An unexpected stress to the arm such as catching a falling object, falling onto an outstretched arm, or an unexpected tug on the arm can produce an injury to the interior of the shoulder called a superior labral tear. The “labrum” is a cartilage-like tissue that lines and deepens the shoulder socket.

Symptoms of a superior labral tear (also called a “SLAP lesion”) include: pain in front of the shoulder which is made worse with overhead movement or lifting, and painful popping or catching.

A tear of the labrum can be very difficult to diagnose. Physical examination and standard MRI testing are not reliable. Injecting dye into the shoulder with MRI scanning is more accurate, but some cases require a trip to the operating room and a look into the shoulder with a TV camera (arthroscope) to confirm the suspected diagnosis.

The good news is that the labral injury can be repaired through tiny incisions using the arthroscope. In fact, because of the location of the tear, the fiber-optic arthroscope allows the surgeon to see and repair the tear much better than large-incision open surgery. Therefore, it is important that, if you suspect you may have a SLAP lesion, to see an orthopaedic surgeon who is skilled in diagnosing and treating the problem.