Managing Shoulder Labreal Tear- Slap Lesions with Chiropractic
What you need to know
SLAP Lesions FAQS
Tips to help your shoulder
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How do Chiropractors test your shoulder
How Do Chiropractors test for a SLAP problem ?
Speeds Test- Pain in the bicep groove
Upper Cut Test- Pain or pop in anterior shoulder
Yergasons Test- Pain over bicipital groove
Bear Hug Test
Belly Press Test
Obriens Active Compression
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Do You Need An MRI
Scans can be beneficial to diagnose a problem in your shoulder BUT
superior labral tears diagnosed by MRI in individuals between the ages of 45 and 60 years may be normal age-related findings
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What happens if you need surgery
Postoperatively, patients who underwent SLAP repair reported a larger proportion and more severe magnitude of shoulder pain during rest, overhead activities, and sleep compared with those who underwent Bankart repair
Study results indicated that patients who underwent SLAP repair experienced worse shoulder pain outcomes compared with those who underwent Bankart repair using the same anchor and surgical technique
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How Common are shoulder Tears
Sporting athletes - over 1 in 3
General population = 6%
Chiropractic Treatment
How we treat Shoulder SLAP lesions and Tears
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Non Operative Management
Patients with SLAP lesions should undergo 3 to 6 months of nonoperative management with the goals of decreasing pain, improving shoulder function, and returning to previous activity levels
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Rehab
Supervised rehabilitation should address deficits in shoulder internal rotation (IR), total arc of motion, and horizontal-adduction range of motion (ROM), as well as periscapular and glenohumeral muscle strength, endurance, and neuromuscular control.
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Chiropractic Care
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Chiropractic care includes
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Shockwave therapy
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Cupping
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Cry needling
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Scapular and shoulder joint adjustments
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What is the Shoulder Anatomy of a Shoulder Injury with SLAP
The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared with a golf ball on a tee.
The labrum is a fibrocartilaginous ring that attaches to the bony rim of the glenoid fossa
doubling the depth of the glenoid fossa to help provide stability
The superior labrum attaches to the superior glenoid by loose connective fibres and provides attachment for the long head of the biceps tendon, forming the biceps anchor. The anterior superior labrum is attached to the middle and inferior glenohumeral ligaments, and the inferior labrum is attached firmly to the glenoid by inelastic fibrous tissue
What is a Slap Lesion
What are the ways SLAP lesions Develop
Compression-type injuries half of the patient presentations were status post a fall onto an outstretched arm with the arm in varying degrees of shoulder abduction. Traction-type injuries sudden jerking movements or after lifting heavy objects , or unexpected pull n the arm Combined type injuries People who participate in overhead sports insidious onset and progressive deep shoulder pain in young athletes with the arm in the abduction and external rotation position during the late-cocking phase of throwing.
What are the signs of a SLAP Shoulder Problem
What are the signs Acute onset of “deep” shoulder pain Mechanical symptoms: popping, locking, catching with various movements and activity History of any sudden, jerking force to the shoulder with an associated onset of pain History of or current episodes of shoulder instability Common SLAP-provoking sports include but are not limited to: Overhead sports (volleyball, baseball pitchers, javelin, swimming) History or current manual/physical laborer occupations Symptom exacerbation with overhead activities Pain radiating down the anterior arm from the shoulder Clicking or audible popping reported in the setting of proximal biceps instability Pain at rest, pain at night
Which sports get SLAP Lesions
Throwing Shoulder
The term "throwing shoulder" refers to a set of functional limitations that prevent the proper function of the shoulder in athletes who perform throwing gestures, such as baseball, handball, volleyball, javelin throwing, or hitting the ball over the head, such as tennis players during the serve Other problems that can co exist with slap lesions are rotator cuff problems, biceps brachia and shoulder instability What is the cause of a SLAP Tear The hypothesised mechanism of a SLAP tear is the resultant friction created by the biceps tendon rubbing over the anterior labrum . Though treatment is often initially non-operative, those who fail conservative treatment go on to arthroscopy with either debridement, surgical repair, or biceps tenodesis
Return to Play with Shoulder Problems
SLAP LESIONS (Throwing Shoulder)
When can you return back to sport : Patients undergoing surgical or nonsurgical management of SLAP lesions should be educated to expect a patient-rated outcome (PRO) of 85% of normal function at an average of 2 to 3 years. Patients should be informed to expect 80% satisfaction within 2 to 3 years of surgery.However, the level of satisfaction was lower in overhead athletes, with 67% reporting an excellent rating. Patients should understand the need to regain 90% of ROM in order to return to full activities. However, at 2-year follow-up, limited evidence suggested that ROM deficits up to 15° may persist. Patients should be educated to regain at least 70% of strength as compared with the uninvolved side before starting a sport-specific or interval return-to-sport program.
