The shoulder labrum is a ring of cartilage that lines the shallow socket of the shoulder joint. Its primary function is to enhance the stability of the shoulder by deepening the socket, thereby providing a secure attachment point for the head of the upper arm bone (humerus). This added stability is crucial for maintaining the integrity of the joint during a wide range of movements, from everyday activities to sports-related motions like throwing and lifting. Additionally, the labrum helps absorb shock, facilitates smooth gliding of the joint, and contributes to maintaining proper alignment of the shoulder structures, allowing for efficient and pain-free shoulder function. The 2 most prevalent labrum repairs are for Bankart lesions and SLAP lesions (Superior Labrum Anterior to Posterior). The biggest difference being that the SLAP tear repair typically involves the biceps tendon. Along those same lines, the timeline and progression of exercises may vary depending on the individual’s surgical technique, the extent of the injury, and the surgeon’s recommendations.
Day 0 – 21
Goals:
• Maintain integrity of repair.
• Protection phase using brace/sling.
• Manage pain/swelling/inflammation.
• Passive ROM as tolerated.
Exercises:
• Cervical Active Range of Motion (AROM)
• Scapular retraction
• Posture/Positioning education
• Elbow, wrist, & finger AROM
• Therapist assisted passive ROM.
• Pendulum
Week 3 – 4
Goals:
• Progress passive ROM to shoulder.
• Continue with brace/sling.
• Begin isometrics.
Exercises:
• Therapist assisted ROM in all planes of motion.
• Table slides
• 5-way shoulder isometrics
Week 4 – 6
Goals:
• Begin active and active assisted ROM.
• Week ~5 discontinue brace (Per MD).
• Week ~6 being bicep tension exercises (SLAP specific)
Exercises:
• Pulleys
• Dowel flexion, abduction, ER, & IR
• Prone rows
Bicep isos (SLAP)
Week 6 – 12
Goals:
• Progress to full passive ROM (~10 weeks)
• Begin resisted strength training.
• Improve neuromotor control.
Exercises:
• Theraband ER/IR.
• AROM flexion, scaption, & abduction.
• Bicep curls with weight (~9 weeks for SLAP)
Week 12 – 16
Goals:
• Achieve full active ROM.
• Dynamic shoulder stability
• Neuromuscular re-education
Exercises:
• 90/90 Resisted External/Internal rotation.
• Resisted lateral raises.
• Weight bearing through arms.
Week 16 – 20
Goals:
• Gradual return to functional activities
• Advance strength, conditioning, and endurance
• Begin overhead exercises.
• Introduction to sport specific exercises
Exercises:
• Shoulder taps
• Weighted presses
• Overhead ball on wall
Weeks 20+ <
Goals:
• Progressive return to sport
• Progressive return to strenuous work
Exercises:
• Functional training dependent on sport/work
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