Physical Therapy Protocol After Arthroscopic SLAP Labral Repair

The rehabilitation protocol following arthroscopic SLAP labral repair spans approximately 4-6 months and consists of four distinct phases.

During the immediate post-operative phase (weeks 0-6), immobilization with a sling is for comfort, with range of motion restrictions limiting flexion to 90 degrees and external rotation to 30 degrees with the arm at side. Internal rotation is restricted to the chest wall. Beginning at week 2, gentle pendulum exercises are introduced along with active range of motion for elbow, wrist, and hand, accompanied by isometric deltoid exercises without resistance.

The intermediate phase (weeks 6-12) begins exercise progression includes advancing to passive range of motion, introducing light isotonic exercises at week 4-6, and initiating rotator cuff strengthening by week 8. Patient may progress faster if meeting objective criteria. Contact sports remain prohibited during this phase, with cryotherapy utilized as needed.

During the strengthening phase (weeks 12-16), goals focus on achieving full passive and active range of motion with progression to end-range stretching. The exercise program encompasses progressive resistive exercises, scapular stabilization, proprioceptive training, and sport-specific exercises.

The return to activity phase (months 3-6) requires meeting specific criteria including full range of motion without pain, normal strength (5/5), normal scapular control, and successful sport-specific testing. Therapeutic interventions include joint mobilization and soft tissue work beginning at weeks 8 and 10 respectively, with pain control modalities implemented as needed.

Important precautions include avoiding contact sports for 4-6 months, positions of instability, and overhead throwing until medical clearance.

The protocol should be individualized based on repair type, tissue quality, patient age and activity level, athletic demands, prior instability history, and individual healing response.