Post-Operative Instructions:
Shoulder Arthroscopic SLAP Repair
Pain Medications
In most cases local or regional nerve blocks will provide 8-12 hours of numbness.
As soon as you start to feel the numbness wearing off, begin taking oral pain medication.Take Tylenol 500mg one tab every 8 hours.
Take Aleve (Naproxen) 220mg two tabs (440mg total) every 12 hours with food.
If you still have pain after Tylenol and Aleve/Naproxen, take one Norco tab (5mg/325mg).
If you still have pain after all of the above, take a second Norco tab.
Keep in mind Norco has Tylenol in it (325mg). If you take an extra Norco, then skip a dose of Tylenol.
DO NOT exceed 3500mg of Tylenol over 24 hours.It is illegal to drive or operate machinery with narcotic medications.
Do not combine alcohol or other sedatives with narcotic medications.
You do not need to take pain medications once you no longer have pain.
You should stop the Norco first (usually 2-3 days), then wean off the others over the next week or two.
Other Medications
Take Zofran as needed for nausea (usually associated with anesthesia/narcotic meds).
Take an over-the-counter stool softener (Docusate/Senna/Miralax) as needed for constipation.
Activity
You may NOT bear any weight on or lift anything with your operative extremity.
Elevate your operative extremity above the heart as much as possible to decrease swelling.
It may be helpful to sleep on a recliner or with pillows supporting the arm.
Recovery Equipment
You should wear the sling at all times day and night for the first 4 weeks.
You may remove the sling for hygiene, but the arm must be supported.
Cold Therapy
We recommend cold therapy use as much as possible in the first two weeks.
Cold therapy units may be used continuously as instructed.
Ice packs should be applied 30 minutes at a time, with 30 minutes off between applications.
Do not apply ice directly to the skin to avoid burning.
Recovery Exercises
You may perform elbow, wrist, and hand exercises as tolerated.
You will begin physical therapy around two weeks after surgery, after your first postoperative visit.
Diet: Please refer to your preoperative packet instructions.
Incision Care: Please refer to your preoperative packet instructions.
Emergencies: Please refer to your preoperative packet instructions.
Post-Operative Rehabilitation:
Shoulder Arthroscopic SLAP Repair
Therapy Plan: Twice per week for 0-3 months, once per week for 3-6 months
ROM Progression
Sling at all times for 0-4 weeks other than ROM exercises. Wean out of the sling over weeks 4-6.
Progress ROM as tolerated with the goal of symmetric full motion at 8-12 weeks.
Weeks 0-4: scapular plane elevation 0-90 degrees, ER with arm at side to 30 degrees
Weeks 4-12: advance AAROM and AROM
Weight Bearing Progression
Non-weight bearing for postoperative weeks 0-4 with progressive weight bearing over weeks 4-8.
No biceps weight-bearing until 8 weeks.
Initial Post-Operative Physical Therapy Visit
Wean out of sling if not already performed
Instruct on ROM exercises for elbow, wrist, hand
Isometric exercises for core, deltoid, biceps, triceps
Phase 1 Physical Therapy (0-4 weeks): protect the joint, progress motion
NO open-chain exercises
Manual therapy 20+ minutes per session
Progress ROM as tolerated as above
Soft tissue mobilization, isometric exercises, core strengthening
Phase 2 Physical Therapy (4-8 weeks): progressive motion and strengthening
Wean out of sling
Continue progressive ROM as above
Soft tissue mobilization, isometric exercises, core strengthening
Phase 3 Physical Therapy (8-12 weeks): return to pre-injury level
Continue progressive ROM as above
Initiate closed-chain and continue core strengthening
Proprioceptive training
Phase 4 Physical Therapy (12+ weeks): return to sport
Advance functional strengthening
Upper body ergometer as needed for endurance
Agility and sport-specific drills as tolerated
Return to throwing at 4.5 months
Return to pitching on mound at 6 months
Full return may take a full 6-12 months or more and requires functional assessment prior to return