PROLOTHERAPY SLAPS IT TO ‘SLAP’ LESIONS
Ross A. Hauser, M.D.

It's common for patients to walk into Caring Medical and tell us that their doctor told them that surgery was the only option. Patients are told that surgery is the only option for such conditions as Meniscal Injury, advanced Osteoarthritis, labral tears of the hip and shoulder, and especially if they have a SLAP lesion.

A “SLAP” lesion is one in which there is a tear in the superior glenoid labrum from anterior to posterior. The symptoms of SLAP lesions typically cause patients to develop pain and a popping or clicking of the shoulder with elevation, adduction or internal rotation. Often, the physical examination is unremarkable. The condition is picked up on MRI arthrography. 

The labrum is a fibrocartilagenous structure which helps to deepen the socket of the glenoid. When a person has a SLAP lesion, the shoulder joint becomes more unstable in the external rotation position. This puts increased pressure on the inferior glenohumeral ligament and the rotator cuff muscles Often patients come in saying they have been told they have a rotator cuff tear or ligament sprain, but the primary problem in these folks is deeper. 

The SLAP lesion typically occurs when a person falls onto an outstretched arm. The typical orthopedic approach with SLAP lesions is to debride (cut out) the injured area and suture or tack down the flap that is left after the shaving. 

A better approach to removing the injured structure, in my opinion, is to rebuild it with Prolotherapy. Caring Medical in Oak Park has successfully treated numerous people with SLAP lesions. The typical program involves three to six visits receiving Prolotherapy with strong proliferants. The person uses physical therapy or exercises to strengthen the shoulder. Supplements are often given, and overhead exercises are curtailed until the shoulder becomes more stable. Prolotherapy to the SLAP lesion is done as well as Prolotherapy to the posterior and anterior stabilizers. Typically the person starts feeling better after their second or third treatment.

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