Arthroscopic SLAP Repair Rehabilitation Protocol.
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Aims:
The aims of rehabilitation are to protect the repair in the early stages and to optimise function in the long-term.
General Points:
• Do not push through pain.
• Do not sacrifice quality of movement for range of movement.
• Do not push into Abduction External Rotation (hand behind head, throwing or push up position) for at least 12 weeks post surgery.
Immobilisation:
• The patient is to wear a sling day and night for 3 weeks (apart from to undertake exercises).
The patient is to wear the sling at night for a further 3 weeks, making a total of 6 weeks in total at night.
Post Operative Instructions:
0-3 weeks:
External Rotation to neutral (handshake position) as tolerated.
Hand, Wrist and Elbow exercises.
Pendular exercises.
Encourage optimal Scapulo-Thoracic positioning.
From 3-6 weeks:
Wean out of sling during the day.
Light activities within field of view only.
Gentle active and passive movements.
Gradually increase External Rotation to neutral (handshake position).
Proprioceptive exercises.
From 6 weeks:
Gradually increase range of External Rotation and elevation.
Progress active assisted through to active isometric rotator cuff in available range.
No long lever open chain exercises until 10 weeks.
No resisted biceps until 12 weeks
From 12 weeks:
Isometric exercises in variable starting positions progressing to
Resisted movements through range and strengthening
Biceps and sports specific rehabilitation avoiding throwing type activity.
From 16 weeks:
Regaining ROM particularly into Abduction External Rotation but dynamic and in particular eccentric control is required.
Functional Milestones and Activity Time Scales:
Driving See general principles of rehabilitation.
Swimming and cycling 8-12 weeks plus.
Golf 12 weeks plus.
Throwing and Racket sports 16 weeks plus.
Contact sports (rugby, football, mountain biking, climbing) 6 months plus.
