull ache preventing me from sleeping, a soft tissue-like click when I raise my arm, and now shaking (possibly from atrophy). I'm wondering how much hope I should place in PT (i.e. it's type 1) or if it's Type2-4 and I should be preparing to save money for surgery. FWIW I saw an ortho about this this week and he basically said "do physical therapy for a month to make a case for surgery". I was in so much shock I didn't get to ask any questions he just walked right out and said he had a lot of patients to see. I'm also wondering if the presence of 3 different types of tears suggests more likelihood of surgery.
Hi Doc! Thank you for your informative videos. I study a lot from your channel since all the videos are well explained and easy to understand. From this video about the diagnosis of SLAP lesion, the study said that it is much better to do arthroscopy than MRI (because 87.5% of the cases missed diagnosing SLAP lesion) and the rehab for this depends on the grade of the injury. Since arthroscopy is quite invasive, and from the combination of those 3 special test we can early diagnose the SLAP lesion, I want to ask, is there any signs that we can use to differentiate and predict the grade based on physical examination only? Thank you
Hi Jessy!! Nice question thank you so much! I suppose we are likely to find that your higher grades of SLAP tears are going to be even more symptomatic - but I would suggest a clinician is less likely to be able to say “that’s definitely Grade 3” or that’s definitely “Grade 4” with clinical examination alone. Hope that makes sense 🙏🏼
Riddle me this: After throwing around 2400 lb of soil bags (I've been lifting heavy weights for 18 yrs now,) 5 days later I had right shoulder discomfort (3 wks ago now.)
If i forcibly ADDuct (elbow flex 90°) my arm INTO my vehicle's arm rest, my shoulder discomfort is completely relieved. Hmmm.... I've r/o rot cuff because it neither produces weakness nor reproduces my pain. Also the pain is so nebulous that I can't tell exactly what structures are involved so at this point, (but lat insertion and bicipital tendon are pinpoint sore) I'm stopping short of X-ray or MRI. My DDX right now is the beginning of inflammatory arthritis to the right shoulder or a possible labral tear. Does this forceful adduction against an immovable object which relieves my shoulder pain give you any indication the bells and whistles going off in your head?
Hello Doctor, I am a cricket player fast bowler. but from last
7-8 months I have been suffering from shoulder pain.There is always a clicking sound in my shoulder in any type of movement. While bowling I don't feel any kind of pain, but it pains too much while throwing the ball. Recently I've done the MRI it's shows i have a slap team which is clocking 11 to 12' O clock and There is separate tear of the anterior inferior labrum which takes the form of a Perthes lesion. Labral tissue is torn from the glenoid rim but remains attached to the periosteum. Stripping of the periosteum along the anterior inferior glenoid. I have no pain or discomfort at all except throwing, i can do everything without any pain but i want to get my throw back. What do you suggest me to do now and how big my tear is in term of grade.
Thank you.