NATA Position Statement - Evidence-Based Management for Overhead Athletes with SLAP Lesions
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Abstract:
SLAP tears are common in overhead athletes. Proper diagnosis and effective management of a SLAP tear in the overhead athlete is imperative for successful return to play. Diagnostically, athletic trainers have a large number of special tests to consider when ruling in or out a SLAP lesion. However, in recent literature, special tests used to diagnose SLAP lesions have been found to lack validity, suffer frequent user error, and/or have limited diagnostic utility. Despite these literature findings and limited clinical diagnostic success, athletic trainers continue to include these tests in their evaluation battery. Once diagnosed, the management of SLAP lesions is approached through conservative or surgical management. Choosing a treatment approach can be difficult for athletic trainers due to the few clinical trials directly comparing the outcomes, and results of cohort studies showing comparable outcomes with regards to function and return to sport. While return to sport with each treatment option vary widely, a recent systematic review on returning to preinjury levels following a SLAP lesion repair found the odds ratio of a full return to play were greater for non-overhead athletes compared to overhead athletes. There remains an unclear and often unrealistic expectation for return to sport in overhead athletes. This presentation aims to provide clinicians with the most up-to-date information regarding diagnosis, surgical interventions, rehabilitation, and return to play for overhead athletes diagnosed with a SLAP tear, thus reducing the potential knowledge gap between educational knowledge and clinical practice.
Objectives:
- Participants will be able to describe the methods used to assess the diagnostic accuracy for the history and physical examination findings to confirm or rule out presence of a pathology.,
- Participants will be able to appraise the current evidence for history and physical examination tests used to diagnose SLAP lesions.,
- Participants will be able to describe the methods used to assess effectiveness of treatment and return to sport.,
- Participants will be able to summarize the current evidence for the management and return to sport outcomes for overhead athletes with SLAP lesions based on current evidence.,
- Participants will be able to apply the current evidence to case studies related to the evaluation and management of overhead athletes with SLAP lesions.
Level:
Advanced
Domains:
Domain 2: Assessment Evaluation and Diagnosis
Domain 4: Therapeutic Intervention
CEUs:
1.25 Category A
Keywords: SLAP, lesion, tear, Superior labral anterior posterior, shoulder, diagnostic, return to sport, examination, treatment, NATA Position Statement
Course Expiration:
This premium course offering must be completed within 12 months from the purchase date.
Created in collaboration with the NATA Foundation Educational Resources Committee.
A portion of the proceeds from this course is donated to the NATA Research & Education Foundation.
Timothy L. Uhl
Dr. Uhl has been practicing physical therapy and athletic training since 1985 in various sport medicine settings. Tim received his bachelors in health science from the University of Kentucky in physical therapy. After three years of clinical practice at the Lexington Sports Medicine Center he went on to receive his masters’ degree in Kinesiology from the University of Michigan. At Michigan he worked with the athletic programs and at MedSport their sports medicine outpatient center. He served both on the staff and as the director of outpatient physical therapy at the Human Performance and Rehabilitation Centers in Columbus, GA. He completed his doctorate in sports medicine from the University of Virginia in 1998 where he studied shoulder proprioception and is presently a Professor in the Department of Physical Therapy, at the University of Kentucky. Dr. Uhl is an active member of the APTA, NATA, American Society of Shoulder and Elbow Therapist (ASSET) and American Shoulder and Elbow Surgeons (ASES), and American Baseball Biomechanics Society (ABBS)
Charles Thigpen, PhD, PT, ATC
CHARLES THIGPEN, PT, PhD, ATC, is a clinician, educator and researcher. He completed his PhD in Human Movement Science from the University of North Carolina-Chapel Hill and has been presenting nationally on shoulder dysfunction and rehabilitation in both the academic and continuing education arenas. He is an assistant consulting professor at Duke University Schools of Physical Therapy and Medicine. He has multiple peer-reviewed publications and book chapters related to prevention and treatment of shoulder pain.
He is currently on the NATA Free Communications Research and Pronouncements Committees. He is also serving on the writing panel for the American Academy of Orthopedic Surgeons Appropriate Use Criteria for the treatment of rotator cuff tears. He is currently the research chair for the Sports Section. He was the 2011 President of the American Society of Shoulder and Elbow Therapists and in 2012, he was awarded the APTA Sports Section’s “Lynn Wallace Award for Clinical Education and Mentoring” in recognition of his contributions to sports physical therapy in the areas of teaching and mentoring. Thigpen was a co-author for the 2013 APTA Sports Sections Excellence in Research Award for “Preseason Shoulder Rom Screening As A Predictor Of Injury Among Youth, Adolescent, And Professional Baseball Pitchers”.