I get daily email from people suffering shoulder injuries all over the world. Many have questions regarding their MRI reports that somehow go unanswered by the MD or just are not explained clearly enough. Sound familiar?

One such email yesterday described an injury as a slat tear. I knew the customer probably meant SLAP tear even though he did not know the true description. Face it - deciphering MRI reports is like reading a foreign language unless you have medical training. Many people suffering from rotator cuff tears/tendonitis may also be suffering from a SLAP injury as well.

What does SLAP stand for? Superior Labrum Anterior to Posterior to be exact. Even more confusing, right? Think of it simply as an injury to the long head of your biceps tendon as it joins with the glenoid labrum (shoulder cartilage) in the top of your shoulder. This is actually more common than you may think. It can occur through a traumatic injury (fall for example) or through gradual stress/degeneration.

The long head of the biceps tendon assists the rotator cuff in depressing the humerus during elevation of the arm and overhead activities like throwing. In my experience, SLAP tears often require arthroscopic surgery to repair them in order to restore function and eliminate pain. If you have a torn labrum, minimize overhead stress or extending the arm fully beyond the plane of your body, especially with a straight arm under resistance.

Exercises in the gym that would place harmful stress on the labrum include full range bench press, military press, incline biceps curls, dips, upright rows above 90 degrees, and deep push-ups or flies. To rehab this injury conservatively, you should focus on scapular and rotator cuff strengthening, always taking care not to load the shoulder joint with significant weight at end ranges of motion.

I included a short video clip today of a scapular strengthening exercise guaranteed to improve your shoulder function if you have such an injury. It is a prone serratus punch progression (starts on the knees and advances to the toes) to increase serratus anterior strength, a muscle often shown to be weak and lacking endurance in those suffering from shoulder pain.