SLAP lesion test | Physiotherapy after a SLAP lesion

SLAP lesion test

The symptoms of a SLAP lesion can often be variable. The diagnosis should be confirmed by a test and also by imaging. The so-called biceps load test is a suitable test.

For this test, the patient’s arm is moved from a supine position into a 90° spread position. The elbow is flexed and the palm of the hand points to the head (supination position). In the final position, the patient should now actively try to bend his elbow against the resistance of the examiner.

This tenses the biceps and the long biceps tendon, which runs through the shoulder joint, can cause pain in a SLAP lesion. A defensive tension is also to be expected in the final position. The biceps load test can also be performed in a second slightly averted form. Both tests have good evidence. Sick patients can be diagnosed by the test while it is negative in healthy patients.

SLAP lesion – OP

Surgery for a SLAP lesion can vary and depends on the type of injury. In case of slight tears and fibrillation of the labrum, simple arthroscopic smoothing may be sufficient. In this case, the cartilage threads are ground off and the joint surface is restored as physiologically as possible.

If the cartilage lip is torn, a suture can be applied. Cartilage tissue is nourished by pressure and traction and heals poorly on its own. The cartilage lip can be repaired with a suture.

Torn off, non-reconstructable fragments, which occur, for example, in the case of a so-called basket handle tear, can be removed arthroscopically in order not to disturb the joint mechanics. Subsequently, a smoothing of the joint surface and the cartilaginous lip takes place here as well. In the case of concomitant injuries to the biceps tendon attached to the labrum glenoid, this can also be sutured.

If the attachment of the biceps tendon at the labrum glenoidale is severely damaged, surgical stabilization is absolutely necessary. If a suture does not provide sufficient stability, it may be necessary to relocate the attachment of the biceps tendon. Depending on the course of the operation, immobilization of the shoulder joint may be necessary for several weeks. Simple cartilage smoothing can usually be immediately reloaded.