Shoulder Labral Tear (SLAP): Symptoms, Causes & PT Treatment
Updated July 20261 minute read
The labrum is a rim of cartilage that deepens the shoulder socket and helps keep the joint stable. A labral tear can cause deep shoulder pain, catching or clicking, and a sense of instability — common in throwing athletes and after a fall or dislocation. Many tears are managed successfully with physical therapy to strengthen and stabilize the shoulder; surgery is reserved for select cases.
What is a shoulder labral tear?
The labrum is a cartilage ring around the shoulder socket. A "SLAP" tear involves the top of the labrum where the biceps tendon attaches; other tears occur with instability or dislocations.
Symptoms
Common features are deep, hard-to-pinpoint shoulder pain, clicking or catching, pain with overhead or throwing motions, and sometimes a feeling that the shoulder is loose or "slipping."
What causes it / risk factors
Repetitive overhead throwing, a fall on an outstretched arm, a dislocation, or heavy lifting can tear the labrum. Some tears are also age-related.
How it's diagnosed
A clinician uses specific tests; MRI (sometimes with contrast) helps confirm when surgery is being considered, because labral findings are common even in pain-free shoulders.
Physical therapy treatment
What a PT does. Your therapist strengthens the rotator cuff and shoulder-blade muscles to stabilize the joint and offload the labrum, and retrains overhead mechanics. Exercises & progression (overview). Cuff and scapular strengthening, stability work, and graded return to overhead or throwing activity. Many tears respond well to a rehab trial. Recovery timeline. Conservative recovery often spans 3 months or more; surgical recovery is longer.
Treatment options compared
PT is a reasonable first-line for many tears. Surgery is considered for significant instability, mechanical catching, or athletes who don't respond to rehab — followed by PT.
Red flags
Seek prompt care for a shoulder that dislocates and won't reduce, a deformed shoulder after trauma, or arm pain with chest symptoms (emergency).
Frequently asked questions
Sources (3)
- AAOS OrthoInfo: SLAP Tears in the Shoulder. — AAOS OrthoInfo
- Schrøder CP, et al. Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial. Br J Sports Med. 2017. — British Journal of Sports Medicine
- AAOS OrthoInfo: Chronic Shoulder Instability and Dislocation. — AAOS OrthoInfo
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.