In part one of this two-part article, Chris Mallac explains the essential anatomy and biomechanics of the biceps anchor, how and why injury occurs, and how to diagnose an injury.
Chicago White Sox starting pitcher Dylan Covey (68), 2018. Credit: Kamil Krzaczynski-USA TODAY Sports
The SLAP lesion was recognized as being a definitive clinical entity after the development of shoulder arthroscopic interventions(1). SLAP is an acronym for ‘superior labral tear from anterior to posterior,’ and the term ‘SLAP’ lesion refers to a particular shoulder injury that affects the long head of the biceps anchor to the glenoid labrum.
The understanding of the pathophysiology behind SLAP lesions has progressed greatly since the advent of arthroscopic shoulder surgery. Previously, with open-shoulder surgery, it was difficult to visualize the superior labrum and biceps attachment, resulting in unknown, missed, and poorly understood SLAP lesions.
Although injuries to the superior glenoid labrum are uncommon(2), an injury to the superior labrum and biceps anchor can be a source of deep shoulder pain, and it is frequently seen as an overuse injury in overhead athletes and baseball pitchers. If left untreated, a SLAP lesion can have devastating consequences for the overhead athlete in terms of pain, dysfunction, and loss of power in sports.
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