Arthroscopic SLAP Repair

The Goal

Dr. Kevin Wall provides specialized, fellowship-trained surgical treatment for SLAP Repairs to restore function and relieve pain for patients in Richmond, VA, and the surrounding Central Virginia communities. The goal of this procedure is to stabilize a torn Superior Labrum from Anterior to Posterior (SLAP), which is the top part of the shoulder socket's cartilage rim where the long head of the biceps tendon attaches. A SLAP tear can cause deep-seated shoulder pain and a sense of "dead arm" or instability, especially in overhead athletes like baseball pitchers or volleyball players. The objective of the repair is to re-anchor the detached labrum to the bone, restoring the stability of the biceps anchor and the overall "suction cup" effect of the joint.

This page is designed to educate you specifically about this procedure. Additional information that generally applies to most of Dr. Wall’s surgeries can be found on these pages:

• Pre-Operative Instructions

• Post-Operative Instructions

• Physical Therapy Protocols

The Procedure

• The Approach: Performed entirely arthroscopically using 2–3 small, minimally invasive incisions.

• Evaluation: Dr. Wall meticulously inspects the superior labrum to differentiate between a stable "fray" (which may only need debridement) and a true detachment that requires mechanical fixation.

• Bone Preparation: The top of the glenoid (socket) is gently prepared to create a "bleeding bone" surface, which is essential for the labrum to heal back to the bone.

• Suture Anchor Fixation: Small, high-strength suture anchors are placed into the bone. The sutures are then passed through the torn labrum and tied down, cinching the labrum back to its anatomical position.

• Concurrent Biceps Management: In many cases, especially in older or high-demand patients, a Biceps Tenodesis may be performed alongside or instead of a SLAP repair if the biceps tendon itself is a primary source of pain.

Post-Op Protocol

• Immobilization (Phase 1: 0–4 weeks): A sling is required at all times, including during sleep, to protect the new attachment. You may remove the sling only for hygiene and very gentle elbow/wrist motion.

• Start Formal PT: Professional physical therapy begins at Post-Op Week 2 for gentle passive motion.

• Phase 2 (4–6 weeks): You will begin weaning from the sling. Therapy focuses on progressive passive and active-assisted range of motion (PROM/AAROM). Strict Restriction: No active elbow flexion or "biceps loading" (e.g., carrying a gallon of milk) is allowed to protect the repair.

• Phase 3 (6–12 weeks): Progression to full active range of motion (AROM). Light strengthening of the rotator cuff and scapular stabilizers begins.

• Phase 4 (12–24 weeks): Progressive strengthening. Overhead athletes begin a "Return to Throwing" or "Return to Play" protocol under the guidance of physical therapy. A full return to competitive sports typically occurs between 6 and 9 months.

When to Seek Care

You should schedule a consultation if:

• You experience a painful "pop" or "click" deep in the shoulder when throwing or reaching overhead.

• You feel a sudden loss of velocity or "dead arm" sensation during athletic activities.

• You have a deep, aching pain in the front or top of the shoulder that worsens with lifting or carrying heavy objects