This comprehensive guide outlines the post-operative rehabilitation process for arthroscopic labrum repair in the shoulder, detailing each recovery phase, physiotherapy exercises, and prevention strategies to restore strength and mobility. It also provides expert advice on managing pain, avoiding complications, and safely returning to sports and daily activities.
The glenoid labrum is a fibrocartilaginous structure in the shoulder joint that anchors the joint capsule and ligaments. It plays a crucial role in shoulder stability and is often involved in pathologies resulting from trauma or repeated microtrauma. Common labral lesions include SLAP lesions in the superior region, Bankart lesions anteriorly, and Kim's lesions posteriorly.
Superior Labrum Anterior Posterior (SLAP) lesion is an injury to the superior labrum of the shoulder, typically centered around the biceps tendon attachment. These lesions often result from repetitive overhead motions or falls on an outstretched arm, causing shoulder pain and instability
A Bankart lesion is a common injury of the glenohumeral joint, often resulting from shoulder dislocation. It involves a fracture of the anteroinferior glenoid rim, occurring in up to 22% of first-time anterior shoulder dislocations.
Bony Bankart lesions commonly occurr in young male athletes during traumatic anterior shoulder dislocations. Anatomical repair and stabilization is crucial because if left untreated, these lesions can lead to recurrent instability.
Shoulder labrum surgery recovery involves a carefully structured rehabilitation process. Surgeons use small incisions and a camera (arthroscope) to either reattach the torn tissue or remove damaged parts. Individuals typically seek surgery to relieve pain, instability, and improve overall function. Arthroscopic repair is common after dislocations or SLAP tears.
Post-operative symptoms include: pain, stiffness, and temporary activity restrictions. However, getting involved in physiotherapy after surgery can help modulate these symptoms and improve overall wellbeing.
The glenoid labrum is a fibrocartilaginous rim that deepens the shoulder socket, stabilizes the humeral head, and anchors ligaments and tendons. Its structure varies: the superior portion is more mobile, while the inferior portion is firmly attached. Vascular supply is primarily peripheral, making the superior region more prone to slow healing. The labrum maintains joint stability through concavity-compression and negative intra-articular pressure. Anatomical variants (e.g., sublabral recesses) must be distinguished from true pathology. These features guide surgical repair and rehabilitation approaches.
Post-operative shoulder labrum rehab is essential to restore range of motion, prevent stiffness, and gradually rebuild strength. Engaging in physiotherapy early on can help facilitate the rehabilitation process and protect repair while preventing scar tissue formation. Physiotherapy is important for preventing frozen shoulder after surgery. This rehabilitation process involves gentle passive and active-assisted exercises initiated early to maintain mobility, along with progressive range-of-motion drills to prevent stiffness.
Scapular stabilization exercises improve joint mechanics, while ice and other modalities help manage pain. This controlled movement approach prevents excessive scar tissue formation while protecting surgical repairs, typically progressing from passive to active motion over 6-12 weeks. Consistent, guided rehabilitation helps restore function while minimizing the risk of adhesive capsulitis.
A comprehensive 26-week rehabilitation protocol is recommended for superior labrum anterior posterior repairs. For Bankart repairs, surgeons typically advise waiting about 6 months before resuming sports activities. Overall, most athletes return to sport after superior labrum repair. Typically it will take 6-9 months for athletes to fully recover. However, it depends on the demands of the sport. Overhead athletes have lower return rates compared to collision athletes.
During the early phase of recovery (0-6 weeks), rehabilitation will focus on passive motion and isometric strengthening. This will allow for isolated activation of the muscles, without putting too much stress on the labrum. A gradual increase in activity is crucial for avoiding re-injury during the rehabilitation process.
(Targets: "post-op shoulder exercises," "rotator cuff rehab after surgery")
The main goals during phase 1 are protection, pain management, and early mobility while preventing complications like stiffness and muscle atrophy.
1. Passive Range of Motion (PROM)
Lean forward, let arm hang, and make small circles (no active muscle use).
Gentle flexion, abduction, and external rotation within pain-free limits.
Use the unaffected arm to assist in lifting the surgical arm (flexion, abduction).
2. Isometric Rotator Cuff Activation
Gently press hand into a pillow or wall (no movement) for:
3. Early Scapular Mobility
Gentle shrugs and retraction (avoid excessive force).
Arm supported at 30° abduction, therapist gently rotates outward (if cleared).
Things to keep in mind:
Avoid lifting, pushing, or pulling.
Stop if sharp pain occurs.
Follow surgeon’s guidance on wear time.
During phase 2, the main goals are to restore active motion, improve rotator cuff/scapular stability, and transition to light resistance.
Assisted shoulder flexion & abduction (keep below 90° initially).
Unaffected arm helps guide motion (flexion, abduction, external rotation).
Light overpressure in flexion/scaption as tolerated.
Elbow at side (0° abduction), light resistance.
Progress from 0° to 30° abduction as tolerated.
Fingers walk up wall (active flexion/scaption control).
Small clockwise/counterclockwise rolls (enhances proprioception).
Against band or cable machine.
Things to keep in mind:
Stay below 90° abduction/flexion until cleared.
Mild discomfort is okay; sharp pain = stop.
Increase resistance only if form is perfect.
During phase 3, it is important to focus on restoring full strength, endurance, and dynamic control of the shoulder while preparing for higher-level activities. Some key exercises during this phase include:
Progression Criteria
Move to Phase 4 when:
Advanced rotator cuff rehab integrates sport-specific training (throwing progressions, plyometrics) to ensure safe return to overhead activities, power, and endurance demands.
During phase 4, it is important to incorporate sport-specific exercises to allow for a smooth return to sport. The main goal is a safe return to pre-injury performance with a focus on power, endurance, and sport-specific demands. This phase would include:
This may include full-intensity throwing with sport-specific drills (pitching, serving), including interval programs to build endurance.
Sport Specific Plyometrics
1. Overhead Athletes (Baseball, Tennis, Volleyball)
2. Contact Sports (Football, Rugby, Wrestling)
Recover faster, move better, and feel stronger with expert physiotherapy. Our team is here to guide you every step of the way.
Strengthening the rotator cuff and scapular muscles before and after surgery helps prevent labral re-injury through three key mechanisms:
1. Dynamic Stability
2. Reduced Shear Forces on the Labrum
3. Improved Movement Efficiency
Overhead athlete strengthening prevents reinjury by developing rotator cuff endurance, scapular stability, and eccentric deceleration control to minimize excessive joint loads. Integrating full kinetic chain drills (hip/core power to arm motion) ensures efficient force transfer and reduces isolated shoulder strain.
Q: When can I drive after labrum surgery?
A: Most patients can drive after 2-6 weeks. Right-arm surgery may require waiting until you're out of the sling (4-6 weeks). Always check with your surgeon or physiotherapist first!
Q: Can you lift weights post-op?
A: Not right away, but with proper physiotherapy you can progress to lifting weights depending on your recovery!
Q: How long will I need a sling?
A: Typically 4-6 weeks for standard repairs. More complex surgeries may require longer immobilization.
Q: Will I regain full mobility?
A: Yes, with proper rehab. Most patients recover near-full range of motion within 3-6 months. Overhead athletes may take longer for sport-specific mobility.
Q: When can I return to sports?
A: Non-contact sports take around 4-6 months for full recovery. Overhead/throwing athletes often need 6-12 months with a supervised return-to-play program.
Take the first step towards regaining your function post-labrum surgery! Book an appointment at Vaughan Physiotherapy Clinic to go through our specialized post-op program.
Our post-op programs include:
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Don’t let post-op pain stop you from regaining your full function after labrum surgery. Contact us today to begin your journey!
By: Tiffany Corpus
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