What exactly causes SLAP/labral tears? What exactly causes SLAP/labral tears?

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Thread: What exactly causes SLAP/labral tears?

  1. #1
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    Default What exactly causes SLAP/labral tears?

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    For the sake of injury prevention, I think it's important that we know what causes a SLAP tear, since it appears to be somewhat common

    It is relatively known what movement causes shoulder impingement, mainly flaring out the elbows on the bench press.
    However, it seems to be less obvious what causes labral tears. The mainstream wisdom is that “overhead athletes” are prone to labrum tears. This is probably true for throwing sports, where SLAP tears are very common, and I think this has been extrapolated without evidence to weightlifters because they “overhead” press, even though the motion is obviously very different from throwing a ball or playing tennis.

    When browsing studies, the closest evidence I could find was probably this:

    In the 1980s and 1990s, it was thought that SLAP lesions resulted from a traction injury to the biceps tendon predominantly as the biceps aided in decelerating the arm late in the throwing motion.1 Later, Burkhart et al theorized that the pathogenesis was a peel back injury mechanism primarily due to adaptive anterior laxity of the shoulder capsule with posterior capsular tightening. Lax anterior tissue allows for the anterior translation of the humeral head during the throwing motion, which impinges the articular portion of the rotator cuff against the posterosuperior glenoid labrum. Chronically, this pushes the biceps-labral complex medially, detaching it from the glenoid rim.21,22 These pathogenic mechanisms have been studied in biomechanical and cadaver models. Many studies show that the biceps-labral complex is under maximal tension during the late cocking phase of throwing, while the arm is abducted and maximally externally rotated
    from: Surgical management of superior labral tears in athletes | OAJSM

    This does not necessarily sound like anything that occurs during the starting strength lifts, or really any common lift. However, hockey players are also known to get SLAP tears, even though they also do not do the above mentioned movement AFAIK. Labral tears also occur in some weightlifters, the numbers are unknown, but anecdotally they appear to be somewhat more common than in the general population. I'm also considering chinups to perhaps bear some danger as they pull on the bicep tendon, which is connected to the labrum, perhaps especially if you come down into a dead hang with a bit too much velocity, this is just a theory of mine though.

    Does anyone perhaps have insight on what might be responsible for SLAP tears (especially in weightlifters)?

  2. #2
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    I'd be more curious to know what causes this level of self-absorbed anal retentiveness.

    Just quit as you said you would or follow the advice you've been given already instead of trying to use this forum to feed your psychodrama.

  3. #3
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    Quote Originally Posted by tiny&mighty View Post
    I'd be more curious to know what causes this level of self-absorbed anal retentiveness.

    Just quit as you said you would or follow the advice you've been given already instead of trying to use this forum to feed your psychodrama.
    Regardless of my personal situation, dont you think its important to know what it is exactly that causes this injury?

    For impingement, we know what to avoid. We dont really have a clue how to avoid SLAP tears, I think a lot of people can be saved a lot of misery if we did.

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    Quote Originally Posted by gadsie View Post
    Regardless of my personal situation, don’t you think it’s important to know what it is exactly that causes this injury?
    No, it's not important. It's only important to you, because you have a history of shoulder injury, which is why you're getting the responses here that you are. But in the grand scheme of things, it's not important.

    Why? Because it's such a rare injury that it doesn't even rise to a the level of concern worthy of your neurosis about it. How rare is it? Looking at a relatively recent study on the the diagnosis and repair of SLAP injuries in the US, in a 10 year period, of the approximately 55 Million that filed a medical claim, approximately 330,000 had a SLAP diagnosis. That's just 0.006% of those that filed a medical claim. Of the approximately 330 Million living in the US, that's 0.001% of the population. As far as medical issues go, that's a rounding error. Again, it's important to you because of your history, but that doesn't mean that it's actually important.

    Quote Originally Posted by gadsie View Post
    For impingement, we know what to avoid. We don’t really have a clue how to avoid SLAP tears, I think a lot of people can be saved a lot of misery if we did.
    Would they? Even if the information was out there on how to avoid a SLAP tear, they would still happen. Just look around you. There's plenty of advice on how to avoid a long, slow death brought about by obesity and smoking, yet here we are.

    Honestly, at 54, I've never heard of SLAP tears before you started posting about it. And I'll likely not think anything of it again after I post this. And that's not because I don't have shoulder issues (I do), but the best way to avoid them in the future is to get your shoulders stronger. Period. Focus on good form and adding weight to the bar.

    As far as your concern about this one little thing, perhaps it's a good opportunity to address how you are responding to your situation. It's not that your SLAP tear (undiagnosed at that) exists, but your creation of a worst-case future completely shaped by this undiagnosed issue is consuming you. If this is how you're responding to a niggling pain at 24, you've got a long, uncomfortable, miserable life ahead of you. Hence Rip's response to you initially. One time-tested way to learn how to cope with the unexpected and the unknown is to read the Stoics and understand Stoicism, which focuses not on the events, but on how you cope with those events.

  5. #5
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    I think Rip noted in the blue book that shoulder injuries in throwers are best prevented by training the press and chins and not relying solely on the bench press to strengthen the upper body.

    You mentioned hockey. I'm guessing most if not all labrum injuries in hockey are due to impacts or falls. Think about the speeds involved and the fact that they're holding a stick that acts as a big lever. Acute injuries are harder to prevent but I'll wager that being stronger can only help.

    Did you actually get a diagnosis or are you still catastrophizing?

  6. #6
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    Thank you for your elaborate reply

    Quote Originally Posted by Bill Anders View Post
    it's such a rare injury that it doesn't even rise to a the level of concern worthy of your neurosis about it. How rare is it? Looking at a relatively recent study on the the diagnosis and repair of SLAP injuries in the US, in a 10 year period, of the approximately 55 Million that filed a medical claim, approximately 330,000 had a SLAP diagnosis. That's just 0.006% of those that filed a medical claim. Of the approximately 330 Million living in the US, that's 0.001% of the population. As far as medical issues go, that's a rounding error. Again, it's important to you because of your history, but that doesn't mean that it's actually important.
    This study accounts for 55 million americans, so that's about 0.5%, obviously still low, but it is also the general population, and only those that seek medical help for their issue. When you look at the asymptomatic athletic population, the percentage comes closer to 25%
    Unfortunately there is no data on weightlifters, but even a prevalence of 10% would be high enough to justify warning about it and looking for prevention strategies, after all, the probability of developing lung cancer after a lifetime of smoking is also about 10%.

    Would they? Even if the information was out there on how to avoid a SLAP tear, they would still happen. Just look around you. There's plenty of advice on how to avoid a long, slow death brought about by obesity and smoking, yet here we are
    I think they would. There are many many people who do not smoke because they are aware of the health risks. People that know about it but still choose to smoke make their decision, but at least you saved the "innocent people" so to say.

    One time-tested way to learn how to cope with the unexpected and the unknown is to read the Stoics and understand Stoicism, which focuses not on the events, but on how you cope with those events.
    Thanks, I will read about that.

    Did you actually get a diagnosis or are you still catastrophizing?
    I decided to go with the health insurance provided MRI, but it takes a long time, I expect my MRI to be in about 2 weeks, and then another week wait for the result.

  7. #7
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    My MRI came back clear:

    Good contrast supply without pathological leakage. No ligament injury or labral injury. Minimal degenerative rotator cuff insertions, the cuff itself is otherwise intact. Normal position of the long biceps tendon. No bursitis.
    Conclusion:
    No labrum or ligament injury.
    While sensitivity of MRI is not 100% and i have yet to look at my left (more clunky) shoulder, I must say I'm happily surprised and have to admit I was probably wrong.

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