SLAP repair – arthroscopic
Sling 4-6 weeks. Washing techniques and sling advice/management.
Day 1 on ward – scapula setting in neutral elbow, wrist and hand exercises.
Follow operation post-op instructions – usually to commence active-assisted elevation in neutral to 90° - external rotation to neutral only.
NB. No isometric medial rotation and anterior deltoid for 2 weeks. Can start external rotation in neutral 30 % Maximal Voluntary Contraction.
Can commence active external rotation from day 1 post-op if pain and muscle control allows to neutral for 2/52. No passive mobilisation into E.R. until 6/52.
2/52 can commence static rotator cuff activation in neutral.
Commence 0-90° active assisted elevation and active lateral rotation beyond neutral as pain and active control allow.
3/52 – 6/52. Progress active assisted to active elevation >90° as pain and control allow.
NB. Concentrate on quality of movement.
No resisted shoulder flexion or resisted elbow flexion and supination for 6/52-8/52.
No resisted shoulder flexion or resisted elbow flexion and supination for 6/52-8/52, avoid eccentric biceps loading until 12/52.
Can progress to active-assisted in all directions from 6/52.Please discuss with Catherine Howard / Debbie Prince if want to progress sooner.
Shoulder clinic review at 6/52, 3/12, 6/12 and 1 year.
Resisted light rotator cuff through range >4/52 onwards, if good control. Use free weights - one kilo and light Thera band. NB – Do not use theraband if patient still has night pain – stick to isometric contraction only.
Progress to active controlled movement > 6/52 in all ranges, esp. abduction.
Proprioceptive exercises 6/52 onwards.
Biceps stretches 12/52 if necessary.
Biceps strengthening 12/52 (eccentric biceps exercises with scapular control).
Aim full active ROM demonstrating dynamic stability through range.
Return to work: Sedentary 4-6 weeks (as pain allows). Physical 3-6 months (as control and strength allows).
Driving: 6 weeks (as pain and range allows) patient confirms they are able to drive safely.
Sport: Non contact 4-6 months. Contact 9-12 months.
Swimming: Gentle with modified stroke 6-8 weeks. Freestyle 12 weeks.