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.
  • 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