Introduction: Dealing with persistent shoulder pain and instability can be challenging, especially after a SLAP tear repair. This blog post discusses effective strategies and treatments to manage these issues.

The patient in question has reported enduring pain across the left shoulder, upper back, chest, arm, and forearm over the past several months. With a history of a SLAP tear initially diagnosed in 2018 and subsequently repaired in 2022, he has undergone previous physiotherapy sessions that yielded limited relief. Post-exertion, his discomfort rates as high as 8/10 on the Numeric Pain Rating Scale (NPRS), highlighting the severity and impact of his condition.

Observations:

During the assessment, several key observations were noted regarding the patient’s condition. Despite full range of motion in the shoulder AND Grade 3 glenohumeral play

There was evident wasting of the scapular and rotator cuff muscles. Manual Muscle Testing revealed weakness in the Infraspinatus, Supraspinatus, and Rhomboids, while Tightness was observed in the Upper Trapezius and Pectoral muscles. Trigger points were identified in the upper trapezius, rhomboids, pectorals, and deltoids, indicative of localized muscular tension and discomfort. Additionally, mild scapular malposition with abduction and elevation, along with prominence of the inferior angle and coracoid tenderness, further underscored the complexity of the patient’s condition. Dyskinesia was also noted during movement assessments, highlighting functional impairments associated with the left shoulder instability post-SLAP repair.

Patient has rated  SPADI (Shoulder Pain and Disability Index): 59%

Diagnosis: Left GH instability with scapular dyskinesia post-SLAP repair

Treatment done in Physio Active :

In our physiotherapy sessions at Physio Active, we employ a variety of advanced techniques tailored to address specific patient needs. These include:

1. Myofascial Release (MFR): Targeted release techniques applied to muscles such as the Upper Trapezius (UT), Pectorals (Pects), and Deltoids to alleviate tension and improve mobility.
2. Scapular Retraction Exercises: Exercises performed in a prone position to strengthen muscles responsible for stabilizing the scapula, aiding in correcting mild malpositions and enhancing shoulder function.
3. Activation Exercises: Including Chin Tuck with resistance band, Pectoral stretches, Wall Clock exercises, and activation of specific muscles like Middle Trapezius (MT), Lower Trapezius (LT), and Supraspinatus (SSA) to promote proper shoulder mechanics and strength.
4. Kinesio Taping (KT),

Each technique is carefully selected and applied under the guidance of our experienced physiotherapists to ensure optimal therapeutic outcomes and patient comfort.

We can also use other Technique like Dry Needling (DN), Ultrasound Therapy, and Interferential Therapy (IFT) to manage pain, reduce inflammation, and facilitate tissue healing.

Conclusion:

Managing left shoulder pain and instability following a SLAP repair requires a holistic and multifaceted approach.

At Physio Active, we prioritize comprehensive care that goes beyond alleviating symptoms. Our treatment plans integrate Stretching, Strengthening, Exercises, Dry Needling, Cupping and Taping

We Equally prioritize hydration optimization, adequate sleep, sunlight exposure or supplementation for Vitamin D3 and a balanced diet rich in essential nutrients like B12 and protein.

We emphasize gentle strength training, flexibility exercises, and daily meditation to enhance overall health and well-being.

Additionally, ergonomic adjustments play a crucial role in preventing further strain and promoting optimal posture. By addressing these aspects collectively, we aim not only to relieve pain but also to improve functional outcomes and quality of life for our patients.