SLAP Repair

Acute phase (0-4 weeks)

Goals

• Protect the surgical repair
• Reduce pain
• Promote cuff and scapular control

Rehabilitation

• *Safe zone: aim for passive range of movement to 120° elevation, 45° abduction, 30° external rotation by end of second week
• Active assisted/supported range from 2 weeks
• No eccentric or concentric loading of biceps
• No forced movements, no combined abduction/external rotation
• Closed kinetic chain/proprioception exercises
• Cuff exercises within this range of movement zone
• Scapular setting exercises
• Elbow, wrist, hand exercises

Criteria for progression

• Pain control
• Adequate range of movement

Intermediate phase (4-8 weeks)

Goals

• Preserve surgical repair
• Restoration of functional range of movement
• Cuff recruitment and scapula control through range
• Enhance proprioception

Rehabilitation

• No passive stretching into end range external rotation
• No eccentric biceps loading
• No heavy lifting/concentric overload biceps
• Encourage active movement with good cuff and scapular control  
• Progress cuff & scapular recruitment through range
• Progress kinetic chain integration
• Proprioceptive re-education incorporating closed chain exercises
• Hydrotherapy permitted

Criteria for progression

• Painfree functional range of movement
• Good cuff and scapular control through functional range

Late phase (>8 weeks)

Goals

• Restore full range of movement
• Optimise cuff and scapular control under load
• Enhance shoulder power, strength and endurance
• Ensure cuff and scapula control maintained during biceps loading

Rehabilitation

• Regain optimal range of movement into combined positions
• Ensure posterior capsule mobility
• Specific biceps strengthening/control work ensuring maintenance of scapula control and humeral head position
• Strengthening and endurance exercises for cuff and scapular musculature
• Preparatory and reactive stabilisation drills in risk positions

Guidelines for return to functional activities