SLAP repair 

The risk of developing stiffness is marginally greater after repair of associated partial thickness or small tears. Hence early passive mobilisation is essential. 

0-4 weeks: Arm placed in a Donjoy ultrasling after surgery. This is worn most of the time but may be removed for short periods to shower, dress, eat. Instruct patient on technique to remove and wear Donjoy ultrasling. Commence hand, wrist and elbow exercises immediately. Commence supine passive external rotation to 30 and passive flexion to 90 using table slides immediately. If the posterior capsule has been released, start sleeper stretches. 

5-6 weeks: Discard sling. Commence passive overhead stretching with a rope and pulley. Commence sleeper stretches (if not already started). 

7-8 weeks: Commence door-frame stretches and strengthening with theraband. 

9-12 weeks: Start biceps strengthening. Continue stretching until full movements are regained. Commence closed-chain scapular control exercises and open-chain scapular strengthening. 

After 12 weeks: May resume working out in the gym. Commence sports-specific rehab at 4 months. Progress activities as strength allows. Unrestricted overhead activities (tennis) should be deferred for at least 6 months. 

Arthroscopic Stabilisation or Bankart repair 

0-3 weeks: Arm placed in a Donjoy ultrasling after surgery. This is worn most of the time but may be removed for short periods to shower, dress, eat. Instruct patient on technique to remove and wear Donjoy ultrasling. Commence hand, wrist and elbow exercises immediately. May perform active flexion to table height. (AVOID overhead elevation / external rotation as well as internal rotation stretching during this phase unless instructed otherwise) 

4-6 weeks: May gradually discontinue use of sling during the day but should continue wearing it at night. May commence active and assisted forward flexion. May commence external rotation to limit specified (or half that of opposite side if not specified). 

7-12 weeks: Discard sling. Commence strengthening (unless a remplissage was performed, in which case strengthening is deferred for 12 weeks). Continue working on regaining range of movements. 

After 16 weeks: May start working out in a gym. Progress activities as strength allows. Return to full activity may take 6 months.

Posterior labral repair

0-3 weeks: Arm placed in a Donjoy ultrasling after surgery. This is worn most of the time but may be removed for short periods to shower, dress, eat. Instruct patient on technique to remove and wear Donjoy ultrasling. Commence hand, wrist and elbow exercises immediately. May perform external rotation as tolerated. (AVOID elevation / internal rotation during this phase unless instruc
ted otherwise) 

4-6 weeks: May gradually discontinue use of sling during the day but sh
ould continue wearing it at night. May commence active and assisted forward flexion. AVOID stretching in internal rotation. 

7-12 weeks: Discard sling. Commence strengthening. Continue working on regaining range of movements. 

After 16 weeks: May start working out in a gym. Progress activities as strength allows. Return to full activity may take 6 months. 


Adapted from: Burkhart S.: “The Cowboy’s Companion: A trail guide for the Arthroscopic Shoulder Surgeon” Wolters Kluwer/ Lippincott 2012.