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SLAP Repair
By: Katy Lutz
Anatomy
•
Shoulder joint involved 3 bones: scapula, clavicle & humerus
•
Humeral head rests in a socket on the scapula called the glenoid
•
A soft fibrous tissue called the labrum surrounds the glenoid to
help deepen and stabilize the joint
•
The labrum deepens the glenoid by up to 50%
so that the head of the humerus fits better
•
It also serves as an attachment site for several ligaments
Injuries
•
Falling on an outstretched arm
•
Direct blow to the shoulder
•
Sudden pull, such as when trying to lift a heavy object
•
Forceful overhead motions
Location of Tears
•
A SLAP lesion (superior labrum, anterior to posterior) is a tear of
the labrum above the middle of the glenoid that may also involve
the biceps tendon
•
A Bankart lesion is a tear of the labrum
below the middle of the glenoid socket
that also involves the inferior
glenohumeral ligament
Signs and Symptoms
•
Pain, usually with overhead activities
•
Catching, locking, popping or grinding
•
Occasional night pain or pain with daily activities
•
A sense of instability in the shoulder
•
Decreased range of motion
•
Loss of strength
SLAP Repair Surgery Procedure
•
https://www.youtube.com/watch?v=1-pKLJRvJpg
Phase 1: 0-4 Weeks after Surgery
-Passive ROM Phase
•
Goals:
•
1. Protect the surgical repair
•
2. Ensure wound healing
•
3. Prevent shoulder stiffness
•
4. Regain ROM
•
5. Control pain and swelling
•
Use your sling most of the time
for the first 2 weeks
•
You may use your hand on the
operated arm in front of your
Exercise Program
•
--ICE: 7 days a week, 4-5 times
per day for 15-20 minutes
 
STRETCHING / PASSIVE ROM (w/
therapist help)
•
Days per Week: 7 Times per
day: 4-5
-1-2 sets of 10-20 reps of each
exercise
Program:
Phase 2: 5 to 7 weeks after Surgery
-Active ROM Phase
Goals:
•
1. Protect the surgical repair
•
2. Improve ROM of the
shoulder
•
3. Begin gentle strengthening
•
Your sling is no longer
necessary unless your doctor
instructs you to continue using
it
STRETCHING / ACTIVE MOTION (patient
performs)
•
Days per week: 7 Times per day: 1
to 3  
- Do 2-3 sets of 15-20 reps
•
Pendulum exercises
•
Wall walks
•
Thera-band internal and external
rotation
•
Table slides
Phase 3: 8 to 12 weeks after Surgery
-Strengthening Phase
Goals:
•
1. Protect the surgical
repair
•
2. Regain full ROM- passive
& active
•
3. Use arm in all plane for
daily activites
STRETCHING / RANGE OF
MOTION
STRENGTHENING /
THERA-BAND
•
Days per week: 7
Times per
day: 1, 2 sets of
15-20 reps 
Weight Training
•
You should not return to training using heavy weights or on weight
machines until your doctor says it is safe
•
Usually safe to return to heavier weight training at three months
following labrum repair
•
You should have full range of shoulder motion and normal strength
in the rotator cuff and scapular muscles
•
The doctor or a physical therapist will test your motion and
strength before you start weight training
•
You can start with 3 sets of 15-20 repetitions, high repetition sets
ensures that the weights that you are using aren’t too heavy.
•
***NEVER perform any weight training exercise to the point of
WEIGHT TRAINING cont…
The following weight training exercises should be avoided:
•
1. Pull downs behind-the-neck (wide-grip)
•
2. Behind-the-neck shoulder press
•
3. Wide-grip bench press
•
4. Standing lateral deltoid raises
•
5. Triceps press overhead
Exercises Usually Problem-Free:
•
1. Biceps Curls
Phase 4: 12 to 16 weeks after Surgery
-Sport Specific Phase
Goals:
•
1. Gradual initiation of
functional activities
•
2. Progress to normal ROM &
strength
•
3. Progressive use of arm for
daily activities
STRETCHING / RANGE OF
MOTION
STRENGTHENIN
G / THERABAND
•
Times per day:
1 Days per
week: 3
•
External rotation at 90°& Internal rotation at 90°,Standing ‘T’s, Resisted forearm supination-pronation
‘Rebounder’ throws with arm at side, Prone external rotation at 90° abduction “U’s
Phase 5: 16 to 20 weeks after Surgery
-Return to Activity Phase
Goals:
•
1. Progression of
functional activities
•
2. Maintain full ROM
& strength
•
3. Begin sport
progressions with
clearance
 
STRENGTHENING / THERABAND
-2-3 sets, 15-20 reps
•
Days per week: 3 Times per
day: 1
•
Continue from phase 4
 
STRENGTHENING / DYNAMIC
•
Days per week: 3 Times per
day: 1

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SLAP Repair

  • 2. Anatomy • Shoulder joint involved 3 bones: scapula, clavicle & humerus • Humeral head rests in a socket on the scapula called the glenoid • A soft fibrous tissue called the labrum surrounds the glenoid to help deepen and stabilize the joint • The labrum deepens the glenoid by up to 50% so that the head of the humerus fits better • It also serves as an attachment site for several ligaments
  • 3. Injuries • Falling on an outstretched arm • Direct blow to the shoulder • Sudden pull, such as when trying to lift a heavy object • Forceful overhead motions
  • 4. Location of Tears • A SLAP lesion (superior labrum, anterior to posterior) is a tear of the labrum above the middle of the glenoid that may also involve the biceps tendon • A Bankart lesion is a tear of the labrum below the middle of the glenoid socket that also involves the inferior glenohumeral ligament
  • 5. Signs and Symptoms • Pain, usually with overhead activities • Catching, locking, popping or grinding • Occasional night pain or pain with daily activities • A sense of instability in the shoulder • Decreased range of motion • Loss of strength
  • 6. SLAP Repair Surgery Procedure • https://www.youtube.com/watch?v=1-pKLJRvJpg
  • 7. Phase 1: 0-4 Weeks after Surgery -Passive ROM Phase • Goals: • 1. Protect the surgical repair • 2. Ensure wound healing • 3. Prevent shoulder stiffness • 4. Regain ROM • 5. Control pain and swelling • Use your sling most of the time for the first 2 weeks • You may use your hand on the operated arm in front of your Exercise Program • --ICE: 7 days a week, 4-5 times per day for 15-20 minutes   STRETCHING / PASSIVE ROM (w/ therapist help) • Days per Week: 7 Times per day: 4-5 -1-2 sets of 10-20 reps of each exercise Program:
  • 8. Phase 2: 5 to 7 weeks after Surgery -Active ROM Phase Goals: • 1. Protect the surgical repair • 2. Improve ROM of the shoulder • 3. Begin gentle strengthening • Your sling is no longer necessary unless your doctor instructs you to continue using it STRETCHING / ACTIVE MOTION (patient performs) • Days per week: 7 Times per day: 1 to 3   - Do 2-3 sets of 15-20 reps • Pendulum exercises • Wall walks • Thera-band internal and external rotation • Table slides
  • 9. Phase 3: 8 to 12 weeks after Surgery -Strengthening Phase Goals: • 1. Protect the surgical repair • 2. Regain full ROM- passive & active • 3. Use arm in all plane for daily activites STRETCHING / RANGE OF MOTION STRENGTHENING / THERA-BAND • Days per week: 7 Times per day: 1, 2 sets of 15-20 reps 
  • 10. Weight Training • You should not return to training using heavy weights or on weight machines until your doctor says it is safe • Usually safe to return to heavier weight training at three months following labrum repair • You should have full range of shoulder motion and normal strength in the rotator cuff and scapular muscles • The doctor or a physical therapist will test your motion and strength before you start weight training • You can start with 3 sets of 15-20 repetitions, high repetition sets ensures that the weights that you are using aren’t too heavy. • ***NEVER perform any weight training exercise to the point of
  • 11. WEIGHT TRAINING cont… The following weight training exercises should be avoided: • 1. Pull downs behind-the-neck (wide-grip) • 2. Behind-the-neck shoulder press • 3. Wide-grip bench press • 4. Standing lateral deltoid raises • 5. Triceps press overhead Exercises Usually Problem-Free: • 1. Biceps Curls
  • 12. Phase 4: 12 to 16 weeks after Surgery -Sport Specific Phase Goals: • 1. Gradual initiation of functional activities • 2. Progress to normal ROM & strength • 3. Progressive use of arm for daily activities STRETCHING / RANGE OF MOTION STRENGTHENIN G / THERABAND • Times per day: 1 Days per week: 3 •
  • 13. External rotation at 90°& Internal rotation at 90°,Standing ‘T’s, Resisted forearm supination-pronation ‘Rebounder’ throws with arm at side, Prone external rotation at 90° abduction “U’s
  • 14. Phase 5: 16 to 20 weeks after Surgery -Return to Activity Phase Goals: • 1. Progression of functional activities • 2. Maintain full ROM & strength • 3. Begin sport progressions with clearance   STRENGTHENING / THERABAND -2-3 sets, 15-20 reps • Days per week: 3 Times per day: 1 • Continue from phase 4   STRENGTHENING / DYNAMIC • Days per week: 3 Times per day: 1