Dr Puah Ken Lee 潘健理
Orthopaedic Surgeon
Shoulder, Elbow & Sports Injuries
Practising at Mount Elizabeth Novena Hospital, Singapore
Appointments by prior arrangement
Dr Puah Ken Lee 潘健理
Orthopaedic Surgeon
Shoulder, Elbow & Sports Injuries
Mount Elizabeth Novena Hospital, Singapore
✔ Subspecialty Focus in Shoulder & Elbow, Sports Injuries
✔ Practising at Mount Elizabeth Novena Hospital
✔ Evidence-based treatment, Individualised Care
What is a SLAP Tear?
A SLAP tear (Superior Labrum Anterior to Posterior tear) is an injury to the upper part of the shoulder labrum, where the tendon of the long head of the biceps attaches to the shoulder socket.
Unlike a Bankart tear, which affects the front of the shoulder and is commonly associated with shoulder dislocations, a SLAP tear involves the superior labrum and often causes pain during overhead activities.
SLAP tears are frequently seen in throwing athletes, racquet sports players, weightlifters and individuals who sustain a fall onto an outstretched arm.
Learn more about the different types of Shoulder Labral Tears.
What is the Shoulder Labrum?
The shoulder labrum is a ring of fibrocartilage that surrounds the shoulder socket.
It helps:
- Deepen the socket
- Improve shoulder stability
- Provide attachment for ligaments
- Anchor the long head of the biceps tendon
Damage to the labrum can lead to pain, clicking and instability.
Learn more about Shoulder Labral Tears.
Causes
SLAP tears may occur following:
- Fall onto an outstretched hand
- Shoulder dislocation
- Heavy lifting
- Repetitive overhead throwing
- Swimming
- Tennis
- Baseball
- Volleyball
- Age-related degeneration
Symptoms
Patients commonly report:
- Deep shoulder pain
- Clicking or catching
- Pain when throwing
- Reduced power
- Pain during overhead activities
- Difficulty lifting weights
- Pain with push-ups
- Night pain
Diagnosis
Diagnosis combines a careful clinical assessment with imaging.
Clinical examination
Your surgeon may perform:
- O’Brien test
- Crank test
- Biceps Load II test
- Speed’s test
- Dynamic labral shear test
No single test is completely reliable, which is why examination findings are interpreted together with imaging.
MRI
MRI or MRI arthrogram is often the most accurate investigation for diagnosing a SLAP tear, although interpretation can be challenging because age-related changes are common.
Types of SLAP Tears
Several classifications exist, with Type II being the most common clinically significant pattern.
- Type I – Fraying
- Type II – Detachment of the superior labrum and biceps anchor
- Type III – Bucket-handle tear
- Type IV – Bucket-handle tear extending into the biceps tendon
Non-Surgical Treatment
Many patients improve without surgery.
Treatment may include:
- Activity modification
- Physiotherapy
- Anti-inflammatory medication
- Ultrasound-guided injections when appropriate
- Progressive strengthening
When is Surgery Recommended?
Surgery may be considered if symptoms persist despite appropriate rehabilitation, particularly in:
- Young athletes
- Overhead throwing athletes
- Patients with mechanical symptoms
- Associated shoulder instability
- Failure of conservative treatment
Surgical Treatment
Depending on age, activity level and tear pattern, treatment may include:
- Arthroscopic SLAP repair
- Biceps tenodesis
- Debridement
- Treatment of associated rotator cuff tears
Treatment is individualised rather than based solely on MRI findings.
Recovery
Typical recovery includes:
| Stage | Time |
|---|---|
| Sling | 3–4 weeks |
| Physiotherapy | Begins early |
| Strengthening | 8–12 weeks |
| Return to office work | 1–2 weeks |
| Return to sports | 4–6 months |
Frequently Asked Questions
Does every SLAP tear need surgery?
No. Many patients improve with physiotherapy and structured rehabilitation.
Is a SLAP tear the same as a rotator cuff tear?
No. A SLAP tear affects the shoulder labrum, whereas a rotator cuff tear involves the shoulder tendons.
Is MRI always accurate?
MRI is helpful but not perfect. Some SLAP tears seen on MRI may represent normal age-related changes rather than the source of symptoms. Clinical assessment remains essential.
Why Choose Dr Puah Ken Lee?
Dr Puah Ken Lee is an orthopaedic surgeon in Singapore with a practice focused on shoulder, elbow and sports injuries. He has extensive experience managing shoulder labral injuries in both athletes and active adults. Treatment is tailored to each patient’s symptoms, examination findings and goals, with surgery recommended only when it is likely to provide meaningful benefit.
Related Pages
- First Orthopaedic Consultation
- Shoulder Labral Tear
- Shoulder Instability
- Shoulder Dislocation
- Rotator Cuff Tear
- Shoulder Surgery
- Return to Sport After Injury
For a full overview of shoulder conditions, visit Shoulder Specialist Singapore
Dr Puah is regularly invited to teach shoulder surgery internationally
Specialist Care for Shoulder Injuries in Singapore
Dr Puah is an orthopaedic surgeon specialising in shoulder, elbow and sports injuries. He provides personalised care tailored to each patient’s condition and activity level.
Consultations are available at Mount Elizabeth Novena.
If you are experiencing shoulder pain that is affecting your daily life or sports, early assessment can help guide appropriate treatment.
Book a consultation or contact the clinic to discuss your condition.
Book a Consultation
Book a consultation or contact the clinic via WhatsApp to get started
Book a consultation at 360 Orthopaedics, Mount Elizabeth Novena
SLAP tears and other labral injuries of the shoulder are common but treatable. Early diagnosis and appropriate management can improve outcomes and prevent long-term problems.
Dr Puah Ken Lee is an orthopaedic surgeon in Singapore specialising in shoulder, elbow and sports injuries at 360 Orthopaedics, Mount Elizabeth Novena. Patients with persistent shoulder pain are encouraged to seek specialist evaluation.