Shoulder Labral Tear (SLAP Tear): Symptoms and Recovery

A labral tear in the shoulder is a tear in the rim of cartilage (the labrum) that deepens the shallow shoulder socket. Common symptoms are deep pain in the shoulder, catching, clicking or locking, pain with the arm overhead, and sometimes a feeling of looseness or a dead arm. A SLAP tear is a tear at the top of the rim, where the biceps tendon attaches. Many labral tears, especially SLAP tears in people over about 35, are treated first with 3 to 6 months of physical therapy.

Labral tears happen in two main ways. Some follow an injury: a dislocation, a fall onto an outstretched arm, or a sudden pull on the arm. Others build up from repeated overhead or throwing loads, as in baseball, volleyball, swimming or tennis. With age, the labrum also frays and degenerates, and many tears seen on scans in people over 40 cause no symptoms at all.

Surgery is more often discussed when a tear comes with repeated dislocation or instability, when a young athlete’s shoulder will not tolerate their sport after a full rehabilitation program, or when mechanical locking persists.

Key takeaways

What it is: a tear in the rim of cartilage around the shoulder socket. A SLAP tear is at the top of the rim, where the biceps tendon attaches.
Common symptoms: deep shoulder pain, catching or clicking, pain overhead, and sometimes looseness or a dead-arm feeling.
First treatment for many: 3 to 6 months of physical therapy focused on rotator cuff and shoulder blade strength and control.
When surgery is discussed: repeated dislocation or instability, persistent locking, or failure to return to overhead sport after full rehabilitation.
Scans: labral fraying and tears are common on scans in people over 40 without shoulder pain.

Where are you right now?

It has just happened: read the month-by-month section and the safety sections. After a dislocation, follow the emergency department’s advice first.
Weeks into physical therapy and not settling: go to “If it isn’t going to plan” and “When surgery is discussed”.
After an injection or surgery: a labral repair, stabilization or biceps tenodesis each has its own recovery. Your surgeon’s protocol comes first.
Getting back to work or sport: the “When can I…” table gives typical ranges for non-surgical care.

Month by month

These ranges are for non-surgical care. Torn labral tissue has a limited blood supply and often does not heal back to the bone on its own. What I’d aim for with physical therapy is a shoulder whose muscles hold the ball steady enough that the tear no longer causes problems.

Weeks 0 to 2: calm the shoulder. Avoid the position that provokes catching, often the arm up and turned back. Keep the arm moving in a comfortable range.
Weeks 2 to 6: strengthening for the rotator cuff and shoulder blade muscles, starting low and close to the body. Catching often becomes less frequent.
Months 2 to 3: exercises move to shoulder height and above, with more speed and control. Daily tasks are often comfortable by now.
Months 3 to 6: sport-specific work, such as throwing or serving, reintroduced in stages. This is when the decision about surgery is usually made, if the shoulder still will not tolerate the sport.

When surgery is discussed

Instability: the shoulder has dislocated more than once, or keeps slipping, especially in someone young or in a contact sport.
Mechanical symptoms: locking or catching that continues despite a full rehabilitation program.
Overhead athletes: the shoulder still will not tolerate throwing or overhead sport after about 3 to 6 months of rehabilitation.
Type of surgery: options include repairing the labrum to the bone, stabilizing the joint, or, for many SLAP tears in people over about 35, a biceps tenodesis instead of a repair. Recovery after labral repair often runs 4 to 6 months for daily strength and 6 to 12 months for overhead sport.

The tear may stay on the scan. What changes is how well the muscles hold the shoulder steady.

Where else this could be coming from

Biceps tendinitis: pain at the front of the shoulder, tender over the groove at the front of the upper arm, often without catching.
Rotator cuff tendinopathy: outer upper arm pain when lifting the arm out to the side, without catching or looseness.
Rotator cuff tear: clear weakness lifting or turning the arm, more common after about 40.
AC joint: pain on top of the shoulder at the end of the collarbone, often after a fall onto the shoulder.
The neck: a nerve root in the neck can cause a heavy, dead or tingling arm, often changed by neck movement. That pattern is more typical of the neck than the labrum.

Is this normal?

“It clicks but rarely hurts now.” Common. Clicking can continue after pain settles, and painless clicking is usually not a concern.
“My scan shows a tear, but my other shoulder might too.” Possible. Labral changes are common in shoulders without pain, especially after 40 and in overhead athletes.
“It aches after throwing practice.” An ache that settles by the next day is common during a return to sport. Pain that builds session to session is a sign to drop back a step.
“It still feels a bit loose.” A feeling of looseness often improves as strength builds. If it is getting worse, or the shoulder slips out, tell whoever is managing your recovery.

If it isn’t going to plan

Perhaps it is month two. Your shoulder catches every time you lift your carry-on into the overhead bin, and the thought is that a tear will not heal, so physical therapy is a waste of time until it is fixed. It is true that the torn rim often stays torn. But the symptoms come from how the ball moves in the socket, and that depends heavily on the rotator cuff and shoulder blade muscles. Many people with a labral tear on a scan have shoulders that work well.

What the shoulder usually needs is strength and control built from low positions up to the one that provokes catching, over 3 to 6 months. If you are 3 months in with no clear change, or the shoulder is slipping out, I’d get it assessed by a physical therapist or doctor. These are the questions I’d ask:

Tear type: where is my tear, and is it linked to instability?
Program: is my rehabilitation reaching the positions my sport or job needs?
Surgery: would repair, stabilization or a biceps tenodesis suit me, and why?
Timeline: what would recovery look like after each option?

When can I…

Activity	Typical range
Sleep on that side	Often 2 to 8 weeks with non-surgical care
Drive	Usually possible throughout non-surgical care
Reach overhead	Comfortable daily reaching often 6 to 12 weeks
Lift	Light loads close to the body throughout; heavier and overhead lifting built up over 2 to 3 months
Desk work	Usually possible throughout
Manual work or sport	Overhead, throwing or contact sport often 3 to 6 months with non-surgical care

If you have had surgery, your surgeon’s protocol comes first.

Call your local emergency number or go to the emergency department if

Dislocation: the shoulder has come out and not gone back, or looks out of shape after an injury.
Circulation: after an injury, the arm or hand is cold, pale, blue or numb.
Chest symptoms: shoulder pain comes with chest pain, breathlessness or sweating.

See a doctor today if

Locked shoulder: the shoulder is locked and you cannot move it through its range.
Numb patch with weakness: a numb patch on the outer upper arm, or new weakness, after a dislocation or fall.
Hot, swollen shoulder: the shoulder is hot, red or swollen, or you have a fever.

Get it checked soon if

Repeated slipping: the shoulder slips partly out during everyday tasks or in sleep.
Dead arm: the arm repeatedly goes dead or weak for a moment during throwing or overhead work.
No progress: catching or pain has not clearly improved after about 3 months of physical therapy.

Related guides: Little League Shoulder and Climbing Shoulder Injuries.