Type II SLAP tear

I have been diagnosed with a type ii SLAP tear in the right shoulder.  Injury occurred swinging from playground equipment back in September 2014.  After injury I started myofascial release therapy, physical therapy, chiropractic adjustments and acupuncture.  Orthopedic SM doctor (2 opinions) feels I can heal without surgery, but also left it up to me if I want to have it repaired. 

 

I am 45, up until the injury I had been training F1 and H1 for six months, I coach wrestling, gymnastics, martial arts, softball, baseball and fitness to kids.  I am always active, I backpack, paddleboard, kayak, unicycle, golf, softball and farm.  In late January I was able to resume GB training to help rehab regressing in sPL, HBP, RC and handstand PEs.  GB training rarely causes pain, it's when I get careless playing with kids at work or in general activities that causes flare ups of inflammation.

 

It has been nearly six months since the injury and there are times when I feel like I need to have the repair so I can return to activities that I love.  There are also times that I feel like I will be able to heal on my own to return to full capacity.  Baseball and softball seasons start soon.  Right now I have no confidence to throw a ball. 

 

I welcome experiences and advice.  Thank you.

I'm generally an avoid surgery if you can help it sort of person beause, as you know, results aren't guaranteed and you can't undo it once it's done. Lots of failed back surgery victims have expressed regret to me about their decision to have the procedure(s).

That said, there's certainly a time for intervention, and not all surgeries are the same. All I have is second hand information, but of all the people I've spoken with those who have undergone shoulder surgery (usually rotator cuff muscle repair and labrum tears) are far and away the most likely to be satisfied and the most enthusiastic about the results.

Whereas things involving the back/hip/knee usually end up being of accepting what is (hopefully) the lesser of two evils, with the shoulder it seems that many people actually go beyond stabilizing their condition and improve it significantly, even to the point of improving athletic performance over time.

That's about all I can offer based on the info you provided. It's a tough call when it's your body and lifestyle at stake, but with a shoulder injury like the one you've described I think you've got a good chance of benefiting from a talented, competent surgeon. Especially if you follow the rehab protocols, give yourself the time you need (not the time you'd like to need) to heal, and invest in strength/mobility/health in the shoulder once you're ready for it.

Good luck and happy healing either way!

Do the doctors agree that the injury has been healing or is it still the same?  If the same, no question; get it repaired.

 

Yours in Fitness,

Coach Sommer

I've had 2 SLAP tears in my left shoulder. The first from trying a back lever when I had maybe 15s on full tuck back lever, the second from playing goalie and diving on a ball (I landed flat on my front, my arm fully extended, and the ball under my elbow). 

 

The first time I didn't recognize it for what it was; it was just an ache that wouldn't go away. I tried rest, physical therapy, general practice, and two orthopedic surgeons. The first orthopedic didn't recognize it for what it was and prescribed therapy for impingement. Ultimately it was 18 months before I had surgery done, and the fallout from waiting was obvious: my right (good) shoulder was visibly more muscular, I had developed a compensatory movement pattern on the left in the form of a shrugging motion, and on the left there was a lot of clicking/grinding/popping. 

 

Rehabilitation after the first tear took the better part of a year, during which I credit a lot of recovery to about 6 months of Foundation and Handstand. In the first 3 months after surgery I was just doing physical therapy, then for 3 months I was doing very light barbell work. After that, F1 and H1. When I tore the labrum a second time (in a different place, btw) I had considered myself to be at 95-ish% of the way to being "fully healed." The muscular imbalances had gone away, there was only one click in a specific motion, the compensatory pattern was gone, and I was doing things that I hadn't realized I had been avoiding (such as sleeping on my left side, or picking up the milk with my left hand). 

 

With the second tear I knew right away what it was, and went to the same doc who did the repair the first time. This time, recovery was MUCH faster; when I went in for my first PT appointment (2 weeks post surgery) the PT was weirded out that I had the ROM. I credit the GST work prior to the injury for balanced muscle development and healthy connective tissues. I was back to F1 and H1 work after about 3 months. It's been 1 year since the second tear, and again I would say again I'm near 95% recovered (and no longer playing goalie). 

 

I learned a lot through the process, including what the labrum is, how surgery facilitates recovery, what recovery is like, and how much of a setback it is NOT to get it. In my case, the tear definitely would not have healed on its own. In the second, it might have, but since recovery from the first was so successful (and frankly, amazing), there was no hesitation in my mind. I had it done a month after injury, and have never second-guessed my decision. 

 

You're about 13 years older than me when I encountered my first SLAP tear, which I'm certain is a factor, but you also have a better musculo-skeletal foundation. If you're on these forums and working F1/H1 I'd say you're in the right place too, knowing about "go slowly and steadily." Part of my first injury was ignorance (F1 wasn't out when I experienced my first tear; I was trying to do my own programming based on Coach's Building the Gymnastic Body book), but another part was haste.

 

Personally, I can't speak to the efficacy of either acupuncture or chiropractice (chiropracticy?). However, I had two excellent experiences with surgery. Take that for what it is: one anecdotal experience. Still, I'm with coach: get the surgery. It's basically zero risk (I'm parroting my doc when I say that), and works. Labrum tears are typically sports injuries, so maybe pick a doc who's accustomed to working with athletic folks to do the work. Then take your time with PT and returning to GST. I hope to see your posts in the future about your successful recovery. 

Hah! I wish my degree was in chiropracticy...

Nearly three weeks post bicep labrum debridement and feeling great.  I am grateful for no sutures or screws.  Physical therapist was impressed with strength and nearly full range of motion in the shoulder.  Ortho surgeon thinks I could be 100% in three months.  That seems quick.  Having started PT and resuming modified F1, H1, front and middle split programs I have some delusions of being back on track in less time.  I am all about the process and will take whatever is given.  I do credit the prehab from F1 and H1 programs to putting me on the road for a speedy and strong recovery.  Many thanks!

Great news! All the best for a slow & speedy recovery (as oxymoronic as that sounds ...). 

Take more time than you think you need! You've got a great situation here; if I were in your position I'd need someone to remind me not to rush things and screw it up!

Happy healing