SLAP Repair Protocol Repair Mr. Devinder Garewal MBBS, BMedSci, FRACS (Orth), FAOrthA Orthopaedic...
Transcript of SLAP Repair Protocol Repair Mr. Devinder Garewal MBBS, BMedSci, FRACS (Orth), FAOrthA Orthopaedic...
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