PHYSICAL THERAPY PROTOCOL
SLAP Repair
Physical Therapy Protocol
Rehabilitation following arthroscopic SLAP repair is designed to protect healing of the superior labrum and biceps anchor while gradually restoring shoulder mobility, strength, and function. Progression should emphasize biologic healing before aggressive strengthening or return to overhead sports.
Protect Repair
Restore Motion
Strengthening
Return To Overhead Function
Important Note
This protocol is intended as a general rehabilitation guideline. Patients undergoing concomitant rotator cuff repair, instability surgery, biceps tenodesis, or revision surgery may require modifications. The surgeon's postoperative instructions always take precedence.
Rehabilitation Philosophy
The superior labrum and biceps anchor require time to heal securely to bone. Early rehabilitation focuses on protecting the repair while restoring controlled shoulder motion. Strengthening of the biceps is intentionally delayed until sufficient healing has occurred.
Phase I: Protection Phase
Timeframe: 0–6 Weeks
Goals
- Protect the superior labral repair
- Control pain and swelling
- Prevent postoperative stiffness
- Maintain elbow, wrist, and hand motion
- Begin protected passive shoulder motion
Sling
- Sling full time except hygiene and therapy
- Sleep in sling
- No lifting
- No resisted biceps activity
- No supporting body weight through the arm
Exercises
- Pendulum exercises
- Passive forward elevation
- Protected passive external rotation
- Elbow, wrist, and hand motion without resistance
- Grip strengthening
- Scapular retraction exercises
Avoid
- Resisted elbow flexion
- Resisted forearm supination
- Forceful biceps contraction
- Heavy lifting
- Sudden overhead movements
Phase II: Motion Phase
Timeframe: 6–12 Weeks
Goals
- Restore full passive motion
- Progress to active-assisted and active motion
- Normalize scapular mechanics
- Gradually discontinue sling
Exercises
- Cane exercises
- Wall walks
- Pulleys
- Table slides
- Scapular stabilization
- Gentle posterior capsule stretching
Continue To Avoid
- Heavy resisted biceps strengthening until cleared
- Forceful throwing
- Heavy pulling exercises
- Sudden overhead loading
Phase III: Strengthening Phase
Timeframe: 12–20 Weeks
Goals
- Restore rotator cuff strength
- Begin gradual biceps strengthening
- Improve endurance
- Restore dynamic shoulder stability
Exercises
- Theraband strengthening
- Progressive rotator cuff strengthening
- Light resisted biceps curls
- Light resisted supination
- Scapular strengthening
- Proprioception exercises
Phase IV: Return To Sport
Timeframe: 20–28+ Weeks
Strength
Restore normal shoulder and biceps strength.
Throwing
Begin an interval throwing program when appropriate.
Competition
Return to unrestricted athletics after demonstrating strength, endurance, and shoulder stability.
Return To Activity Guidelines
Desk Work
Usually within 1–2 weeks.
Driving
After sling discontinuation and when safe vehicle control has returned.
Daily Activities
Progress gradually after the first 6 weeks.
Weight Training
Progressive strengthening begins around 3 months.
Throwing Program
Typically initiated around 5–6 months depending on sport and progress.
Competitive Sports
Usually 6–8 months, depending on restoration of strength, motion, and function.
Therapist Notes
- Protect the superior labrum and biceps anchor during the first 6 weeks.
- Delay resisted biceps strengthening until adequate healing has occurred.
- Restore shoulder mechanics before aggressive strengthening.
- Emphasize rotator cuff endurance and scapular control.
- Progress overhead athletes cautiously with objective strength milestones.
- Notify the office if pain, stiffness, or instability deviates from expectations.
Red Flags
Contact The Office For
- Increasing shoulder pain
- Redness or drainage
- Loss of shoulder motion
- Sudden weakness
- Loss of shoulder function
Seek Urgent Care For
- Chest pain
- Shortness of breath
- Calf pain or swelling
- Severe uncontrolled pain
Related Resources
Questions About SLAP Repair Rehabilitation?
Successful rehabilitation after SLAP repair depends on protecting the healing labrum and biceps anchor while progressively restoring motion, strength, and shoulder function for a safe return to work and sports.
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