Current Concepts in the Recognition and Treatment of Superior Labral (SLAP) Lesions

Pathology of the superior aspect of the glenoid labrum (SLAP lesion) poses a significant challenge to the rehabilitation specialist due to the complex nature and wide variety of etiological factors associated with these lesions. A thorough clinical evaluation and proper identification of the extent of labral injury is important to determine the most appropriate nonoperative and/or surgical management. Postoperative rehabilitation is based on the specific surgical procedure as well as the extent, location, and mechanism of labral pathology and associated lesions. Emphasis is placed on protecting the healing labrum, while gradually restoring range of motion, strength, and dynamic stability of the glenohumeral joint. The purpose of this paper is to provide an overview of the anatomy and pathomechanics of SLAP lesions and review specific clinical examination techniques used to identify these lesions, including 3 newly described tests. Furthermore, a review of the current surgical management and postoperative rehabilitation guidelines is provided. J Orthop Sports Phys Ther 2005;35:273-291. Key Words: dynamic stability, glenohumeral, rehabilitation, shoulder The inherently complicated nature of injuries involving thesuperior aspect of the glenoid labrum can present asubstantial clinical challenge. Successful return to unre-stricted function requires integrating the appropriate diag-nosis, surgical management, and rehabilitation in a coordinated effort. The advent of new arthroscopic techniques has helped to provide a better understanding of normal labral anatomy, capsulolabral anomalies, and the pathomechanics of conditions involv-ing this structure. Likewise these techniques have also drastically improved the surgical treatment options available to successfully address these pathologies. Andrews et al3 originally described the detachment o