SLAP repair – arthroscopic
On Ward:
- Sling 4-6 weeks. Washing techniques and sling advice/management
- Day 1 on ward
- scapula setting in neutral
- el bow, wrist and hand exercises
- Follow operation post-op instructions – usually to commence active-assisted elevation in neutral to 90°
- external rotation to neutral only
N B. No isometric medial rotation and anterior deltoid for 2 weeks. Can start external rotation in neutral 30 % Maximal Voluntary Contraction.
- external rotation to neutral only
- 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.
- Review by clinical specialist at ~2/52 post-op in clinical specialist shoulder clinic at RSH, to be booked before discharged by ward staff.
2-6 weeks:
- C.S.C. OP follow-up at ~2/52 at RSH.
- 2/52 can commence static/isometric rotator cuff strengthening 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
6 weeks:
- Can progress to active-assisted in all directions from 6/52.Please discuss with Martin Kerridge-Weeks / 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.
- Progress to active controlled movement > 6/52 in all ranges, esp. abduction
- Proprioceptive exercises 6/52 onwards
12 weeks:
- 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
Click on the links below to read the guidelines for individual procedures:
- Arthroscopic Sub-Acromial Decompression
- Rotator Cuff Repair
- Arthroscopic Subacromial Decompression + Arthroscopic Excision of Distal Clavicle (ACJt resection)
- Anterior Stabilisation (open or arthroscopic)
- Acromio Clavicular Joint Reconstruction
- Anatomical Shoulder arthroplasty – Hemi arthroplasty (HA) or Total Shoulder Replacement (TSR)
- Arthroscopic Capsular Release and MUA of Frozen Shoulder
- ORIF Clavicle / Hook Plate Clavicle
- ORIF proximal humeral fractures – (Proximal Humeral Locking Plate)
- ORTHO SPACE (In space Implantation)
- Physiotherapy Protocol for REVERSE Total Shoulder Replacement