Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I'm heading into surgery to repair a shoulder problem called a SLAP. I don't want to miss any of baseball season. Can you fill me in on what to expect after the surgery?

Answer:

SLAP stands for superior labrum, anterior and posterior. It refers to a torn rim of fibrous cartilage (the labrum) that edges the shoulder socket. The tear is at the top of the socket (that's what superior means) and goes from the front (anterior) to the back (posterior) of the socket. This is a common injury in overhead throwing athletes, but can also occur as a result of trauma from a fall. The exact steps in the postoperative process are determined by the type of SLAP lesion, type os surgery that was done (e.g., debridement versus repair), and how much other damage was present. The postoperative rehab program usually consists of movement, activities, and exercises performed during each of several phases from immediate post-op up to 24 weeks (six months) later. At first, you will probably be immobilized in a special sling. Certain, simple shoulder movements calledCodman's or pendulum exercises are allowed. A physical therapist will show you how to do these. The therapist will guide you through the entire rehab process. You will shown which movements to avoid and how to regain all motions and strength over time. After the first four weeks, you'll be allowed to stop wearing the sling. Some shoulder motions such as external rotation are still fairly limited. This prevents strain on the repaired labrum and allows healing without disruption. During the intermediate phase of rehab and recovery (three to six or eight weeks post-op), the therapist will do some hands-on work with you to restore normal movement of the entire shoulder complex. This includes not just the arm and shoulder joint, but also the forearm, elbow, and scapula (shoulder blade). All of these structures are important in restoring smooth, rhythmic motion of the arm for all types of sports, not just overhead throwing activities. By the end of 10 weeks, you'll be actively engaged in endurance training and starting some flexibility exercises. It's important to make sure the shoulder joint has balanced motion in all directions without tightness in any one movement pattern. Strengthening, flexibility, and endurance training continue to the end of the first three months. At this point, the program will start to shift more toward sports-specific activities. Your surgeon will let you know when you are ready to resume throwing activities. A full strengthening program is needed before getting back to full sports or athletic activities. For the best results possible, it's important to follow the surgeon's and the physical therapist's directions. Cooperation and compliance bring about good results in up to 90 per cent of the patients treated this way. Christopher C. Dodson, MD, and David W. Altchek, MD. SLAP Lesions: An Update on Recognition and Treatment. In The Journal of Orthopaedic & Sports Physical Therapy. February 2009. Vol. 39. No. 2. Pp. 71-80.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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