slap repair protocol repair mr. devinder garewal mbbs, bmedsci, fracs (orth), faortha orthopaedic...
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Warringal Medical Centre | Suite 7, 214 Burgundy St, Heidelberg, Victoria 3084
1300 ARMCLINIC | 1300 276 254 ! (03) 9459 0861 [email protected] melbournearmclinic.com
SLAP Repair Protocol
SLAP Repair
Mr. Devinder Garewal MBBS, BMedSci, FRACS (Orth), FAOrthA
Orthopaedic Shoulder Surgeon
Warringal Medical Centre | Suite 7, 214 Burgundy St, Heidelberg, Victoria 3084 1300 ARMCLINIC | 1300 276 254 ! (03) 9459 0861 [email protected] melbournearmclinic.com
Sling When will I go home? What can I do? What can’t I do? 4 weeks You will be discharged
on the same day as the operation
Range of movement within safe zone*
No combined abduction/external rotation, no end range ER, no lifting
Acute phase (0-4 weeks) Goals
o Protect the surgical repair o Reduce pain o Promote cuff and scapular control
Rehabilitation o *Safe zone: aim for passive range of movement to 120° elevation,
45° abduction, 30° external rotation by end of second week o Active assisted/supported range from 2 weeks o No eccentric or concentric loading of biceps o No forced movements, no combined abduction/external rotation o Closed kinetic chain/proprioception exercises o Cuff exercises within this range of movement zone o Scapular setting exercises o Elbow, wrist, hand exercises
Criteria for progression o Pain control o Adequate range of movement
Intermediate phase (4-8 weeks) Goals
o Preserve surgical repair o Restoration of functional range of movement o Cuff recruitment and scapula control through range o Enhance proprioception
Rehabilitation o No passive stretching into end range external rotation o No eccentric biceps loading o No heavy lifting/concentric overload biceps o Encourage active movement with good cuff and scapular control o Progress cuff & scapular recruitment through range
SLAP Repair
Mr. Devinder Garewal MBBS, BMedSci, FRACS (Orth), FAOrthA
Orthopaedic Shoulder Surgeon
Warringal Medical Centre | Suite 7, 214 Burgundy St, Heidelberg, Victoria 3084 1300 ARMCLINIC | 1300 276 254 ! (03) 9459 0861 [email protected] melbournearmclinic.com
o Progress kinetic chain integration o Proprioceptive re-education incorporating closed chain exercises o Hydrotherapy permitted
Criteria for progression o Painfree functional range of movement o Good cuff and scapular control through functional range
Late phase (>8 weeks) Goals
o Restore full range of movement o Optimise cuff and scapular control under load o Enhance shoulder power, strength and endurance o Ensure cuff and scapula control maintained during biceps loading
Rehabilitation o Regain optimal range of movement into combined positions o Ensure posterior capsule mobility o Specific biceps strengthening/control work ensuring maintenance of
scapula control and humeral head position o Strengthening and endurance exercises for cuff and scapular musculature o Preparatory and reactive stabilisation drills in risk positions
Guidelines for return to functional activities Driving Lifting Swimming Golf 6-8 weeks Light lifting 4 weeks.
Avoid heavy for 3 months Breaststroke 6 weeks, freestyle 12 weeks
3 months