Monday, May 15, 2006

NIH: The SLAP tear

Normally there wouldn't be much Nats injury news on an off day, and I'm fortunately not here to say that anyone has broken an arm climbing out of bed. I think that only happens to Wake Forest football players. The only real news of the day is that Guzman has been moved over to the 60-Day DL. Not sure what purpose there was to waiting this long to do so, but it's been done.

One of the things I wanted to do with this new focus on the blog is to explore exactly what the injuries are. The whole thing is still a work in progress, I'll admit.

The SLAP tear, for the layman, based on my research. The first question I had was what the hell a SLAP is. It's always been presented in upper case, and since I was never told there was a part of the body called a slap, I figured it was an acronym. Sure enough, SLAP stands for "Superior Labrum Anterior to Posterior".

My next question was what, exactly, a Superior Labrum is. Yeah, I'm just getting into this whole anatomy of a baseball player thing (and thank god this isn't Yudachat, cause I know that Jeff Gannon would be showing up after that comment). Through a little research I've found that there isn't a Superior Labrum, just a few above average ones. The labrum in question is actually caled the glenoid labrum, which is part of the shoulder joint that runs generally from the edge of the armpit closest to the body and curls up to about the midpoint of the shoulder joint. It's a ring of cartelidge.

Superior actually refers to the tear itself. A superior tear is a tear to the labrum at the front of the body, and an anterior tear is in the back of the body. More specifically a SLAP tear tends to occur where the bicep tendon meets the labrum.

What causes it? Throwing overhand. In sports it's most common in baseball players (like Christian Guzman) or volleyballers. Compare the overhand motion of a serve with that of a throw, and you'll see some very similar motion. It's basically a form of repetitive stress injury, though it can be caused by one-time events such as lifting heavy boxes or having your arm jerked. More frequently it happens to pitchers, who put a hell of a lot more stress on their arms, but it can happen to position players as well. Or to anyone, really.

It's one of the arguments against getting kids too much into pitching at an early age. This is a slight veer fromt he topic, but as younger and younger kids are being pushed to throw more sophisticated pitches in the little league ranks, shoulder injuries are on the rise. Young arms and shoulders that are still going through puberty aren't built to sustain the kinds of stressful forces that can rip even healthy adult shoulders to pieces.

The long and short of it is Guzman suffered from the proverbial throwing his arm off.

Most pitchers who get a SLAP tear have peaked in their careers. Their velocity and stamina will be down. However, a position player is more likely to make a recovery to regular season form, just because they aren't relied upon to throw the ball 100 times a game.

The biggest name position player I can find who suffered a SLAP tear was Troy Glaus, who had his 2004 campaign cut short by what was diagnosed as a SLAP fray (some sites seem to suggest the terms are interchangable, others that there is a subtle difference that I can't fully grasp). He has not only come back, but come back strong. He's hitting better since the injury, and his fielding is showing no sign of suffering.

So the prognosis for Guzman could still be good. He's got plenty of recovery time, and the injury isn't quite the career-death sentence as it would be for a pitcher. Still, only time will tell.

Sources used while assembling this entry: article: Labrum, it nearly Killed Him. By Will Carroll
Orthopedic Center, St. Louis: Patients Guide to SLAP Tears. By Dr. Mark Miller
Various wonderful drawings I got from entering "glenoid labrum" into a Google Image search.


At 9:39 AM, Blogger Brian said...

Good stuff, David.

At 5:01 PM, Blogger thurdl said...

Thanks. I so hope I can keep stuff like this up.

At 3:48 PM, Anonymous Anonymous said...

If you're looking for more information about SLAP tears from a patient's point of view, check out !


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