Conservative Treatment for Patients with Suspected SLAP Tears: A Case Series

Objective: Outcome following non-operative management of superior labral anterior to posterior (SLAP) lesions has been under reported with little empirical data demonstrating the effectiveness of conservative treatment. Material and Methods: 10 patients, 5 matched pairs, presenting with symptoms consistent with a SLAP lesion performed a standardized phased rehabilitation program completing patient reported outcome (PRO) and pain measures before and following rehabilitation. Physical therapy notes and home exercise logs were reviewed and all exercises were recorded and coded using the phased rehabilitation protocol as a guide. At followup, patients were divided into two groups; responders and non-responders to treatment based on PRO. The volume of exercise and type of exercise performed for each patient were compared using frequency counts. Results: The non-responders did on average 33 more stretching exercises than the responders. The non-responders did on average 21 more scapular orientation exercises than the responders. There were few to no differences in the volume of strengthening exercises between the two groups except responders performed 38 more scapular retraction exercises at shoulder level while non-responders performed 49 more scapular retraction exercises below shoulder level. Conclusions: This case series identified few exercises that were beneficial to patients\u27 responding to conservative intervention but more often identified exercises that were performed that did not facilitate an improved patient outcome. Therapeutic exercises are often the cornerstone of a rehabilitation program, yet limited evidence exists in which specific exercises are beneficial or not beneficial in patients with symptoms consistent with a SLAP lesion