Slap lesion, Labrul tear in Shoulder

Got to love it when you Dr. calls to tell you "Doug, your shoulder is jacked!" Thinking to myself, Doh, I knew that.

So got the results of my MRI back and apparently I have a slap lesion, (superior, anterior, and posterior) or labrul tear.

Anyone had this one? Apparently rotator cuff is fine. Said I will most likely need surgery.

Anyone heard of a Dr. Knapp in LA. Its where I'm being referred and trying to dig up info, good or bad on him. Primary Care dude claims he is the mang for shoulders, but I would like a 3rd party confirmation of this.

I have read the shoulder threads previously and most seem to be rotator cuff issues.

Per our conversation this past weekend: I had my surgery done by David Morrison at

http://socalsportsmedicine.com/

Hope this helps.

comish: I have the same problem and I'm going on the surgery in 4 weeks to repair my labrum. If I were you, I'd try to go into rehab and see if PT helps, if it doesn't, then I'd consider the surgery.

My wife had shoulder problems and tried PT for a few months without success. The MRI indictated possible rotator cuff tear. She had surgery 4 weeks ago and it turned out she had a labrul tear. A week after surgery the doc told her she could move her arm and begin PT. The recovery time for labrul vs cuff tear is much shorter.

I can't offer an opinion regarding LA docs

A SLAP lesion is pretty common. Are they planning to scope it? The surgery has got a good track record.

Hmm, Like what all of you are saying about the shorter recovery. Doesn't sound like I will be catching too many waves this summer... Keep the recovery stories coming though.

Seeing the specialist next week, that is just the diagnosis from my primary Dr. after the MRI. I already knew I had a labral tear from 10 or 12 years ago that I never fixed. Then I crashed about 2 months ago and it is totally fucked, still can't raise the arm past the shoulder. I guess the fact that its superior, anterior, and posterior sorta explains why its fucked. Figured I needed surgery and am hoping for just the scope.

Thanks for the name DT. From what I'm hearing this guy is pretty good...

I had a labral tear, along with some floating chunks of cartiladge that was repaired with arthoscopic surgey. They did a technique called capsular shrinkage where they superheat the labrum to get it to shrink up and tighten up around the humeral head. Sounds good, right? Except for the long recovery time prior to PT. I was in a sling for 12 weeks before I could do PT. They say the scar tissue from this procedure is what holds it together, so rather than go right into PT to break up scar tissue, I was immobilized for 3 months. That sucked. PT was brutal at first, but results have been ok since. I have dislocated again, but that was pure physics.........

http://www.sportsinjurybulletin.com/...shrinkage.html

http://www.ejbjs.org/cgi/content/abstract/85/12/2283

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I have dislocated again, but that was pure physics.........

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Interesting, here is what I found in one of your links

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Thermal shrinkage does appear to offer potential benefits, but it may be best suited for minor instabilities - and probably should be combined with proven arthroscopic techniques for shoulder repair. Great care must be taken to prevent extensive burns and axillary-nerve injury.

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Did they use screws to attach your labrum back to the bone?

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Originally Posted by ak_telemike

I had a labral tear, along with some floating chunks of cartiladge that was repaired with arthoscopic surgey. They did a technique called capsular shrinkage where they superheat the labrum to get it to shrink up and tighten up around the humeral head. Sounds good, right? Except for the long recovery time prior to PT. I was in a sling for 12 weeks before I could do PT. They say the scar tissue from this procedure is what holds it together, so rather than go right into PT to break up scar tissue, I was immobilized for 3 months. That sucked. PT was brutal at first, but results have been ok since. I have dislocated again, but that was pure physics.........

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I had the same surgery. It's kind of misleading because it's arthroscopic, but the recovery time is the same (if not longer) than if they cut you open. My recovery time was much less than yours, though. I think I was back at work in two weeks. If I remember right, three to four weeks in a sling with no PT, then PT two or three times a week for about a month. Doc said it would be three months total before I could go back into sports, which ended up being about right. The good thing is that my repaired shoulder is now stronger and more stable than my untouched/uninjured shoulder.

Edit: I didn't have a torn labrum. Just very loose ligaments and a frayed/damaged rotator cuff that was pinched often because of the looseness of the joint. The laser surgery was relatively new when I had mine done (about 7 or 8 years ago). They had already had success with it then, and I can only guess that they've had more success since.

They did not use screws to reattach the labrum.

First injury was due to a dislocation playing goalkeeper in indoor soccer. Hit the ground hard with my hand when I dove to make a save, and the thing came out and then dropped back in a few seconds later. I went 6-8 months w/o surgery, just rest and PT. I had full range and strength, but super bad pain when skinning, climbing, etc. Sometimes it was ok, other times I wanted to cry.

The first surgeon I saw told me I was jacked and tried to schedule full shoulder reconstruction on the spot. I wanted a second opinion. The second guy said he wanted to do arthoscopic sugery, including the capsular shrinkage, but also wanted permission to cut me open if need be. Sounded better to me.

In addition to the capsular shrinkage, they took out 3 floaters, and repaired a flapper of cartalidge. Those floaters and the flapper were probably what was causing the pain when they got hung up in the joint.

12 fucking weeks in a sling - even at night. All through a semester of college. PT was rough, but very successful. Cute girls at the clinic didn't hurt.

Of course, I dislocated it again a couple years later patrolling. Side slipping down an AC closure line opening the gates I slipped and planted my uphill pole to brace myself. POP! (like a high brace kayaking) Out it goes and down I go. It's been ok since then, but I am careful to tuck it in instead of reach out if I crater face first.

Ugh - sorry to hear that Comish. I have nothing but sympathy for shoulder injuries. Dealt with a nasty one a couple of years ago and subsequent surgery. Not fun, but of course, the good results make it worth it.

The only thing I'd add is don't overestimate what you can do following surgery. I did way too much both work wise and just activity wise - I wish I'd been a bit more gentle with my recovery (just didn't feel I had a choice with my schedule, but should have found a way around it).

Best of luck!

And be thankful your not a woman - trying to get a bra on with a bum shoulder SUCKS. :)

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Originally Posted by watersnowdirt

Ugh - sorry to hear that Comish. I have nothing but sympathy for shoulder injuries. Dealt with a nasty one a couple of years ago and subsequent surgery. Not fun, but of course, the good results make it worth it.

The only thing I'd add is don't overestimate what you can do following surgery. I did way too much both work wise and just activity wise - I wish I'd been a bit more gentle with my recovery (just didn't feel I had a choice with my schedule, but should have found a way around it).

Best of luck!

And be thankful your not a woman - trying to get a bra on with a bum shoulder SUCKS. :)

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That's what you get for turning all your potential boyfriends gay...no one to help you.

Saw the specialist today. Kinda interesting. He said I won the most interesting patient of the day award and that all the guys in the back were going to be quite interested in my shoulder. I guess its "locked" at the moment. I tore off two pieces of my bicep tendon and they are stuck between my arm and the joint. So he was like, "yep, I have to fix that. No choice for you."

So I'm having arthroscopic done, don't know when yet. He isn't sure whether they will take the bits out, reattach them (sounds like this will only happen if there is blood still in them), or do some sort of transplant.

So, anyone had this? How long till I'm feeling well enough to go back to my desk jockey job? One day, a few, or a week? Trying to plan things like a beach party, vegas weekend etc. Sounds like my deal depends on what exactly they have to do...

You'll likely be in a sling for the first 6 weeks after surgery. So depending on what kind of work you do you may or may not be able to get back to work quickly.

After the first 6 weeks is up then you be able to start some range of motion work and some strengthening.

Every time I see this topic my brain reads "Slap lesbian labia" before I get it sorted out.

I had a SLAP Lesion repaired back in 96 or 97. I trashed my shoulder playing football and it just kept getting worse over a couple of years. It got to the point where working out was excruciating. Inclines were like a form of torture.

Anyway, they went in and reattached my bicep with a biodegradable tack. That way, they wouldn't have to go in and remove the screw.

I had surgery on a Wednesday, took Thursday off, and then drove to my physics class on Friday. In restrospect, I should have taken Friday off since the Darvocet was treating me a little more nicely than I had suspected. "Oooooh...look at the pretty clouds." :D I was off the painkillers by Sunday and resumed a normal schedule. I can't remember how long I was in a sling; but if I had to guess I'd say two weeks. Full strength/use didn't return for a month or two. My doc wanted me doing range of motion type stuff fairly early. He said PT wasn't necessary, but in retrospect I'm not sure if that was the best advice. I went and saw a PT/trainer after 8-9 months and that helped a lot.

I hope that helps. Good luck, comish!

Oh and these guys have an excellent reputation:
www.kerlanjobe.com

Dr. Jobe was basically the team ortho for the Dodgers and Lakers for years. He invented the Tommy John procedure. Lombardo did my sister's knee.

Arty,

Thanks mang. Ya, Dr. Lombardo's kids went to my high school so I have seen him previously. I think I have a pretty good "shoulder expert" so I feel pretty good about that side. Good to hear about your experience. Sounds not tooo bad.

Yeah, it really wasn't all that bad. Also, I just have two dime size "x" scars on my shoulder from the scope and instruments. You can barely even see them anymore. You can put vitamin E oil on them after they heal up to keep the scar tissue down, or just leave them alone if your wife digs scars. :D

I'd guess you've seen this:

http://www.tetongravity.com/forums/s...light=shoulder

I had a labrum repair (disolving tacks) and the "capsular shrinkage" done. 4 weeks in a sling, 5 months PT, cleared to ride my bike, ski, etc in 4 months.

Good luck, heal fast.

Anterior labrum tear here from 12 to 6 o’clock. No dislocation. Biceps tendon attaches at the superior end, so SLAP can be problematic. Shoulder doesn't feel unstable. It is a bit more limited in ROM, but almost the same as non injured side. I did PT before ski season and then skied over 80 days with no issues (but no bad falls on that side). <antijix> So far so good </antijix>. MTB will be a bigger test. Doc doesn’t want to cut till I dislocate, which may or may not happen.

Posterior dislocation & labrum tear for me a couple of years back. No surgery, lot's of PT for 6-8mos. Now back in the gym pumping iron. I can't go as heavy as I used to though, but full range of motion and no shoulder instability.

I guess I was lucky to be able to heal up on my own w/o surgery. However, ended up tearing my bicep on the same shoulder/arm last year while doing arm curls in the gym. I suspect that the tear (full rupture) was because of a weakened bicep tendon from my shoulder dislocation. Never did get the bicep tear repaired cuz the doc said just to leave it if I'm not experiencing any pain. Sux to get old!

All the best with your surgery. The PT will be a long & painful experience, but be patient and stick with it. You'll be good as new before you know it!

Surgery scheduled for July 12th. Damn, I would love to get it done sooner since I'm sorta walking wounded right now... They are claiming 3 months and I'm good to go? These guys are sports Dr's and seem fairly aggresive which I like, but that is definitely sounding aggresive.

I was just diagnosed a few weeks ago after MRI. Also partial rotator tear. I initially fractured my shoulder in early feb. Dman pucker brush. They missed the break with the first xray. PT really isn't cutting it. I am heading back in a few weeks for another consultation. ie to schedule surgury. Was thinking early september to ensure recovery before ski season. (Nov 29th)

It's been good mtn biking but I can throw a ball for shit.

Am I pushing it with a 3 month recovery as well? I saw a copy of their post op timetable and it looked doable...

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Originally Posted by comish

Surgery scheduled for July 12th. Damn, I would love to get it done sooner since I'm sorta walking wounded right now... They are claiming 3 months and I'm good to go? These guys are sports Dr's and seem fairly aggresive which I like, but that is definitely sounding aggresive.

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No, that's not aggressive for this. It's a pretty quick recovery process, even more so I imagine if you set up a good PT program post op.

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Originally Posted by comish

Surgery scheduled for July 12th. Damn, I would love to get it done sooner since I'm sorta walking wounded right now... They are claiming 3 months and I'm good to go? These guys are sports Dr's and seem fairly aggresive which I like, but that is definitely sounding aggresive.

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Comish - I don't know how I missed this topic. I am having my meniscus repaired the same day July 12th. Anyway, I had the same surgery labrum torn bicep tendon done a couple of years ago. I was a quick 2 hr outpatient with the shoulder all jacked up. The first day you are all drugged up so there is no problem. The hardest thing for me in the whole process was sleeping. I won't kid you but it is a nightmare. I also hope it is not your primary arm. I had my right shoulder worked on and I am right handed...talk about a pain in the ass. Writing, mouse control, brushing your teeth etc etc will be a circus the first week. Practice now.

Recovery time is different for all as you know but I took an aggressive schedule. I had surgery on Monday and took that whole week off. I started PT 5 days after the surgery. Slow and steady but went 3-4 times per week. Make sure they work on the potential scar tissue.

As for surfing, your summer will be shot. I ask my Dr the same question and he said give it min 3 months of rehab before hitting the waves but by all means swiming is great for your shoulder.

For the love of God, get the shoulder strap that hooks up to the ice cooler with the pump. I have no idea what the thing is called but it will cut down on the recovery time big time. When I had my first knee surgery I bought the thing and it is one of my best decisions ever. It is interchangable with my knee pad and shoulder pad. In case you have no idea what the hell I am talking about let me know and I will take a few photos of the machine for you. I would let you borrow mine but I am going to need it for my knee. Your insurance will probably authorize it for you. Here is an example

http://cgi.ebay.com/Opti-Ice-Cold-Th...QQcmdZViewItem

Thanks AB,
Actually got it rescheduled to June 23rd which I'm psyched about. Ready to get this thing on the road to recovery.

Nice!!! Friday is a good call on the surgery. Then a few recovery days Monday, Tuesday, Wednesday what a shame that the round of 16 will be on those days.

Good luck! I'm scheduling mine on monday!

done on friday. now a one handed typer. shoulder feels ok, i can sleep which im psched about, but why does my freakin head kill me?!?!

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done on friday. now a one handed typer. shoulder feels ok, i can sleep which im psched about, but why does my freakin head kill me?!?!

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I had capsular shift done to my right shoulder on June 15th and stopped taking pain killers by the end of the second day. You will feel much better within a week.

Figured I should post an update. I'm 3 months out of surgery and doing pretty well. Doc cleared me to do whatever I want. I was like, Surf, yep. ride, yep. Mtn bike, yep. backpack a slot canyon, yep. The last one was good because I left the next day for a little trip to Paria Canyon in Utah.

Psyched to be cleared to bike and surf again. Shoulder feels pretty good. Still don't have full range of motion or full strength yet, but its better every day.

The whole deal really wasn't that bad. If I didn't have headaches relating to the anesthesia for the 4 or 5 days post surgery I think this would really have been not a big deal. I could sleep fine, shoulder never really hurt, just have to do the rehab. I was in a sling for a week and slept with it for a month. Had surgery on a Wednesday or Thursday and was back at work on Monday so not too bad. Because of my headaches I could not have gone back on Friday, but my shoulder prolly would have been ok. Really not too painful at all. I had disolving tacks, carpentry as the Doc puts it. No capsular shrinkage that I'm aware of. All artroscopically done so 3 tiny scars, although you really can only see 1 of them.

All in all I'm psyched. Should be more stable than anytime in the last 11 years which is pretty exciting and almost makes me wish I had done it sooner.

My only tip for future surgery candidates is to get the Doc's authorization for PT when setting up the surgery. My Doc wanted me to start PT 1 month after, but I didn't get to see him until 5 weeks after which is when I got the reference (insurance required) and then 10 days later to get a PT appointment put me >6 weeks after surgery before starting PT which was a little late and probably made my recovery a little slower as a result. Get that reference early and make the followup appointments early is my only piece of advice. Now, bring on some waves!

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Originally Posted by comish

Now, bring on some snow!

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Had to fix that for ya. Great to hear all went well. Doesn't it feel nice to have a shoulder that works?