02/12/2026
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🚨 SLAP tears don’t automatically mean surgery.
Steinmetz et al. (2022) looked at outcomes for patients with SLAP lesions undergoing physical therapy… and the results matter.
Here’s what we know:
✅ A substantial percentage of patients improved with nonoperative management
✅ Pain decreased
✅ Function improved
✅ Many avoided surgery altogether
Translation?
A SLAP tear on MRI ≠ a surgical sentence.
Especially in:
• Recreational athletes
• Overhead lifters
• Non-throwing populations
• Adults over 30 (where labral changes are often degenerative, not traumatic)
The shoulder is a load-management problem more often than it is a “structural damage” problem.
What tends to work?
1️⃣ Restore posterior cuff strength
2️⃣ Improve scapular upward rotation & posterior tilt
3️⃣ Build tolerance to horizontal abduction + ER under load
4️⃣ Gradually reintroduce overhead volume
5️⃣ Respect irritability — don’t just “strengthen through pain”
6️⃣ Manage total throwing/lifting dosage
Surgery may absolutely be indicated in certain high-level throwers or traumatic instability cases.
But for many?
Smart, progressive rehab works.
MRI findings should guide decisions — not make them for you.
📚 Steinmetz RG et al. (2022). Outcomes of nonoperative management for SLAP lesions.
If you’re dealing with a SLAP tear, don’t panic.
Build capacity.
