SLAP Repair

Tears to the biceps anchor are variable and may be catergorized as below:

  1. Degenerative fraying of the superior portion of the labrum
  2. Separation of the superior portion of the glenoid labrum and tendon of the biceps brachii
    muscle from the glenoid rim
  3. Bucket – handle tears of the superior portion of the labrum
  4. Bucket – handle tears of the superior portion of the labrum extending into the biceps tendon
  5. Anteroinferior Bankart lesion that extends upward to include a separation of the biceps tendon

SLAP I and III repair involves re-attaching the labrum. SLAP II, IV & V repairs re-attach the labrum but also re-attach the biceps anchor. This impacts the rehabilitation process – see below.

Post-op

Check notes for time scale this phase may last anything between 3-6 weeks.

SLAP I & III – Active elbow movements allowed
SLAP II, IV & V – follow guidance below for elbow

  • Sling – remove 4 times a day for exercise
  • Commence gentle pendular exercise
  • passive ROM exercises for shoulder
  • Passive elbow flexion / extension only
  • Passive forearm supination only
  • Teach postural awareness and scapular setting
  • Assess kinetic chain control / core stability and provide exercises as required

Week 4-6:

  • Wean off sling
  • Active-assisted ROM shoulder exercises
  • Commence active-assisted elbow flexion
  • Commence active supination / pronation
  • Progress to active gleno-humeral movement
  • Scapular stabiliser exercises
  • Strengthen rotator cuff muscles
  • Posterior complex stretching
  • Increase proprioception through open & closed chain exercise

Week 7-9:

  • Active assisted ROM exercises with active elbow flexion – No resisted elbow exercises

Week 10:

  • Terminal stretching

Week 12:

  • Re-commence all activities including throwing incl active elbow strengthening
Milestones
Week 6 Full Active range of elevation
Week 12 Full active range of movement with dynamic scapula stability throughout range (Concentric and eccentric)