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A superior labral anterior posterior (SLAP) repair is a surgery performed to reattach the labrum of your shoulder to the joint and restore stability. Your shoulder is formed through the articulations (joints) of the humerus, scapula and clavicle. Within this joint there is a shallow cavity on the scapula in which the humeral head sits in. Reinforcing this cavity and providing a ‘deeper pocket’ for the humeral head to fit into is a fibrous cartilage called the glenoid labrum. The shoulder is then reinforced further through the surrounding ligaments and muscle attachments. This design allows for a large amount of movement however consequently this results in limited stability.This design produces a mechanically unstable joint sacrificing stability for range resulting in it’s vulnerability to injury.

Damage to the labrum can be caused through trauma e.g. a fall, sport or as a result of degenerative changes. Due to the proximity of the bicep tendon and its attachment on the superior part of the labrum, this is commonly injured in conjunction with a labral tear. There are 4 degrees of tears:
  • Type 1 – the labrum remains intact but there is evidence of fraying or degeneration
  • Type 2 – the superior labrum is detached from the glenoid rim
  • Type 3 – the superior labrum is torn away and displaced into the joint (bucket-handle)
  • Type 4 – the superior labrum tear extends into the biceps tendon and both are displaced into the joint
All these types of SLAP tears are treated arthroscopically (Key-hole surgery) through either debridement (trimming) or re-attachment. Surgery for all SLAP tears is recommended especially if you want to return to sporting activity or training.


Physiotherapy before SLAP Repair of the Shoulder



Physiotherapy prior to SLAP repair of the shoulder is a highly useful and recommended intervention. Physio.co.uk will help conservatively treat with your injury to help deal with your injury allowing you to resume as much functional ability as possible. Also, pre-surgical physiotherapy with Physio.co.uk will prepare your shoulder for surgery and provide a solid platform for post-surgical rehabilitation, speeding up your rehab period. Treatments performed include:

  • Cryotherapy (Ice)
  • Pain management
  • Protective taping and bracing

Acute management of symptoms
  • Strengthening surrounding musculature
  • Myofascial release
  • Advice on surgery and post-surgical management

Symptoms after SLAP Repair of the Shoulder



Following SLAP repair shoulder surgery, your shoulder will be placed in a protective sling for 3-4 weeks to help protect the repair, aid recovery and maximise rehab potential. Common symptoms experienced following SLAP repair include:
  • Swelling
  • Pain
  • Bruising
  • Numbness – due to the anaesthetic used in the operation. This should resolve within a
  • few hours
  • Nausea

Physiotherapy after SLAP Repair of the Shoulder



Following SLAP repair surgery it is essential to have physiotherapy. Physio.co.uk will provide a thorough assessment and explanation of what will be undertaken in the coming weeks as well as design a personal rehabilitation programme. Treatment will be focussed on acute management after surgery and progress on to regaining full movement, strength and functional use of your arm.


Weeks 1-3



Initial treatment with Physio.co.uk will concentrate on minimising post-operative complication, reducing acute symptoms and initiation of movement. Treatment will include:
  • Cryotherapy (Ice)
  • Pain management
  • Sling use (day and night) including recommended exercises
  • Passive range of movement within safe zones in and out of sling
  • Active assisted movements
  • Active movement of fingers, hand, wrist and elbow to prevent stiffness in and out of sling
  • Stretching
  • Scapular stabilising exercises
  • Proprioceptive exercises
  • Closed chain activities
  • Postural awareness
  • Weight bearing exercises
  • Wound management
  • Wound de-sensitising

Weeks 4-6



Following week 4 your sling will be removed and you will be allowed to commence increased active range of motion and begin strengthening exercises. Physio.co.uk will develop your programme with attention to personal requirements so that your surgery milestones are met. Treatment will include:
  • Active and passive range of movement
  • Scapular stabilising exercises
  • Postural exercises
  • Open and closed chain activities
  • Proprioceptive training
  • Soft tissue massage
  • Scapular strengthening exercises
  • Posterior Capsule Stretching
  • Joint mobilisations
  • Scar management

Weeks 7-12



Following week 7, Physio.co.uk will focus on a continuation and progression of exercises. You will be reaching full range of movement and your strength and control of movement will be progressing. Rehab will be directed to attaining full range of movement, improving muscular strength and endurance and beginning sport and occupational activities. Treatment will consist of:
  • Increased active range of movement
  • Begin bicep strengthening
  • Shoulder and scapular strengthening
  • Proprioceptive neuromuscular facilitation (PNF)
  • Increased scapular training
  • Aggressive capsular stretching (to attain full ROM)
  • Proprioceptive training
  • Increase muscular endurance
  • Increased joint mobilisations
  • Begin non-contact work (if returning to sport)
  • Light impact work e.g. running
  • Open Chain activities

Weeks 12+



Following week 12, your movement and strength will be equal to your non-injured are. With full recovery between 3-6 months, Physio.co.uk will provide an intensive return to activities rehabilitation programme with a clear focus on maximising functional use of your arm. Treatment will include:
  • Advanced strengthening in unsafe zones (end range limits)
  • Advanced core stability exercises
  • Advanced proprioceptive exercises
  • Plyometrics
  • Sports specific activities
  • Functional training
  • Advice on long term management

Summary



A SLAP repair of the shoulder is an arthroscopic surgical procedure where the labrum of your shoulder is repaired following a traumatic incident. This is a common injury within sport which without surgery would continue to cause progressive problems. Physiotherapy is an essential component of rehabilitation and Physio.co.uk will provide a comprehensive and intense treatment programme to ensure a full return to sporting and functional activity. Call Physio.co.uk now on 0330 088 7800 for more information or to book an appointment please contact us.


Call us on: 0330 088 7800
Phone: 0330 088 7800
Call us on: 0330 088 7800
Mobile: 0330 088 7800
Email us on: office@physio.co.uk
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