SLAP Tear vs. Rotator Cuff Tear: What’s the Difference?

Shoulder injuries can be as complex as the joint they affect. There are so many different types of tissue surrounding and making up the shoulder joint, from muscle, cartilage, and bone to tendons and ligaments. Rotator cuff tears and SLAP (superior labrum anterior to posterior) tears are two of the most common serious shoulder injuries.

At Keck Medicine of USC, Orthopaedic Surgery in the Boyle Heights neighborhood of Los Angeles, California, orthopaedic and sports medicine specialist George Hatch, MD, explains the difference between rotator cuff tears and SLAP tears. 

Shoulder anatomy

The shoulder is arguably the most complex joint in the body. It’s a ball-and-socket synovial joint, and connects the humerus upper arm bone) to the scapula (shoulder blade) and clavicle (collarbone).

The glenoid fossa of the scapula forms the base of the socket. A thick “o-ring” of cartilage with a deep cup (the labrum) fits over the ball-end of the humerus. The rotator cuff is the group of muscles and tendons that wrap around the joint, letting you lift and move your arm. 

The shoulder joint is surrounded by a capsule filled with synovial fluid which makes the joint glide and pivot smoothly in multiple directions.

SLAP tears

SLAP tears occur where the biceps tendon attaches to the top of the labrum, and runs from front (anterior) to back (posterior). SLAP tears can be caused by:

• A fall onto an outstretched arm
• An automobile accident 
• Repetitive overhead motions (like those used in tennis, weightlifting, or house painting)
• Sudden and/or forceful pulling on the arm 
• Shoulder dislocation

The key symptoms of a SLAP tear include feeling like the joint locks, catches, or pops; weakness of the shoulder; decreased range of motion; and pain when moving the shoulder or arm.

Rotator cuff tears

Rotator cuff tears occur where the four muscles in the upper arm connect as tendons to the bone at the top of the humerus. The tear can be partial (only separating partway through) or complete (severing the tendon completely or detaching it fully from the bone). Rotator cuff tears can be caused by:

• A hard fall onto an outstretched arm
• A hard bodily impact in a contact sport (football or rugby)
• A jerking lifting motion while lifting something heavy (weightlifting or warehouse work)
• Wear and degeneration attributed to repetitive motions

The key symptoms of a rotator cuff tear include pain at night or when lying down; crackling sounds when the shoulder is moved; weakness in the affected arm; and pain when raising or lowering your arm past a certain point.

Treatment for labrum and tendon tears

Dr. Hatch at Keck Medicine of USC, Orthopaedic Surgery, believes in a conservative approach to SLAP and rotator cuff tears. He may recommend a combination of wearing a special arm sling, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroidal joint injections to rehabilitate your shoulder joint.

Dr. Hatch also is skilled in the use of orthobiologic treatments, which include:

• Platelet-rich plasma (PRP) injections
• Bone marrow injections
• Hyaluronic acid injections

These all use natural materials created by the body to speed healing. Surgery is typically the final resort when it comes to shoulder injuries.

Have you sustained a SLAP or rotator cuff tear injury? Schedule an appointment with Dr. Hatch by calling Keck Medicine of USC, Orthopaedic Surgery at 323-442-5860, or booking an appointment online today.