Shoulder
Lesion slap
by Uperform
This name comes from English and means “Superior Labral Antero-Posterior Lesion”. This lesion therefore corresponds to damage to the upper part of the labrum, and is often associated with the tendon of the long biceps.
1) A LITTLE ANATOMY:
The scapulohumeral region is made up of 3 bones: the clavicle, the scapula (or shoulder blade) and the humerus. Its mobility is ensured by a musculotendinous and ligament complex.
More specifically, the shoulder joint includes the head of the humerus, and the end of the scapula, called the glenoid. The latter is covered with the glenoid pad, also called the labrum, whose role is to establish contact between the two bony parts and stabilize the joint. The long biceps tendon also attaches to this labrum.
2) WHAT IS THE “SLAP” LESION?
This name comes from English and means “Superior Labral Antero-Posterior Lesion”.
This lesion therefore corresponds to damage to the upper part of the labrum, and is often associated with the tendon of the long biceps.
Following a traumatic event, the labrum undergoes a tearing, and the long biceps can be brought to break.
3) WHAT ARE THE LESION MECHANISMS?
The causes of this type of injury are multiple:
The age of the subject increases the rate of lesions of the labrum, the latter tending to be damaged with wear.
Violent trauma, which can come from two types of incidents:
A fall on the palm of the hand, elbow extended, causing compression of the humeral head
Violent and repeated throwing movements, typical of certain sports (volleyball, tennis, baseball)
Repeated shocks induced by certain sports such as boxing
4) WHAT ARE THE SYMPTOMS?
Following one or more traumatic events (the most frequent), this lesion leads to:
More or less intense pain during certain movements of the shoulder
A sensation of snapping and/or discomfort in the shoulder
A feeling of shoulder instability
A loss of strength in certain movements
5) IS IT SERIOUS?
The importance of the lesion can vary, ranging from the tearing of certain fibers to the complete tearing of the labrum and the complete rupture of the tendon of the long biceps.
In order to classify the pathology, the SLAP lesion has 4 stages of severity ranging from the least serious (stage 1) to the most severe (stage 4). This is a major injury, which will require professional follow-up.
The diagnosis is then based on the clinical examination carried out by the practitioner, which generally makes it possible to determine the severity. This is confirmed by medical imaging (arthro-scanner, arthro-MRI).
It is interesting to note that from one case to another, the physical handicap as well as the pain can vary. For example, some victims manage to move their shoulder almost normally, while others will have to keep it immobile or suffer intense pain.
It is all of these examinations that will determine the severity as well as the therapeutic approach, whether surgical or not. The healing time also depends on the size of the lesion, its location and the speed of treatment.
6) IS SURGERY AN OPTION?
Surgical treatment can be offered to sports and/or active patients. It allows to reduce the immobilization time, a faster recovery and a reduced recurrence rate.
However, in most cases, conservative (and medical) treatment is nevertheless proposed in order to hope for results via a non-invasive solution.
The decision to operate or not will therefore be made following a discussion with the orthopedist in charge of your case.
7) HOW DOES THE REHABILITATION TAKE PLACE?
Conservative and post-operative treatment are similar on many points.
It will start with an immobilization of the shoulder to allow time for the tendon to heal.
Respecting the healing process, the work will then focus on:
Recovery of normal joint amplitudes
Gradual rehabilitation of the joint
Global and specific muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athleticization and rehabilitation in the sporting gesture
8) CAN I CONTINUE TO TRAIN?
In the event of a SLAP lesion rupture, it is generally essential to stop sports activity initially in order not to aggravate the situation.
Consulting a health professional then makes it possible to determine the procedure to follow in order to return to your sports practice as quickly as possible in complete safety.
9) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!