SLAP (Superior Labrum Anterior to Posterior) repair is a surgical procedure aimed at treating a tear of the labrum in the shoulder joint. The labrum is a cartilage structure that forms a cup-like shape around the ball of the shoulder joint, stabilizing the humeral head (the ball) within the shallow socket (glenoid). A SLAP tear occurs when the top (superior) part of the labrum, where the biceps tendon attaches, is injured. This injury often results from trauma, repetitive overhead movements, or degenerative changes.

This guide will walk you through the details of SLAP repair surgery, the recovery process, rehabilitation strategies, and how Palms Physiotherapy & Allied Health can help in both pre-habilitation (pre-surgery) and post-operative rehabilitation (post-surgery) to ensure a successful recovery.

SLAP Repair Surgery: Procedure, Recovery, and Rehabilitation

What is SLAP Repair Surgery?

SLAP repair is performed to address tears in the labrum that occur at the point where the biceps tendon attaches to the top of the shoulder socket. These tears often result from direct trauma, repetitive overhead activities (such as throwing), or aging. SLAP tears are classified into several types, with the most common being Type II, where the labrum is detached from the glenoid, and the biceps tendon is affected.

Indications for SLAP Repair Surgery

• Recurrent shoulder pain that doesn’t improve with conservative treatments.

• Shoulder instability: Feeling of the shoulder “slipping out” of the joint.

• Weakness or loss of function: Difficulty lifting or throwing, especially in overhead sports.

• Failure of non-surgical treatments: Physical therapy, medications, or injections.

• Tear pattern: The location and severity of the tear may require surgical intervention for proper healing.

The SLAP Repair Surgery Procedure

1. Pre-Surgical Preparation

• Evaluation: The surgeon will perform a thorough assessment using physical exams, X-rays, MRI, and sometimes a diagnostic arthroscopy to confirm the presence and extent of the SLAP tear.

• Pre-Habilitation (Pre-Surgery Rehab): Palms Physiotherapy & Allied Health will help prepare the shoulder by focusing on strengthening the muscles around the shoulder, improving range of motion, and enhancing overall shoulder stability. This reduces the risk of complications during surgery and shortens recovery time.

2. Surgical Procedure

• Anesthesia: SLAP repair is typically performed under general anesthesia, often in conjunction with a regional nerve block to manage pain.

• Incision: Small incisions are made around the shoulder, and an arthroscope (a small camera) is inserted to view the shoulder joint. This is called arthroscopic surgery, making the procedure minimally invasive.

• Labrum Repair: The surgeon uses specialized instruments to reattach the torn labrum to the glenoid (shoulder socket) using sutures or anchors. In some cases, the biceps tendon may also be repaired if it is involved in the tear.

• Duration: The procedure typically lasts 1–2 hours, depending on the complexity of the tear and any additional shoulder injuries that need to be addressed.

3. Post-Surgical Care

• Pain Management: Post-surgery, you may experience some discomfort and will be prescribed pain medication, including ice therapy to reduce swelling.

• Bandages & Sling: The shoulder will be placed in a sling to immobilize the joint and allow for proper healing. The sling is typically worn for 4–6 weeks, depending on the surgeon's protocol.

Recovery Timeline After SLAP Repair Surgery

Immediate Post-Operative Phase (Days 1–7)

• Rest and Recovery: During this phase, the focus is on managing pain and swelling. Patients will need to wear a sling for 4–6 weeks to limit movement and protect the repaired structures.

• Ice Therapy: Ice packs are used to reduce swelling and manage post-surgical pain.

• Limited Motion: Movement is restricted to passive range of motion exercises (with the guidance of a physiotherapist) to prevent stiffness and improve mobility.

• Follow-up Appointments: You will have follow-up visits with your surgeon to monitor healing.

Short-Term Recovery (Weeks 2–6)

• Gradual Mobilization: Depending on your surgeon's protocol, gentle range of motion exercises will be initiated at 2–3 weeks post-surgery. The physiotherapist will guide you through safe movements that don’t strain the healing tissues.

• Sling Wear: The sling is typically worn during the first 4–6 weeks. You may be encouraged to begin using the arm for light tasks after the sling is discontinued, but heavy lifting or overhead activities will be avoided.

• Physical Therapy: Rehabilitation with a physiotherapist begins as soon as you are able, with a focus on restoring shoulder flexibility, and reducing pain and inflammation.

Intermediate Recovery (Months 2–3)

• Strengthening: As the shoulder heals, strengthening exercises are introduced to rebuild the shoulder muscles, including the rotator cuff and scapular stabilizers. These exercises help restore shoulder stability and function.

• Continued Therapy: You will continue to work on improving the range of motion and gradually increase the intensity of strengthening exercises. More complex movements and exercises will be incorporated, focusing on improving the stability of the shoulder joint.

Long-Term Recovery (Months 4–6)

• Full Range of Motion and Strength: By 4–6 months, you should be able to perform functional activities like overhead motions, lifting light weights, and participating in low-impact activities.

• Return to Sport/Work: Athletes and individuals who perform heavy manual labor can return to their activities between 4–9 months, depending on the demands. Light office-based work may be resumed within 2–4 weeks, with full return to work expected after 3–6 months.

Rehabilitation After SLAP Repair Surgery

Phase 1: Early Rehabilitation (Weeks 1–6)

• Focus: Pain management, restoring basic range of motion, and preventing stiffness.

• Exercises:

  • Passive range of motion (PROM): Shoulder movements performed by a physiotherapist to restore flexibility.

  • Pendulum exercises: Gentle movements to promote circulation and mobility in the shoulder.

  • Pain Control: Ice, gentle stretching, and anti-inflammatory medications may be used to minimize discomfort.

Phase 2: Intermediate Rehabilitation (Weeks 6–12)

• Focus: Restoring full range of motion and building strength.

• Exercises:

  • Active range of motion (AROM): Performing shoulder movements independently, under the supervision of a physiotherapist.

  • Strengthening: Focused on the rotator cuff muscles and scapular stabilizers to enhance shoulder function.

  • Functional Training: Exercises specific to daily tasks or activities to improve shoulder use and endurance.

Phase 3: Advanced Rehabilitation (Months 3–6)

• Focus: Returning to functional and sports activities, building full strength and stability.

• Exercises:

  • Progressive strengthening: Resistance training that builds shoulder strength.

  • Proprioception training: Exercises to improve the shoulder’s stability and coordination.

  • Activity-specific training: Training that mimics sports or heavy-duty physical tasks to help return to normal activity levels.

How Palms Physiotherapy & Allied Health Can Help

Pre-Habilitation (Pre-Surgery)

• Shoulder Strengthening: Before surgery, we focus on strengthening muscles to promote a faster and safer recovery.

• Range of Motion and Flexibility: Enhancing shoulder flexibility helps reduce post-surgery stiffness and aids in quicker healing.

• Education: We provide education on what to expect during and after surgery, helping you mentally and physically prepare for the procedure.

Post-Operative Rehabilitation

• Personalized Rehab Plans: After surgery, we develop individualized rehabilitation programs that focus on restoring your strength, flexibility, and function.

• Pain and Swelling Management: Our physiotherapists use a variety of techniques, including ice, manual therapy, and ultrasound, to manage pain and reduce inflammation.

• Functional and Strengthening Exercises: We guide you through exercises aimed at improving your daily function and strength to return to your normal activities.

• Sports-Specific Rehabilitation: For athletes, we provide rehabilitation focused on returning to sports with confidence.

Frequently Asked Questions

1. How long will it take to recover from SLAP repair surgery?

Full recovery typically takes 6 months to a year. The first 3–4 months will focus on regaining range of motion and strength, with return to more demanding activities occurring after 6–9 months.

2. Will I have permanent weakness after SLAP repair?

While some patients may experience mild weakness in the shoulder, most regain full function with appropriate rehabilitation.

3. How soon can I return to work after SLAP repair surgery?

If you have a desk job, you can likely return to work within 2–4 weeks. If your work involves lifting or overhead activities, expect to return after 3–6 months.

4. Will I need to wear a sling after the surgery?

Yes, a sling is typically worn for 4–6 weeks post-surgery to protect the repaired shoulder and facilitate healing.

5. Can I participate in sports after SLAP repair surgery?

You can expect to return to light activity after 3–6 months, and full participation in sports may be possible between 6–12 months, depending on the type of sport and your rehabilitation progress.

For more information or to schedule a consultation, contact us at Palms Physiotherapy & Allied Health. We are here to support you in every step of your recovery journey.

This guide for SLAP Repair Surgery is optimized for patients seeking a comprehensive understanding of the procedure, its recovery, and the role of Palms Physiotherapy & Allied Health in supporting both pre-surgery and post-surgery rehabilitation.