SLAP tear : Nemesis of throwing athlete

With increasing popularity of cricket in India more and more patients need orthopaedic advice regarding shoulder problems. Most common complaint of this group is difficulty in throwing . Onset is usually insidious. It starts with mild ache and discomfort generally taken casually. The speed and accuracy of throw starts falling gradually and finally ends with ‘dead arm’.

Studied extensively in baseball pitchers , the pathology is a tear in the superior labrum leading to partial detachment of long head of biceps ( Type 2 SLAP tear).

SLAP = Superior Labral Anterior to Posterior tear.

Why this happens in throwing shoulder :

With repeated throwing the posterior capsule of shoulder gets thickened and inelastic. This starts pushing the humeral head superiorly during abduction and external rotation ( throwing position of shoulder). It leads to shearing stress on superior labrum with every throwing action ultimately causing SLAP .

How to diagnose :

SLAP is till now considered an arthroscopic diagnosis because there is no specific clinical diagnostic test for it and MRI reporting for shoulder is still evolving at most centers. With careful history, thorough examination, high index of suspicion and good interaction between the surgeon and radiologist we can give our patients an accurate diagnosis and hence prognosis.

First Arthroscopic SLAP repair at BLK (B L Kapoor, Pusa Road):

We had a 24 year old cricket player with pain Rt shoulder for last few months. The pain was so much that he in fact was planning to to quit the game. MRI was not conclusive. Arthroscopic examination revealed a type 2 tear and lax biceps tendon.

We repaired the tear with two suture anchors , one anterior and one posterior to biceps tendon. We used antero- inferior, antero- superior and posterior portals. Patient is already doing muscle strengthening exercises at three weeks post op.

Upcoming Events
  • Coming up with a mega campaign "Lets Fight Arthritis" on the occasion of World Arthritis Day, at A4 Block, Gauri Shankar Mandir, Paschim Vihar, New Delhi. The campaign will be on 9th October 2016(Sunday). 

  • Health Awareness Campaign on 28th August at Gurudwara Singh Sabha E Block Karampura, Delhi.

  • Coming up with a mega campaign on Spine & Back Pain on 5th June 2016 at Gurudwara New Ranjeet Nagar (near Satyam Ciema), Patel nagar, Delhi in association with Sukhmani Charitable Trust, Delhi.

  • Coming up with an awareness campaign on Arthritis Management & Control on 22nd May 2016 at Guru Ram Dass Charitable Medical Centre - Gurudwara Sri Guru Singh Sabha, Moti Nagar, Delhi.  

  • Mega campaign on Arthritis Management on "Mother's Day" 8th May 2016 at West Patel Nagar, Delhi - 110008

  • Mega campaign on Arthritis Management in association with "Varishth Nagrik Kesari Club" - Punjab Kesari Delhi on 6th April 2016 (Wednesday)

  • Dr. Ashwani Maichand Participated in Shoulder Conclave 2016 at JWT Marriott, Pune

  • Dr. Ashwani Maichand was the Table instructor for young doctors at Cadaver Joint Replacement Training on 21st February 2016 at All India Institute of Medical Sciences (AIIMS)

  • Arthritis Awareness campaign on 28th february 2016 from 10 am to 1 pm at Minomax Knee & Shoulder Clinics (8/29, West Patel nagar, Delhi, India)

  • Participating as a speaker on "Dificult cases of Hip & Knee Replacement" in 2nd Masters Course in Arthroplasty at Meril Academy, VAPI, Gujarat from 4th to 6th February 2016






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Contact Us
Dr Ashwani Maichand
M.S., M.Ch. (Ortho)
Fellowship Joint Replacement
Specialist : Knee & Shoulder
Dr. Rahul Kakran
M.s., M.Ch (Ortho)
Specialist : Minimal Invasive Spine Surgery (MISS)
Dr. Rajni Koundal
Consultant Physiotherapy
For Appointment : 9999074745
( Mr. Sunny ) 
For Upcoming Events : 9999071715
( Mr. Sarabjeet Singh)
Address : 
MinOmaX Knee & Shoulder Clinics
8/29, West Patel Nagar,opp. D.A.V. Sr. Secondary School (near Metro Pillar no. 198, Delhi-110008)
Timings : Daily 5:00 PM to 7:00 PM  ( Except Sunday).
Please Take Prior Appointment to avoid inconvinience.