What Are Subscapularis Tears and SLAP Lesions?

The largest rotator cuff muscle is known as the Subscapularis. This muscle has a tendon attachment that is separate from the other rotator cuffs. Subscapularis Tears are tendon tears that result in significant weakness, pain, and often total impairment of shoulder elevation. 

Subscapularis Tears are often part of large rotator cuff tears. Being a vital stabilizer of the biceps tendon, the Subscapularis when torn almost always results in subluxation of biceps tendon.

Subscapularis tendon tears need to be separately looked for intentionally, during an arthroscopic shoulder examination. Fortunately, these tears can be arthroscopically repaired. 

SLAP Lesions or Superior Labral Anterior-Posterior lesions are tears of the labrum adjoining the top portion of the glenoid socket. The labrum is also known as the meniscus of the shoulder. SLAP Lesions result in a detachment of the base of the Long Biceps Tendon as that tendon essentially sources from the top of the labrum. Young overhead athletes, particularly swimmers and throwers, usually suffer from such lesions. 

These lesions can also occur in people from any age-group due to trauma caused by skiing, fall, or motor vehicle accident. A tight shoulder can often pre-dispose to a SLAP lesion in throwers. It is absolutely essential that pitchers allow their throwing shoulder stay stretched. SLAP lesions can be prevented by using the sleeper stretch, on pitchers. Symptoms of these lesions typically are pain, tightness, and soreness in the outside or back of the shoulder. There might be a catching or snapping sensation occasionally. 

What Are Proximal Interphalangeal (PIP) Joint Injuries and Skier’s Thumb?

A PIP or Proximal Interphalangeal Joint is the middle joint of a finger. This joint can be pretty unforgiving, becoming extremely stiff, when injured. There are varying degrees of Proximal Interphalangeal (PIP) Joint Injuries. 

A simple dislocation without any fracture is invariably a stable injury. Splinting a simple dislocation can be counter-productive as it often results in stiffness. This stiffness often becomes so severe within 3 to 4 weeks that nothing less than a surgical procedure is able to restore motion. What is often not realized is that a finger bone heals fast. If a joint bears a fracture that is significant, the injury can essentially turn irreparable within just 3 weeks. This is why a hand surgeon should be consulted quickly after Proximal Interphalangeal (PIP) Joint Injuries. 

Skier’s thumb, which was previously known as Gamekeeper’s Thumb, is an injury whose present principal cause is skiing, resulting in the change in name. This injury is suffered by the Ulnar Collateral ligament of the MP or Metacarpophalangeal Joint of the thumb, which is the sturdy joint that attaches the thumb to the hand. Ligaments are structures functioning as joint stabilizers. Each finger joint has a ligament that stabilizes the joint. 

Skier’s thumb is often the result of a fall onto the thumb, particularly when the thumb is harshly bent back by a ski pole, the ground, or anything that stresses the Ulnar Collateral ligament by pulling the thumb away from the hand.