The Management of Superior Labrum Anterior-Posterior Tears in the Thrower's Shoulder

The adaptive and pathologic features of the throwing shoulder present a unique challenge to sports medicine specialists. Internal impingement can be exacerbated by problems in the athlete's kinetic chain and results in varying features of posterior capsular contracture, rotator cuff tear, and superior labral injury. Superior labrum anterior-posterior lesions with or without injury to the biceps tendon is a common cause of pain and decreased performance in throwing athletes. The optimal nonoperative and surgical treatment of superior labrum anterior-posterior tears is determined by a detailed patient history, complete physical examination of the shoulder and entire kinetic chain, and by advanced imaging. Treatment and rehabilitation that allow elite overhead athletes to return to the same level of play remain a challenge.