SLAP Repair Recovery
Superior Labrum Anterior-Posterior (SLAP) Repair
What the operation does
The labrum is a rim of cartilage around the shallow socket of the shoulder, deepening it. At the very top, the long head of the biceps tendon anchors into that rim. A SLAP tear is a tear of the labrum at that spot — where the biceps pulls. The operation stitches the torn labrum back down to the bone with small anchors, restoring the attachment.
Why the biceps is the centre of this
The biceps tendon runs up the front of the arm, through the shoulder, and attaches at exactly the point that was repaired. Every time you bend the elbow against resistance or turn your palm upward, that tendon pulls on the repair. Understanding that explains the single restriction that matters most below.
No resisted biceps use for about six weeks
This is the key instruction. Lifting anything with the elbow bending, turning a doorknob or a screwdriver forcefully, pushing up out of a chair with the arm, carrying a bag by the handle — all pull the biceps and therefore the repair. Moving the elbow freely without resistance is encouraged; loading it is not. Biceps strengthening deliberately does not appear in this programme until month two.
External rotation is limited early too
Unlike a biceps tenodesis, this operation repairs labrum, and turning the arm outward stretches the front of the shoulder across the repair. So outward rotation is usually restricted for the first few weeks and reintroduced gradually — which is why the passive rotation exercise appears in phase 2 here rather than phase 1.
Who this operation suits, and the age question
Worth being direct about. SLAP repair works best in younger patients — broadly under thirty-five — with a genuinely traumatic tear, particularly overhead athletes. In patients over about forty, and where the labrum is worn rather than torn by an injury, repairs are associated with more persistent pain and stiffness, and many surgeons prefer a biceps tenodesis instead. If you are in the older group and this was still the right operation for you, your surgeon had a specific reason.
Stiffness is a real risk here
More than after most shoulder operations. Stitching down the top of the labrum can tighten the shoulder, and a stiff shoulder after a SLAP repair is one of the commoner reasons people remain dissatisfied. That is the tension your programme is managing: enough protection for the repair, enough movement to keep the joint free. It is why passive movement starts immediately even though loading does not.
The sling
Usually worn for around three to four weeks, and largely to stop you using the arm reflexively. Coming out of it for the exercises is expected. Keeping it on longer than instructed is a common route to a stiff shoulder.
If you throw
Throwing athletes deserve a frank picture. Return to throwing is generally slow — commonly six to nine months with a structured interval programme — and the published results in throwers are more mixed than for almost any other shoulder operation. Many return to sport; fewer return to exactly the level they had. Planning around that is better than assuming it.
Pain relief takes time
Improvement is usually gradual over three to six months rather than immediate. Deep aching in the front of the shoulder can persist for months as the repair settles, and it is not by itself a sign of failure. Judging the outcome before six months tends to undersell it.
Night pain
Common for the first one to three months and often the last symptom to go. Lying flat lets the shoulder settle into an aching position with nothing to distract from it. Many people sleep propped up for several weeks.
If the repair does not settle
Where pain persists past six to twelve months, particularly in an older shoulder, the usual next step is converting to a biceps tenodesis — cutting the biceps away from the repaired anchor and reattaching it lower down, which removes the source of the pull. That is a recognised and generally effective second operation rather than a disaster, and it is worth knowing the path exists.
What else was found
SLAP tears frequently occur alongside rotator cuff damage or shoulder instability, and whatever else was treated changes the plan. A cuff repair done at the same time is the more restrictive of the two and takes over the timetable. It is worth asking explicitly what was done.
Driving and work
Driving generally waits until you are out of the sling and can control the wheel with both hands without pain — commonly around four to six weeks. Desk-based work is often possible within one to two weeks with the sling on. Work involving lifting, pulling or overhead reaching commonly waits three to four months.
How the first year usually unfolds
Four weeks in a sling with passive movement and no biceps loading. Four to eight weeks the sling goes, active movement returns and rotation is restored. Two to four months brings strengthening, including the first biceps work. Four to six months brings heavier strengthening and most daily activity. Six to twelve months is sport-specific, with throwing latest of all.
Staying in touch with your care team
What your labrum looked like, your age, and what else was repaired all change this recovery. Your surgeon knows those details. If something about your recovery is worrying you or does not match what is described here — particularly a shoulder losing movement rather than gaining it — contact your care team.
Exercises for SLAP Repair
An illustrated, phase-by-phase exercise program for this procedure. View the SLAP Repair exercise program.
Recovery education · Condition guides · Exercise programs
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This guide is general education and doesn't replace evaluation by a licensed provider. Recovery and treatment vary by person — follow the guidance of your own surgeon or care team.