What it is

A SLAP lesion is an injury to the superior labrum where the long head of the biceps anchors. The labrum deepens the socket and contributes to the stability of the joint. Injury follows traction, a fall on an outstretched hand, or repetitive overhead loading.

Many improve with rehabilitation. Selected cases require arthroscopic repair or biceps tenodesis.

What happens when it occurs

The superior labrum peels or tears. The biceps and cuff struggle to stabilise the joint under load. Strength and control restore function. Surgery is considered when pain and instability persist in overhead roles.

Common causes and risk factors

  • Falls on the hand or sudden traction
  • Repetitive overhead sport and lifting
  • Previous instability or cuff problems

Who is most affected

Throwers, overhead lifters, and contact athletes.

Typical symptoms

  • Deep shoulder pain with clicking or catching
  • Pain with throwing, pressing, or overhead lifting
  • Loss of power at the end range

When to seek care

If deep pain and catching persist or if instability feelings occur with overhead tasks.

How we diagnose

History, clinical tests, and often an MRI arthrogram are used to define the lesion. Examination also screens for cuff and instability.

Management

  • Strength for the cuff and scapula
  • Throwing or overhead volume management and technique coaching
  • Consider injections for pain control in irritable phases
  • Arthroscopic repair or biceps tenodesis when required

Rehabilitation milestones

Conservative: phases with focus on control in the end range and graded exposure to throwing.

Post repair:

Phase 1 weeks 0 to 4: sling for comfort, protected passive range.

Phase 2 weeks 4 to 8: active range and light strength.

Phase 3 months 2 to 4: progressive strength, begin interval throwing.

Phase 4 months 4 to 6: return to sport after testing.

Readiness to progress

  • Pain is low in the end range
  • Strength symmetry within 90 per cent
  • Throwing programme stages completed without the next day flare

Prevention

  • Manage season volumes with planned deloads
  • Keep external rotator and scapular strength high
  • Maintain thoracic and shoulder mobility

Australia snapshot

  • Seen in cricket, baseball, water polo, and CrossFit communities
  • Public and private services offer MRI arthrogram and arthroscopy
  • Strong outcomes with staged rehabilitation

Latest insights

Control at the end range is the currency of overhead sport.

Surgery is a path to stability for selected shoulders. Strength still does the heavy lifting.

Frequently Asked Questions

No. Many SLAP lesions settle with rehabilitation and careful load management.

Reattaching the biceps to the humerus, which unloads the labrum to reduce stress on this structure and pain, while preserving function.

After strength and control milestones are met, you complete an interval programme.

Helpful to define the lesion and plan treatment when symptoms persist.

Yes, after symptoms settle and control improves. Build load gradually.

Persistent catching with weakness or instability needs review.