SLAP Tear Sling Recommendations
There is no specific evidence-based recommendation for sling use in the treatment of SLAP tears, as slings are not a standard component of SLAP tear management protocols. 1, 2
Treatment Framework for SLAP Tears
Initial Conservative Management (First-Line Treatment)
Conservative treatment should be attempted first for all SLAP tears, with the following components 1, 2:
- Physical therapy focusing on rotator cuff and periscapular muscle strengthening 1
- Core musculature strengthening exercises 1
- Capsule flexibility exercises 1
- Activity modification and anti-inflammatory medications 1, 2
Approximately two-thirds of patients can expect symptom relief with nonoperative management 3. Athletes who complete their rehabilitation program have a 78% return-to-play rate and 72% return to prior performance level 4.
When Immobilization May Be Considered
While slings are not specifically recommended for SLAP tears, the evidence from rotator cuff management suggests that immobilization devices (including slings) are primarily used for pain control and preventing further injury during the acute phase 5. However, the American Academy of Orthopaedic Surgeons found no clinical data supporting or refuting the effect of slings on tendon healing or outcomes 5.
Important caveat: The stroke rehabilitation guidelines mention sling use "especially during ambulation training to protect the shoulder from traction injury" 6, but this applies to hemiplegic shoulders, not SLAP tears—this evidence should be disregarded for your clinical scenario.
Post-Surgical Immobilization (If Surgery Required)
If surgical repair is performed after failed conservative treatment 1, 2:
- Throwing athletes must avoid throwing for minimum 6 weeks post-repair 1
- Additional 6-week strengthening phase follows (total 3 months minimum rest from throwing) 1
- Return to sports should be based on functional testing, not arbitrary timeframes 1
Factors Predicting Conservative Treatment Failure
Consider earlier surgical consultation if the following risk factors are present 4:
- Older age
- Overhead sport participation (especially baseball pitchers)
- Traumatic injury mechanism
- Positive compression rotation test
- Concomitant rotator cuff injury
- Longer symptomatic period
- Presence of Bennett spur
Clinical Bottom Line
Do not routinely prescribe a sling for SLAP tears. Instead, initiate structured physical therapy with rotator cuff, periscapular, and core strengthening combined with capsular flexibility exercises 1. Reserve surgical intervention for patients who fail a comprehensive 3-6 month conservative trial 1, 2, 4.