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Shoulder Pain - SLAP Tears and Prolotherapy

S.L.A.P. stands for Superior Labral Anterior to Posterior tear. This is a tear of the cartilage lining of the socket of the shoulder. The tear in this tissue is from the front toward the back and at the top, or superior, part of the cartilage socket, or labrum. Because the long biceps tendon attaches at this socket location the injury generally includes some biceps tendonitis with some pain radiating down the arm. It is not bone or cartilage disease such as osteoarthritis and therefore, SLAP tears are much more treatable with prolotherapy. This therapy has the ability to draw cartilage growth factors to the torn cartilage for healing. In essence, the prolotherapy causes your body to "tack down" the torn fragment of cartilage. When it is successful these prolotherapy needles, along with the repositioning therapy and exercises, can help the patient to avoid a surgery for which outcomes are far from certain.

The condition is discovered and verified by MRI after the patient complains of pain and/or weakness whenever raising the arm and especially while performing a twisting motion at the same time, such as when turning a screwdriver. It is also common for the shoulder to pop or click as the patient raises the arm and brings it across the front of the body. The labrum normally stabilizes the ball of the shoulder, particularly when the patient twists outwardly (external rotation). The tear causes the ball to be less stable in the socket which adds stress and load to the rotator cuff tendons. Because of this the patient may need therapy for the rotator cuff tendinitis, but with a SLAP lesion this will not correct the actual cause. Prolotherapy should be applied simultaneously in order to prevent the injury from recurring.

The SLAP tear commonly occurs when the patient falls on an outstretched arm, although there are many sport activities that duplicate this type of trauma. Examples of sports causes all involve violent and repetitive forward thrusting of the effected arm, such as in the motion of throwing a baseball or the repeated attempted knock-out punch in boxing.

The course of therapy typically includes physiotherapy to reduce pain and inflammation while performing various recommended exercises which exclude overhead activities until the lesion is healed, along with PINS Prolotherapy at twice per week for 5 to 10 weeks.

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