REHABILITATION AFTER ARTHROSCOPIC SLAP REPAIR. 

After SLAP repair, the patient wears a sling for four weeks.  During that four-week period, the patient is urged to perform external rotation stretches as far as possible, trying to match the external rotation between the operated arm and the unoperated arm by the end of four weeks.  Sleeper stretches (four sets of ten) are performed twice a day (Fig. 5).  After four weeks, the sling is discontinued.  At that point, the patient begins overhead stretching and continues with passive external rotation stretching.  At 6 weeks postop, Thera-Band strengthening is begun using the same four-pack program as described above under rotator cuff rehabilitation.  However, in most cases, resisted contraction of the biceps at six weeks postop will still be a bit painful due to repair of the SLAP lesion at the biceps root.  If there is pain with resisted forward flexion of the arm at six weeks postop, we delay the biceps curl until eight weeks postop.  At eight weeks, closed-chain scapular control exercises are also begun (Fig. 6) as well as open-chain scapular strengthening (Fig. 7).  The low row (Fig. 8) is particularly good for strengthening scapular retractors. 

At three months postop, the patient may begin working out with strengthening in the gym.  If he is a baseball player, he may begin to lob a baseball and initiate some slow throwing motions, gradually progressing to an interval throwing program beginning at four months postop.  Baseball players will usually need to include pectoralis minor stretches as a part of their regimen (Fig. 9) (Table I & II).  At seven months postop, the patient may return to full unrestricted activities, including all overhead sports activities. 

If the patient has had multiple structures repaired (for example, combined rotator cuff and SLAP repairs), then we tailor our rehabilitation program toward the repaired tissues that require the longest period of immobilization for healing.  For example, with a combined SLAP repair and rotator cuff repair, we would not begin strengthening until twelve weeks postop in order to allow for complete healing of the rotator cuff.