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SLAP is an acronym for "Superior Labrum Anterior and Posterior". [1] SLAP lesions are commonly seen in overhead throwing athletes but middle-aged labor workers can also be affected, and they can be caused by chronic overuse or an acute stretch injury of the shoulder.
Over time, with enough force, a tear may develop in the labrum. The labrum is a rim of cartilage around the shoulder socket to help hold the head of the humerus (upper arm) in the joint. This condition is called a superior labrum anterior posterior (SLAP) lesion. The outcome in all these steps is the dead arm phenomenon.
In the United States acetabular labrum tears usually occur in the anterior or anterior-superior area, possibly due to a sudden change from labrum to acetabular cartilage. [2] The most common labrum tears in Japan are in the posterior region, likely due to the customary practice of sitting on the floor.
The diagnosis is usually initially made by a combination of physical exam and medical imaging, where the latter may be projectional radiography (in cases of bony Bankart) and/or MRI of the shoulder. The presence of intra-articular contrast allows for better evaluation of the glenoid labrum. [8] Type V SLAP tears extend into the Bankart defect. [9]
The glenoid cartilage underneath the labrum in the glenohumeral (GH) joint is disrupted by glenolabral articular disruption. [5] The articulation of the humeral head inside the glenoid fossa of the scapula forms the GH joint itself, which is a synovial ball and socket joint.
This is a difficult test to perform for an accurate diagnosis. [2] False positive findings can be the result of a rotator cuff tear, while pain in the superior glenohumeral region is a weak predictor of a SLAP tear. [4]
Diagnosis is typically based on symptoms and confirmed by X-rays. [2] They are classified as anterior, posterior, inferior, and superior with most being anterior. [2] [1] Treatment is by shoulder reduction which may be accomplished by a number of techniques. [1]
The combination of scapulothoracic exercises and glenohumeral exercises allow for a more effective healing process. Scapulothoracic exercises focus on movements of the scapula relative to the thoracic ribcage. Muscle groups such as serratus anterior, trapezius, and rhomboid major/minor need to be strengthened to allow for shoulder function.