You are here

SLAP Repair Rehabilitation Protocol

normal biceps labral complex arthroscopy

normal biceps labral complex picture

shoulder capsular anatomy



Phase I –Protective Phase (0 to 6weeks)

  • Maintain shoulder range of motion (ROM), diminish pain and inflammation while protecting repair of SLAP lesion.
  • Protect SLAP repair by avoiding active elbow flexion.
  • Sling: continue sling/shoulder immobilizer use for 4weeks.  Must wear sling at night.
  • Pendulum exercises.
  • Supine active assisted forward elevation (FE) to pain tolerance.
  • Once patient understands the difference between active and passive motion, the patient should start passive FE with pulleys, and given instructions for home pulley system.
  • Passive and gentle active-assisted ROM exercises
  • Flexion to 60°(week1) progress to 145 ° by week 6.
  • Elevation in scapular plane to 60°.
  • External rotation to 15 °(week 1) progress to 45 ° by week 6.
  • Internal rotation to 45 °
  • Use modalities to control pain and swelling (i.e. cryotherapy, HVGS, TENS).
  • Home exercise program should be established so patient performs exercises 3-5 times per day.

Phase II –Early Intermediate Phase(7 to 14 weeks)

  • Discontinue shoulder immobilizer.
  • Gradually progress ROM to full.
  • Flexion progress to 180° by week 10.
  • External rotation at 90° abduction to 90° by week 10.
  • Internal rotation at 90° abduction to 60° by week 10.
  • Begin increased strengthening exercises at week 10.
  • Progress ROM to functional demands (throwing etc) at week 10.

Phase III – Intermediate phase (14 to 19 weeks)

  • Patient should have full nonpainful ROM before progressing to phase III.
  • Add isometric IR, ER, and FE exercises.
  • Progress with muscle strengthening program, stretching and ROM exercises.
  • Cybex strength testing – goal >85% of contralateral side at 19 weeks.

Phase IV – Advanced Strengthening (19 to 24 weeks)

  • Patient should have full nonpainful ROM and muscular strength 75% of the contralateral side before progressing to phase IV.
  • Progressive Resistance Exercises.  Start light, progress as tolerated.
  • UBE 90°/sec-120°/sec for endurance.
  • Wall pushups, press-ups.
  • Total Gym – rows, presses, pullovers. 
  • Rockwood exercises – flex, abd, ext, add, IR, ER, rows, presses.
  • Can use dumbbells or theraband tubing for Rockwood exercises.

Phase V – Return to Activities (After 6months) (24weeks)

  • Patient should have full nonpainful ROM and muscular strength 90% of the contralateral side before progressing to phase V.
  • Work on any focal deficits.
  • Progress with sport specific training.
  • Establish home program for strength and ROM maintanence.
  • Improvement continues for 12 months post op.

For Detailed Rehabilitation protocols see:

  • Brotzman SB, Clinical Orthopaedic Rehabilitation, Mosby, 2003.



The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer