SLAP tears in the shoulder are common among manual laborers

A superior labral tear from anterior to posterior, or “SLAP tear,” is among the most missed diagnoses of serious shoulder injuries in North Carolina. Each year, workers suffer from these tears —causing sudden shoulder pain or incapacity.

As Johns Hopkins Medicine explains, SLAP tears do not heal on their own, and they do require surgery to correct. At best, a significant SLAP tear will leave a worker down for eight to 12 weeks; at worst, it can leave them with permanently frozen or incapacitated shoulders.

SLAP tear

SLAP tears are tears of the labrum, which is cartilage in the shoulder that holds the joint in its socket. The labrum can tear completely off the bone after a dislocation or traumatic event, or it can tear along its edge during aging. However, SLAP tears occur specifically on the labrum where the biceps tendon attaches to the shoulder.

These tears can occur during a traumatic event, but they can also tear slowly over time due to overuse. These injuries are common in workers who perform frequent throwing, shoulder rotation or overhead lifting activities as a part of their job.


Because these injuries are deep inside the shoulder joint, they can be extremely difficult to diagnose. In fact, even X-rays and MRIs can miss them, and often the only way a doctor can know for certain whether a tear exists is by opening the shoulder and inserting an arthroscope, an optical instrument, into the joint to examine it. Still, seasoned experts know to look for certain indicators like a popping sound during shoulder rotation.

A small tear can be minor, and many workers continue to function normally with pain killers or other noninvasive treatments, but a serious tear can completely debilitate a worker or end a career. Even mild tears can worsen over time, so workers should not ignore them.

Treatment and prognosis

Cartilage essentially has no regenerative potential in adults, so since these injuries are tears to cartilage, SLAP tears do not heal with time, rest or treatment. They do require surgery to repair.

The typical recovery time after surgery is eight to 12 weeks, but this time frame will depend on age and physical condition, how serious the injury and repair and the commitment to physical therapy during recovery.

These injuries are difficult to diagnose.  To get them covered in North Carolina, the worker must have an identifiable “injury by accident” when the injury occurred.  The worker, as soon as he or she realizes that the shoulder has been injured, needs to carefully take note of all the circumstances leading up to the moment of injury.  Anything that interrupted the ordinary or normal work routine and caused the injury, can be the “accident.”   The “accident” is often a subtle detail, but that detail is critical to getting the injury covered.   An insurance claim adjuster may deny or dispute a claim, if the worker does not disclose all the little details that constitute the “injury by accident.”   Many claims are lost for this reason.   Workers do have the right to appeal a denial to the Industrial Commission, and if the tear is work-related because of an interruption of the normal work routine, then we would have something to work with on your appeal.

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