Labral Tears and options- anyone else been thru this?

[bluelew]

I have had shoulder pain for roughly a year and a half. It has prevented me from squating with a standard bar (I bought a safety squat bar and love it) or military/ BTN press because I can't hold weight behind the head or in front without pain. Benching has been ok with good and bad days- mostly good until last month. Deads are no problem. So I finally saw a sports surgeon and had an mri. My shoulder looked good (suprisingly after years of heavy military pressing and squats) and there wasn't a lot he noticed. There was an area of discoloration in the labrum not far from where the biceps ties in. He believes there is some fraying of the labrum but would need to scope it to be sure. If he is right it would involve some hooking of the labrum to the bone (I think that is what he said) as well as smoothing out any fraying. He says it is fairly common and recommends the procedure. After a year and a half he doesn't believe it will heal on it's own whatever the problem is. I opted for a cortizone shot so I could get some opinions from those who have been in this position. Anyone have this done and returned to heavy lifting. I know bench shirts would possibly help but I want to stay raw. Any opinions welcome. Anyone try to rehab w/o surgery- what did you do exercise wise? Thanks in advance.

[Lones Green]

Yeah, it is super common, and it normally happens in the area you described.

I have a friend who tore his, (playing rugby) and he got the surgery. Its pretty simple, 3 small holes. You're in a funny looking sling for a few weeks, then a regular sling, then you start the rehab on it. He finished 6 weeks ahead of time, but I can't remember how long the recovery was total. It wasn't as bad as you'd think.

You could try going to a PT and seeing what they think, if they could rehab it or if you need surgery. Usually, they'll be able to do a couple of tests on you involving ROM, flexibility, etc, and they should be able to know right then.

Great idea though, I think its best to seek out the opinion of others, and get a few opinions from different Doc's.

[thegreatone]

Here are PT rehab protocals that may give you some idea on what you are in for post op. My recovery was much faster than the protocals but I wasn't allowed to lift anything heavier than a coffee cup for 6 months but not because of pain or the labrum repair. I had a detached biceps tendon which required an anchor to be inserted and that was what held me up. I was pretty close to a pain free ROM in a month and if it wasn't for the anchor would have been back at it then. I think the protocals are for the average joe so athletic, trained individuals should/could make it back faster.

http://www.peninsulaortho.com/downloads/slap2.pdf

http://www.brighamandwomens.org/Reha...20Protocol.pdf

[dammstrate]

I had this exact injury. Remember exactly when I did it, putting back a heavy
raw bench into the rack without help (ahhh, one of the dangers of lifting raw...hahaha). After I could bench ok, just so I didn't flare back at the top to hard. Well, that isn't going to make a bench bigger. MRI showed the tear
pretty clearly. Shopped around for an ortho until I found one who had done the surgery on athletes. Knew I was in the right place when he said "you will never bench 600 until we fix this." Boo-ya. Arthroscopic surgery put two pins
in the glenoid (the socket), then stiched the labrum down on to the pins to hold it to the glenoid. Without this mechanical pinching of the two areas together, it will never heal by itself. Trying to rehab it without surgery is the wrong path for a lifter. GET IT FIXED. I was in a sling for about a week, after that just held my arm next to my side, no problems. Started lifting the bar again after 8 weeks, was full strength about 4 months post op, new PR the next meet which was 5 months post op. GET IT FIXED.

[bluelew]

That's very reassuring Dammstrate- thanks for sharing. Anyone else have this done with good/bad results?

[NUCadet97]

I had a bankhart lesion (labrum tear) with capsular shift due to multiple dislocations. I tried to rehab using PT, chiro and electrical stimulas, cortisone, just about eveything for about 1.5 years. Nothing worked the joint remained unstable. I had corrective surgery in 2005 and have not had a problem since. Surgery was not bad, mine was repaired using a full incision, and rehab went well with full recovery 4-5 months post op. Out of the sling in 2 weeks, completed PT (3 days per week) in 8 weeks.

[Sean S]

My training partner had a labrum repair along with shaving some bone spurs and cleaning some other things up. He was in rehab a few days after surgery and ended up back and as strong as ever with less pain in the shoulder.

[thegreatone]

That's very reassuring Dammstrate- thanks for sharing. Anyone else have this done with good/bad results?

I agree that having it fixed it the way to go. If you don't and continue there is a chance you could cause other issues. You may end up subconsciously altering your movements/technique to alleviate the pain which could lead to an off balance which could then lead to further issues. Just a thought. I know my should is as good as it has even been.

[ehubbard]

It sounds to me like there isnt much damage, but the only way to know is to have it scoped. I have a SLAP tear in my right shoulder that has not been fixed. I was much like you in terms of symptoms and I opted to not have surgery. I hired Eric Cressey who put me through a ton of mobility / flexibilty and corrective protocols and my shoulder has been pain free ever since. Most people have developed muscular imbalances coupled with mobility issues that cause inpingement in the shoulder which can be fixed with corrective protocols. Keep in mind that your tear injury may differ from mine and dammstrate's and may exhibit varying degrees of pain and disfunction. Having said that, dammstrate makes me reconsider my decision to avoid surgery at all costs. The timeline I was given by the surgeon was closer to 6 months. My bench has been going up steadily (up until the last few months with the purchase of my first house and subsequent working on the house while I am unemployed). However, I do often wonder if it is holding me back.

My advice would be to try to find out which orthopaedic surgeon your local NFL or MLB team sends its shoulder patients to, and go see him/her. Hopefully they take your insurance.

[Tom Mutaffis]

I have a friend who was able to rehab his without surgery; it was a long process (6+ months) and he is still not as strong as before but he has maintained good size and has close to 100% of his overhead press strength (the bench is what suffered).

Your best bet would probably be to combine some of the advice above. I would look to improve your mobility/flexibility in your shoulders and if that does not help then you would likely want to find an Ortho who works on athletes and get it fixed.

[bluelew]

Thanks guys- this is truly a great resource. Looks like I will have the surgery and move on. Kudos to WBB for a great web site.

[mdschultze]

I tore mine twice back in my college football days. The first tear came from blocking a linebacker in the 2nd game of the year. The trainers pretty much called me a pussy and I went back and played the 2nd half and the rest of the season. During the off season, I got stronger than I had ever been. I was able to workout without problems. I didn't think I had a tear or anything. I benched about 385, squated in the upper 500 and powercleaned 375 with no pain or soreness. Then in spring practice, I reinjured my shoulder doing a walk thru. After that I had horrible pain and numbness all the way down my arm. The trainers actually sent me to the team dr and I found out I had a torn labrum. It was torn in the front and back. He asked if I had injured it before because I had scar tissue build up around the joint, which ended up fraying some ligaments and tendons. He told me that I could have had it fixed immediately after the initial injury and had minimal down time. He also said the only thing allowing me to play the rest of the year was my actual shoulder muscle.

I had my surgery, which only used 2 small incisions. I was in a sling for about a week and started rehab a week and a half after surgery. I was ordered to sleep in the sling for a month. Rehab lasted about 8 or 10 weeks. The proceedure was basically pinning the front and rear of the cartillage, allowing them to heal. And fusing the ligs and tends back together. There was also a small disk inserted in the joint that dissolved away after time. Im not sure the point of this but everything seemed to come out ok.

[ehubbard]

I tore mine twice back in my college football days. The first tear came from blocking a linebacker in the 2nd game of the year. The trainers pretty much called me a pussy and I went back and played the 2nd half and the rest of the season. During the off season, I got stronger than I had ever been. I was able to workout without problems. I didn't think I had a tear or anything. I benched about 385, squated in the upper 500 and powercleaned 375 with no pain or soreness. Then in spring practice, I reinjured my shoulder doing a walk thru. After that I had horrible pain and numbness all the way down my arm. The trainers actually sent me to the team dr and I found out I had a torn labrum. It was torn in the front and back. He asked if I had injured it before because I had scar tissue build up around the joint, which ended up fraying some ligaments and tendons. He told me that I could have had it fixed immediately after the initial injury and had minimal down time. He also said the only thing allowing me to play the rest of the year was my actual shoulder muscle.

I had my surgery, which only used 2 small incisions. I was in a sling for about a week and started rehab a week and a half after surgery. I was ordered to sleep in the sling for a month. Rehab lasted about 8 or 10 weeks. The proceedure was basically pinning the front and rear of the cartillage, allowing them to heal. And fusing the ligs and tends back together. There was also a small disk inserted in the joint that dissolved away after time. Im not sure the point of this but everything seemed to come out ok.

I believe that if it's torn in the back and front you are usually pretty screwed and have to get surgery.

[mdschultze]

It was originally a front tear that should have been repaired. The dr said it would have been a quick fix with minimal downtime, but after the second injury it was more complicated. But I still recovered in about 3 months.

[packers0415]

I had a torn rotator cuff and a torn labrum in my left shoulder. I had surgery to repair the rotator and the labrum. It took about 6 months, but I came back stronger than before. If you only have a torn labrum, the surgery is much easier and the rehab is much quicker than the rotator. My only regret is that I didn't have the surgery sooner as I put up with the pain in loss in strength for over a year before the surgery.