SLAP Repair

What is a SLAP repair?

SLAP stands for Superior Labral Anterior to Posterior and it describes a type of tear to the labrum of the shoulder. The labrum is a ring of cartilage around the socket of the shoulder joint. A SLAP injury refers to a tear in the top (superior) part of the labrum, where the biceps tendon attaches.

If the symptoms of your SLAP tear do not improve with conservative therapy, you may need to have it surgically repaired.

How does SLAP repair work?

Most SLAP repair surgeries are done arthroscopically. With an arthroscope, your surgeon can examine the inside of your shoulder joint and identify the type of SLAP tear, which will determine the best type of repair. Some tears just require removing the damaged tissue. Others involve re-attaching the torn away labrum, and possibly also cutting the biceps tendon.

What to expect after SLAP repair?

Day 1 to 3 weeks

For the first 3 weeks you will wear a sling, but you will still be able to start your rehabilitation physiotherapy program.

Before you leave hospital, your therapist will teach you how to keep your armpit clean and some initial exercises including:

  • postural awareness and scapular setting
  • kinetic chain control exercises
  • exercises regain scapula and glenohumeral stability, aiming for shoulder joint control rather than range
  • passive range of motion, progressing to active assisted motion
  • closed chain exercises, as tolerated
  • active elbow flexion and extension in standings, as tolerated
  • core stability exercises with sling

3–6 weeks

By week 3 you will probably no longer be using the sling. Your exercises will progress as directed by your physiotherapist. Your program will involve:

  • active glenohumeral flexion, abduction, internal and external rotation
  • scapular stabiliser exercises
  • exercises for kinetic chain control
  • strengthening rotator cuff muscles
  • posterior complex stretching
  • increase proprioception through open and closed chain exercise

By week 6, you should have full active range of shoulder elevation.

If you have an office-style job, you will be able to return to work during this period, if you can manage it.

6–12 weeks

Your physiotherapy program will incorporate:

  • posterior capsule mobility
  • manual therapy to eliminate any stiffness, as needed
  • eccentric biceps exercises with scapula control, depending on biceps function
  • sports-specific rehabilitation

By 6–8 weeks you should be able to resume driving and start swimming breaststroke for exercise.

By 12 weeks you can expect full active range of shoulder movement with dynamic scapula stability throughout range. At this stage, you resume functional activities and you might be able to resume manual work, swim freestyle, play golf, lift heavier objects and play contact/impact sports. Your surgeon will be able to advise you on what is appropriate at the time.

12 weeks +

You can now start biceps strengthening exercises.