Type III S.L.A.P. Tear: Any Advice?

So, I've dealt with soulder instability to some degree for 7 or so years now, and just six months ago had a couple of incidences while training where I felt a crunching sensation in my right shoulder, followed by chronic shoulder pain and an increase in shoulder instability.

After a couple weeks of steroidal anti-inflammatories and several months of physical therapy (some of which was with a friend of Charles Poliquin who is trained in active release) I experienced a small improvement in pain, and essentially no improvement in the shoulders stability. So I had an MRI done, and it turns out I have a type III S.L.A.P. Tear.

My doctor highly recommends surgery if I want to continue with my current desired level of activity. Which for me is full time work as a professional hand balancer and aerial straps artist, and as well as basic tumbling skills and hand to hand. But, naturally, my doctor has very little frame of reference for the types of things i need to be able to do as a circus performer.

Thus: i turn to the community full of knowledgeable people who know exactly the kinds of things I will need to do with my shoulder in the future, and who may have some experience with Labrum tears.

The question is, of course, if I want to move forward with such a career; am I likely to be able to do so after such an injury? Is surgery my best course of action? Or should I start planning to focus on a less shoulder intensive discipline/ look at new career options?

I have insurance, so the cost of surgery is not a problem, nor is the the recovery and rehab time an issue. I am 20 years old and highly motivated and willing to work as long as it takes to get my shoulder back into working order if it is possible to do so.

Thanks so much to anyone who takes the time to read this and is able to offer some advice.

Well the first thing that comes to mind is get as many trusted opinions as you can.

Look into some of Eric Cressy's stuff, as this type of injury is what he's best at working with. However he deals primarily with baseball pitchers, which is quite different than what you are doing.

Anecdotally folks i've talked to have varying experiences with surgery. One very high level yoga teacher separated both shoulders while doing a version of back limbers, had one repaired and the other left separated. He says the repaired side doesn't feel right. Of course that's a different injury but the lesson remains, there is at least some chance that after surgery things won't be the same.

On the other hand i know many who say after surgery things have never been better.

Of course all that said, with a Type III tear, you've got the flap of the tear sitting in the joint, no amount of rehab is going to change that, and if it's causing pain, that might all the reason you need to have the surgery.

For sure, the techniques have really come along way, so your chances of success are very good.

Thanks for your reply Cole, I appreciate it. I'll definitely keep looking for as Many opinions as I can get on the matter, and i'll take a look at Eric Cressey's stuff as well

Marlon,

I was diagnosed with a mild slap lesion late last year. After being bothered with the shoulder for about 6 months I went and got the MRI and ended up meeting with a surgeon. The surgeon gave the opinion that I would need surgery and wouldn't be able to do all the things I wanted to do without it, and it this time simple things like pull-ups bothered me and especially any swinging type stuff.

Anyway afterwards I thought I would go for surgery but I gave myself 6 weeks with a physio that I trusted to give conservative management one last try, gradually my shoulder improved to the point where surgery didn't seem necessary and I have not had a single problem with the shoulder since, it actually feels better than my other one. A 100 percent recovery without surgery tho it did bother me for a good six months.

Unrelated to this I did end up having an operation for another injury and it sucked (all better now tho). surgery is no joke and sometimes stuff goes wrong, your body doesn't like it and where possible I would always try and avoid it.

My advice to you, give conservative a serious shot, just because you have a slap lesion doesn't mean surgery is your only option, and in the end these doctors don't really understand what you're doing unless they are somewhat involved in the sport. Things that helped me : (some of these seem obvious)

1. Cease all aggravating activities for at least 2 weeks, let that inflammation settle

2. For me rear shoulder capsule stretches were extremely helpful

3. A lot of Trap work and rotator cuff strengthening (you probably already do it)

Be patient and see how you go conservatively, the lesion will scar over time so you may be ok. That being said surgery may be the only option which if it is I wish you good luck.

Hope this helps