SLAP Lesion?


#1

Has anyone had any experience with SLAP lesions? My son may be suffering from this. We won’t know for a couple of months. That’s the soonest we’ll be able to get in to see an ortho specialist.


#2

My sixteen year old son just had shoulder surgery two weeks ago to repair his SLAP II Lesion Labrum Tear. His doctor is Ted Schlagel of the Denver Steadman Hawkins Clinic here in Denver. They are the Orthopedic Surgeons for the Broncos and Rockies and are the best in this Region.

He tore his labrum last Spring, rehabed it all last Summer and Fall, pitched this Spring and hurt it again the last game of the Spring Season.
Surgery was his only option if he wanted to continue to pitch. They drilled three acnhors into the bone behind the labrum and then sutured the labrum to the anchors. His rehab and recovery time will be between 6-9 months. So far he is doing very well and is a bit ahead of schedule. The success rate for this type of surgeries on pitchers is around 85%.

Do a GOOGLE on SLAP II Leasions and you will pull up several articles that can explain it in more detail than I can. The orthopedic Surgeon can only be sure it is a SLAP tear once an MRI is done. Basically it is a tear of the labrum, most commonly where the biceps tendon attaches to the labrum. If you want to be sure of what is going on be adamant about getting an MRI or else you will spends months or years trying rehab and guessing what is going on in there.

Good luck and I would be happy to answer any further questions you may have.


#3

Thanks tfree. I’ve done a bunch of searching and reading and have found some good info. It sounds like it could be SLAP because of a “clicking” feeling but, as you know, diagnosing takes more than the physical exam. He’s saying that since he’s been more strictly adhering to the physio routines, he’s noticed an improvement. I’m hopeful that this means it’s not an avulsion but maybe just an inflammation of a tendon that will heal.

An interesting thing from one site (
http://images.google.ca/imgres?imgurl=http://www.shoulderdoc.co.uk/images/uploaded/biceps_heads.jpg&imgrefurl=http://www.shoulderdoc.co.uk/patient_info/article.asp%3Farticle%3D559&h=327&w=248&sz=17&hl=en&start=4&um=1&tbnid=B4s5Vzg1ts-zJM:&tbnh=118&tbnw=89&prev=/images%3Fq%3Dbiceps%2Btendon%26svnum%3D10%26um%3D1%26hl%3Den%26sa%3DX
)
is that the cause can sometimes be when the humerus is moved inward, it pulls on the biceps tendon, which goes over the head of the humerus and attached to the scapula at the top of the labrum, and that pulling brings the top portion of the labrum with it.

Could this happen during the deceleration portion of the delivery? That would be at the extreme end of deceleration? Has anyone really researched how throwing can cause the labrum to pull away from the scapula?


#4

Yes. Based on what our Doctor explained to us the biceps contracts during the deceleration phase of the delivery. The harder the pitcher throws the more violent the contraction. This is why virtually all PTs and orthopedic surgeons really focus on and promote scapular strengthening excercises to help those muscles absorb more of the load during the deceleration phase. I don’t know of any specific study that validates this.

It is my opinion that certain mechanical flaws that cause a pitcher’s arm to be left behind when he reaches foot plant also contributes to biceps tendon/ labrum issues as those tissues get over stretched during the excleration phase and over time weaken making them more suseptable to injury during decleration. My son’s arm action could best be described as the “inverted W” and his arm was not in the high cocked position at foot plant. No amount of instruction, expaination or slow motion video was enough to convince him to correct this flaw as he was toping out at 84 at 15 years of age. Therfore I was not surprised when this injury occured.

Now, at sixteen, post surgery, he has committed to altering his mechanics.


#5

FYI- Current research suggests many SLAP lesions are a result of the ‘peel-back mechanism’ created at extremes of the arm-cock position during throwing. The tension and twisting of the biceps tendon peels the tendon from the labrum or the labrum from the glenoid. The deceleration or traction mechanism proposed earlier has questionable merit.

Just ask if you’d like further information…