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SLAP tear advice


Mike Antonio
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Mike Antonio

 Good day everybody.  I'm reaching out hoping to get some advice regarding a torn labrum. 

 The background. I started having shoulder problems in summer of 2016.  I went from using the rings to using the parallettes to doing floor programs to now not being able to do anything  with my right shoulder.  I even went all the way back to foundations 1 to try and start over from the very beginning.  Move such as table tops or crabwalk's seem to be my nemesis.  I started having treatment with Physio, massage and Chiro back in October 2016. I've made no progress and things of actually only gotten worse over time.  Make no progress my doctor finally sent me for x-rays and ultrasound.  I saw the orthopaedic surgeon yesterday.  He said based on my symptoms and explanation of my problems but it's very likely I have a slap tear.  MRI is coming soon to confirm.  He offered me a Cortsione shot which I passed on. 

 So I'm just wondering, is there any chance of me healing a slap tear at this point without surgery?  And if so, any recommendations on rehabbing going forward? 

 

 Thanks everybody for your time. 

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Mark Schoenhard

I suffered a type 1 SLAP tear in 2014. Spent eight months trying to rehab and heal. I couldn't get to a place where I could perform in a very active job and lifestyle. Chose surgery, with the knowledge from Coach Sommer that in a year the shoulder would feel decent and in two years it would feel good. It was over two years when I felt I was 100%. I am now grateful for that time as I have learned how to train properly, allow proper recovery, nutrition, prehab and patience. Now I am working on handstand line, press handstand, cartwheels, handstand roll-outs, back extensions, pull-overs, Russian dips, side lever twists, kip extensions, L-sits and the wonderful bent arm straddle planche. It wasn't easy, but I guess that's where the good things happen.

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Coach Sommer

Hello Mike,

Surgery.

Your doctor is an idiot for making you wait this long for the MRI.  

Yours in Fitness,

Coach Sommer

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Mike Antonio
2 hours ago, Mark Schoenhard said:

I suffered a type 1 SLAP tear in 2014. Spent eight months trying to rehab and heal. I couldn't get to a place where I could perform in a very active job and lifestyle. Chose surgery, with the knowledge from Coach Sommer that in a year the shoulder would feel decent and in two years it would feel good. It was over two years when I felt I was 100%. I am now grateful for that time as I have learned how to train properly, allow proper recovery, nutrition, prehab and patience. Now I am working on handstand line, press handstand, cartwheels, handstand roll-outs, back extensions, pull-overs, Russian dips, side lever twists, kip extensions, L-sits and the wonderful bent arm straddle planche. It wasn't easy, but I guess that's where the good things happen.

 

Thanks for the reply. Let's me think there is light at the end of the tunnel! 

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Mike Antonio
1 hour ago, Coach Sommer said:

Hello Mike,

Surgery.

Your doctor is an idiot for making you wait this long for the MRI.  

Yours in Fitness,

Coach Sommer

Thanks Coach. I don't disagree at all. Half the problem is I'm in Canada. Although our health care is free which is great, the wait time on an MRI is 6 - 8 months. The best things in life are not always free. 

 

Any advice on training between now and surgery?

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Ryan Segervall
4 hours ago, Mike Antonio said:

Thanks Coach. I don't disagree at all. Half the problem is I'm in Canada. Although our health care is free which is great, the wait time on an MRI is 6 - 8 months. The best things in life are not always free. 

 

Any advice on training between now and surgery?

Seek out an M.A.T (Muscle activation technique) therapist. There are several up in Canada but I think they are more in the Toronto area, not sure if thats close to you. It can certainly help, but if that labrum is torn its torn and there not much to do other than surgery. 

MAT will help root out muscular dysfunction in your body which im sure there is plenty provided the trauma you've gone through with your shoulder. Check out their website for more information. In my opinion its one of the more if not the most effective treatment out there for solving muscular dysfunction (limited range of motion, tightness, compensation, acute & chronic pain). Ive had really great results going through the MAT RX process,  check it out 

- try to find a MAT RX specialist if not look for a MAT Master specialist (these are the most advanced variations of the treatment). 

http://muscleactivation.com/about-us/ 

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Mike Antonio
46 minutes ago, Ryan Segervall said:

Seek out an M.A.T (Muscle activation technique) therapist. There are several up in Canada but I think they are more in the Toronto area, not sure if thats close to you. It can certainly help, but if that labrum is torn its torn and there not much to do other than surgery. 

MAT will help root out muscular dysfunction in your body which im sure there is plenty provided the trauma you've gone through with your shoulder. Check out their website for more information. In my opinion its one of the more if not the most effective treatment out there for solving muscular dysfunction (limited range of motion, tightness, compensation, acute & chronic pain). Ive had really great results going through the MAT RX process,  check it out 

- try to find a MAT RX specialist if not look for a MAT Master specialist (these are the most advanced variations of the treatment). 

http://muscleactivation.com/about-us/ 

I really appreciate the information. Toronto  isn't that far from where I live. I will definitely look into this. 

Is this something you think I would benefit from now or post surgery?

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Ryan Segervall
2 minutes ago, Mike Antonio said:

I really appreciate the information. Toronto  isn't that far from where I live. I will definitely look into this. 

Is this something you think I would benefit from now or post surgery?

both, It would be more of a bandaid now just to get you to surgery (IF you need it, depending how bad you may be able to avoid surgery but would'nt bank on it). Post surgery it would be HUGE benefit. 

 

http://www.coremuscleactivation.com/ I would go see these guys. I have seen their work and am confident they will be able to help you a lot. 

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Surgery involves stopping most upper body activities for around 3 months, and then months of rehab.

Conservative treatment (training around it) can work; labrums will scar over, but it takes time, and scarring is always weaker than the tissue around it.

My own experience (right shoulder - SLAP + complete labral avulsion anteriorly/inferiorly; left shoulder - small SLAP; both shoulders stabilised by having the capsule tightened) is that the right shoulder definitely needed surgery. I couldn't exert force, and lifting my arm up off a desk, as you do when you change from mouse to keyboard - felt as if the arm was going to fall off.

The surgeon found a few more things in the right shoulder, and over-tightened the capsule. Goodbye shoulder flexion and external rotation.

A year later, when having the left shoulder repaired, I told him not to tighten it so much, and he complied.

I could probably have gotten away with conservative treatment for the left shoulder, but the point of all this is that by the time you go slowly through conservative treatment, you may as well have had the surgery and done the rehab.

If surgery is what you choose, some suggestions:

  • tell the surgeon that you're a gymnast.
  • tell the surgeon to fix the SLAP (or whatever is on the MRI, remembering that imaging doesn't always show the full story, and that imaging can show things that aren't a problem anyway) but not to perform any shoulder stabilisation unless necessary, and even then do the minimal amount of capsule tightening.
  • get manual lymphatic drainage for the arm a day or two, then a week after the surgery. Didn't do this for the right shoulder, arm swelled up, bloody painful. Had MLD for the left the day after surgery, no problems at all. Maybe this was just a coincidence.

There area few rehab specific things I could suggest, but it depends on your MRI findings. Please let us know what happens.

By the way, like @Mark Schoenhard, I'm back doing Russian dips.

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Mike Antonio
9 hours ago, Nick Murray said:

Surgery involves stopping most upper body activities for around 3 months, and then months of rehab.

Conservative treatment (training around it) can work; labrums will scar over, but it takes time, and scarring is always weaker than the tissue around it.

My own experience (right shoulder - SLAP + complete labral avulsion anteriorly/inferiorly; left shoulder - small SLAP; both shoulders stabilised by having the capsule tightened) is that the right shoulder definitely needed surgery. I couldn't exert force, and lifting my arm up off a desk, as you do when you change from mouse to keyboard - felt as if the arm was going to fall off.

The surgeon found a few more things in the right shoulder, and over-tightened the capsule. Goodbye shoulder flexion and external rotation.

A year later, when having the left shoulder repaired, I told him not to tighten it so much, and he complied.

I could probably have gotten away with conservative treatment for the left shoulder, but the point of all this is that by the time you go slowly through conservative treatment, you may as well have had the surgery and done the rehab.

If surgery is what you choose, some suggestions:

  • tell the surgeon that you're a gymnast.
  • tell the surgeon to fix the SLAP (or whatever is on the MRI, remembering that imaging doesn't always show the full story, and that imaging can show things that aren't a problem anyway) but not to perform any shoulder stabilisation unless necessary, and even then do the minimal amount of capsule tightening.
  • get manual lymphatic drainage for the arm a day or two, then a week after the surgery. Didn't do this for the right shoulder, arm swelled up, bloody painful. Had MLD the day after surgery, no problems at all. Maybe this was just a coincidence.

There area few rehab specific things I could suggest, but it depends on your MRI findings. Please let us know what happens.

By the way, like @Mark Schoenhard, I'm back doing Russian dips.

Great info! Thank you very much. I would love to get back to doing Russian dips again! 

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