SLAP tear - surgery/no-surgery/recovery options?
- 03-08-2012, 09:57 AM
SLAP tear - surgery/no-surgery/recovery options?
Anyone here have experience with this? I recently had an MRI that showed a labrum (SLAP) tear. I see a specialist next week but I'm wondering if people here have had experience with this, in regards to therapy, non-surgical options, surgery and recovery? Is it possible to return to 100%? Is surgery generally required for this type of tear? Anything I can do to speed up the healing?
- 03-08-2012, 10:23 AM
They usually don't recommend surgery right away. I had this too and ended up getting surgery a little over a year later and it's still not 100%. It's been about 5 years for me and I'm probably at 85% of what i was. They will usually recommend a lot of internal/external rotation exercises in the future as well as physical therapy. Most doctors don't advise surgery unless you don't get much help from the physical therapy.
- 03-08-2012, 10:30 AM
What do you mean in terms of %85? In terms of strength, or mobility & range of motion?
The strange thing is, we tested my range of motion and it seems fine. I also trained 2 weeks after the initial injury (without knowing it was injured badly/torn) and my strength was not effected in my press or my rows. But it sure as heck hurt for a while after re-abusing it. I think I tweaked something else halfway between my shoulder and neck, underneath my shoulder blade as well. It hurt like hell there, and at the shoulder head, after it happened... but the MRI only checked the shoulder.
I also had a ball of something protrude through the upper portion of my pec for about a week or two after the injury, pushing out on the skin, after it happened. I told them this but they didn't scan the pec region at all. I'm guessing another tear there? There was no bruising.
I'm guessing after all this, I'll be (or should be) switching back to volume work and give up powerlifting for a while.
03-08-2012, 10:49 AM
I had a Bankart tear which is on the front and bottom of the joint, and i had surgery to repair it. It happened from dislocating my shoulder a few times. They ended up fixing the tear with three anchors and kevlar sutures and pleated over my shoulder capsule to help tighten and stabilize it. Took a solid two months to heal with physical therapy but dont count on lifting for a good five.
03-08-2012, 10:55 AM
Yeah I'm just going to be squatting 3 times per week. That's all I'm doing now, squats, GHR and split squats. Going to join a Bikram studio to maintain some upper body strength and for core work. I hope I can at least do that while it heals.
03-08-2012, 11:17 AM
I have CJC + ghrp6. Should I start using this? Or maybe add in MGF and do site inj?
I've heard people suggest CJC + ghrp6 locally to the area, but they are just GH releasing peptides. GH is released from the brain, not from our torsos, so site injecting CJC makes absolutely no sense to me.
03-08-2012, 11:23 AM
Ive gained back 100% of my range of motion from the injury but my strength has suffered. I can't do all of the same exercises i could before. I can't do heavy lifting or bench press regularly with barbells. I have to stick to mostly dumbells which is still ok. Military press is also a major no-no for me. Every lift i do now I'm very conscientious about what and how I'm lifting. Everyone is different though. I have no hopes of powerlifting in my future.
03-08-2012, 12:20 PM
No more military press? Sucks, my standing press was almost over 200 was just about there.. I guess back to volume training for me when things are healed.
03-08-2012, 12:27 PM
I had a slap tear along with full thickness tears in both supra and infra repaired last April. It's now 100% as far as strength and ROM. They usually won't do surgery until the tear is from '10 o clock' to '2 o clock' around the labrum. If this describes your tear, I recommend getting it fixed asap - it's not going to fix itself and will only get worse. FWIW, I have an '11 o clock' to '1 o clock' tear on the right that I'll have repaired as soon as the tear gets a little worse.
<----resident shoulder surgery expert w 5
03-08-2012, 12:31 PM
My shoulder expert is booked solid for the next month, so I made an appointment with a new doc for Monday. Now I've gotta make sure he gets the MRI screens, since they only sent me the review (doesn't say type I or II etc). What a pain. The previous doc is pretty amazing, should I wait the month? Or go to the new one Monday?
03-08-2012, 12:39 PM
03-08-2012, 12:43 PM
But you are the expert with lots of experience Would you say go asap, or is 1 month an ok wait time (that's just for the MRI follow-up .. no idea how long to book for surgery).
03-08-2012, 12:51 PM
To Gutterpump if you know your specialist is good at what he does it's well worth the wait.
03-08-2012, 01:04 PM
It all depends on the surgeon bro, luckily mine is the ortho surgeon for the tigers and the red wings
03-08-2012, 01:30 PM
Ok, I think I will wait the month then.
I guess I'll have to give up powerlifting after all this and just stick to volume work?
Btw, thanks for all the advice and posts guys.
03-08-2012, 01:58 PM
I lost some ROM but nothing drastic. My strength is back to where it should be, however i play it safe in the gym nowadays and dont do any flatbench or heavy dumbbell flys. I have no problem though with weighted dips and such as long as i REALLY warm up the rotators first. Waiting a month is not going to affect anything, i waited 10 years! The surgeon couldnt believe how well i compensated for it, and he said when i went under, he could just slide my shoulder right out of place. I recommend getting it fixed.
03-08-2012, 02:49 PM
Well I just walked over to my specialist at lunch since he's in my area. Good thing I did, I managed to get an appointment for Monday, so no waiting. They can do the surgery within a week of seeing him.
Do you think I'd be able to do things like use the prowler post surgery? Upper body is used, but in an eccentric/static hold type of way (not repetitive movement), and the angle isn't quite overhead. I only use the longer/higher bars, not the low bar.
03-08-2012, 04:39 PM
I've been reading about PRP platelet rich plasma therapy. Dr's take your blood, stick it in a centrifuge, and pull out platelet rich plasma which has a concentrated level of growth factors in it. They then inject this into the problem area.
This turned on a light in my head...may as well just inject straight growth factors (like MGF). PRP is supposedly for the ultra rich.
03-09-2012, 03:55 AM
The surgeon is going to tell you not to do ANYTHING other than physical therapy for the first two months. You'll start feeling better relatively quickly which gives a false sense of it being all better, but it takes two months to properly heal. Tissue to bone always takes longer to heal than tissue to tissue or bone to bone.
03-09-2012, 05:40 AM
Right, yeah I'm not planning on doing any sort of activity in those two months, but after 8 weeks I plan to start squatting again, at least split squats and GHRs if I can't hold the bar up yet. I'm hoping I can start up at the Bikram yoga studio I'd planned on joining after the first 8 weeks too. I think it'd be great rehab for it.
I'm on HRT so I think I will start GH as well for 6 months. My clinic can prescribe it.
03-09-2012, 07:40 AM
As the godfather said, don't do anything besides pt for at least 3 months post surgery. Believe me, you won't want to. The most important thing by far is to get a good, make that great phys therapist that has worked with athletes. A good pt will have a bit of a sadistic streak in them. No prowler my friend.
Good luck, keep us posted in fact, start a rehab thread we can follow
03-09-2012, 08:48 AM
03-09-2012, 09:45 AM
So no squats in the first three months? Even with the safety squat bar used for good mornings? Yikes.... I'm going to get real bored. Good thing I signed up for Gamefly!! I'm thinking at least a stationary bike should be ok, even within the 3 months? Damn am I ever going to have to sort out a solid come back plan for the summer/fall. Good thing for muscle memory. Strength comes not as fast though
A rehab thread sounds great, even if it's just for motivation for myself. I'm thinking I should get the surgery without delay, so that I can get back to training again in the summer. My therapist tried to tell me not to rush into surgery, but tears don't heal themselves, and if I want to keep on training at a decent level, it needs to be done.
03-09-2012, 10:48 AM
03-09-2012, 10:58 AM
Do you still flat bench now, and at a heavy weight? That's how I hurt mine. I caught a lift off while unprepared, with my arms locked out - and it was attempting a 1RM after being out of the gym for a month from being sick. The weight bounced, and all that pressure was on my labrum. Didn't feel the pain immediately, and I did a crazy shoulder workout 2 days later which just wrecked it. I gave it 3 weeks off, felt better, and then proceeded to wreck it again. I'm sure it's a type II or above right now.
03-09-2012, 11:01 AM
No squats bud, you won't even be able to get your arm back that far for prolly 5-6 months. Don't know about the safety squat bar, never used one, but I wouldn't push it. The first 3 months are critical for healingOriginally Posted by Gutterpump
03-09-2012, 11:09 AM
My injury also didn't really hurt right away, it just felt odd. I heard a snapping/popping sound and my shoulder seemed to be an inch lower or so than the other. The Doctor was amazed at the MRI thinking there is no way the tear could have been that bad from simply bench press. They couldn't do Arthroscopic surgery as the damage was too bad. They had to do a full open incision.
A few years after I got into a fight with a guy pushing a woman around and partially tore it again. It's been a long road back for me. Some people snap back rather fast but I haven't been as lucky.
03-09-2012, 11:18 AM
Crap, I'm worried about them having to do an open surgery now too. I feel like I really must've messed it up badly since I kept training on it, with very heavy weight.
That sucks about the fight. Did you have to get the surgery re-done?
My infraspinatus and supraspinatus, as well as bicep tendon are all intact, luckily. But I am getting pain shooting down the bicep at times. My upper pec also had a ball in it after this happened, that took a while to go away and was pretty painful. Freaked me out. Must've been a muscle tear?
03-09-2012, 11:22 AM
90% of the time they can do it w a scope-depends on the skill level of your surgeon. I had a mini open repair on the right in 2010 and it was no big deal. Stop the worrying and get it fixed
03-09-2012, 11:29 AM
True nuff. Well, at least some decent games are coming out this month lol. Ninja Gaiden 3, Resident Evil: Escape from Racoon City, Prototype 2, Mass Effect 3, Darkness II and Syndicate. Got those all in the queue lol
03-09-2012, 11:42 AM
Yeah man don't worry about the surgery. It will be fine. It's rare they have to do an open surgery nowadays. The tear I had during the fight didn't have to be repaired because it was only a partial tear and not a full thickness tear. Partial tears will heal on their own. You couldn't have picked a better time for surgery. Although Skyrim was pretty rocking for a while for me. I'm anxious to see how the new Resident Evil turns out.
03-09-2012, 11:58 AM
Well thanks for all the words of support guys. Going to start the log Monday, that's when I see the specialist and book the surgery. Where's a good place to create it? We don't have an injury repair/rehab forum here.
03-09-2012, 12:01 PM
03-12-2012, 07:05 PM
Hi guys, I just booked the surgery for this Thursday.
My Dr wants to do something a little interesting / different than the typical anchoring of the labrum. He wants to reconnect the bicep tendon and insert it to another place, so that it doesn't pull on the labrum. He said he has more success this way.
I let him know I definitely wanted surgery since he wasn't pushing it. I told him I train and power lift and would like to return back to it, so he said for sure, we can do surgery. He said this new type of SLAP repair is fine if I plan to return to the gym and lift heavy, etc. I was a bit hesitant because they won't be anchoring the actual labrum, but just re-inserting the bicep tendon to another structure, while keeping things symmetric, etc.
Anyone heard of this?
Btw, I'll be starting my log soon in the Exercise Science forum.
03-12-2012, 07:52 PM
Im no expert in endoscopy but this sounds like an unnecessary method of repair. Relocate the bicep tendon and leave the labrum alone?? Why not just reattach the labrum?? Honestly, i would get a second opinion first.
03-12-2012, 08:22 PM
I know, it does sound odd to me, but he swears this method has better recovery rate, and I can still lift heavy once it's done. He said we could do the older procedure, but again said the success rate isn't as high as this one. I think I'll cancel and get a 2nd opinion.
I think I'm going to get a 2nd opinion from this place here. They look pretty good:
03-13-2012, 09:56 AM
I believe "success rate" is all dependent on the persons attitude and approach towards recovery. Its imperative to do physical therapy starting a week after surgery, and to just sit back and let it heal for a few months. Too many people try to push the envelope and end up ripping apart what was repaired. My surgeon even told me he would be pissed if i did something stupid and undid everything because he used the best real estate to reattach everything. The procedure that your doctor recommended might very well be the new thing, but i would still get a second opinion anyway, its your shoulder after all. Good luck.
03-13-2012, 10:50 AM
Thanks. Yeah I'm almost certain the difference in healing rate between the two options, are due to trying to heal tissue to bone in the first, and tissue to tissue in the 2nd, which is easier/faster for the body to do. He initially didn't want to do any surgery but I told him I want it done so that I can lift again, so he knew I wanted a solid procedure to re-stabilize my shoulder. I'll post up the 2nd Dr's advice once I meet him.
03-14-2012, 11:31 PM
OP, Depending on how you feel about surgery, that is my ultimate suggestion. I tore 270 degrees of my labrum 4 years ago. My first doctor I saw was convinced that physical therapy would help me, so he put me on narcotics and physical therapy for close to 4 months before finally I went and got a second opinion who - after hearing my experience - wanted to schedule me for surgery right away. A 3 hour surgery turned into 6+ hours once he got inside my shoulder he realized that I had torn all 360 degrees by that point and was sublexing multiple times per day. I don't remember the name of the secondary injury this caused but, it involved the ball of my humerus carving a groove out of my shoulder socket from dislocating so many times. All in all the choice is yours, but regardless of which you choose, I wish you the best of luck and a speedy recovery!
- I also had a 2nd labral repair done on the same shoulder from a snowboarding accident 9 weeks ago. Feel free to PM me if you have any questions man!
03-15-2012, 03:46 AM
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