Capsule tear shoulder

Hello everybody!

I would really like some advice about my shoulder and how to deal with it. The problems basicly started september 2011, i was training too much, no proper warm up etc etc just the usual beginners mistakes. I went to the doctor who advised 1 month of rest. I didnt fully rest tbh but dropped most of the lifting and didnt do any kickboxing as well. After the month of "rest" i went to the PT to get checked out. He advised to drop all the training activities above a 90 degree angle and to start strengthening my rc muscles, he said i probably had impingement of the supraspinatus. Well my being addicted to training i continued to do some pull ups twice a week without doing any chest work, so after two months my shoulder felt really bad and i decided to stop training all together, i kept going to the PT and had visited an orthopedic surgeon. after 2 months the surgeon wanted to make some echo's which showed some bursitis but everything else was oke. He suggested rest so i did that for 3 months, while my condition didnt get any better, he suggested an arhroscopy, last thurday i had my arthroscopy and the surgeon told my i had a tear in my shoulder capsule. His advise was to start training intensely as soon as possible, everything when very fast so i didnt have a chance to ask if there are any dangers in starting to train again, ofcouse i was very happy to hear it but i am concerned that i could possibly injure myself even more. Furthermore i dont know if i should contact my PT again he diagnosed my with impingement in the first place :S. the surgeon did mention that if my shoulder doesnt improve over the next 2 months i could have another surgery where he could stitch the tear.

hopefully you guys can provide some useful advise thanks

huh???

Why didn't he stitch it while he was in there?????????? :?: :cry:

i dont know I just called my PT said that tear will not heal on its own and that the problem will exist if i dont have the surgery As you can probably see i am no specialist at all i dont even fully understand the how everything in the shoulder works, the only thing my orthopedic surgeon told me that i have a "tear in my shoulder capsule". My PT furthermore told me i cannot make the injury worse only it wont heal, moreover my PT said that the advise of the surgeon is basically something to let me wait another 2 months .

It should be possible to call the surgeon and get some more information from him as to why he didn't fix it during the arthroscopy.

The PT isn't to 'blame' for not diagnosing the tear, impingement is pretty common and has become kind of a catch all term for shoulder pain. Though with being a kickboxer, that should have been a red flag to the possibility.

If you are indeed good to train even with the tear, you could look into kinesotape, there are some methods of taping that are very good for dealing with this kind of pain.

Cole Dano said:

It should be possible to call the surgeon and get some more information from him as to why he didn't fix it during the arthroscopy.

The PT isn't to 'blame' for not diagnosing the tear, impingement is pretty common and has become kind of a catch all term for shoulder pain. Though with being a kickboxer, that should have been a red flag to the possibility.

If you are indeed good to train even with the tear, you could look into kinesotape, there are some methods of taping that are very good for dealing with this kind of pain.

Yep, my little brother is a jockey (training only, he's too heavy to participate in races) and had a capsule tear during judo practice. He's currently walking around with his shoulder taped in and still goes to train the horses almost every morning.

thanks for the replys guys! Yea My surgeon is on a holiday, first chance to talk to him is on the 30th of July :S. But i was wondering if a capsule tear can heal on its own, why would the sugeon suggest 2 months of training otherwise? then again my PT said that it will never heal on its own, but is this the case? Futhermore do you guys know if i can further damage my shoulder if i start training again? (just pull ups, push ups, handstands and ring dips). I am quite eager to start again, but only if its save :S

And if i do decide to get another sugeon how much time will i be out of training?

thanks!

Tear in the capsule does not help. Need more information. He could be referring to minor tearing of a ligament which will heal. Or he could be referring to a labrum tear which will not heal. Really need more information.

Nic is correct, I wish we could give you a definitive answer but it just isn't possible.

Did your surgeon give you a report after the procedure? The only alternative is to take that to your PT and see if that provides some answers. If your weren't given one, the surgeon's office might be willing to forward it to you or the PT.

I know this is frustrating, but hang on and be safe.

iam currently tring to get some kind of report. Hopefully they are willing to help! Calling the hospital all the time

oke I have got a Bankart-laesie (Bankart-lesion) Hopefully this helps

This gives a pretty good overview of the situation -

http://orthopedics.about.com/cs/general ... ankart.htm

Basically the repair would take a long time to heal. The conservative approach is to wait and see if you have further dislocations.

Your PT absolutely needs to know this. You will be doing a lot of rotator cuff work. Erik Cressy has some good material on working with this kind of injury as well.

Did you have a shoulder dislocation?

Nope i never had that as i know of. My PT says i have to get sugery to get it fixed as it doesnt heal on its own. Although i do know why my shoulder feels unstable all the time, if i do RC work my shoulder does feel better. But both my sureon and my FT say i can do strenght training, is this true? Iam currently trying to get a surgery asap as i do wanne get this fixed, i have had this problem since sept 2011 :S Just so many questions as my surgeon suggested to train for 2 months but why is that if it doenst heal on its own :S?

??? I still don't understand why your surgeon did not do the work during your recent arthroscopy! :face palm:

Maybe kneecapping should be brought back in fashion! 8)

Can you recall if there was a specific incident where this happened? What were you doing? Or did you just notice you had pain one day?

Unstable shoulders are 'smart' in that you generally just won't want to do movements that feel unstable, so there is some built in protection.

If your surgeon was serious about training, he would know better than me. I imagine he wants you to wait to see if you can regain stability and 'normal' function before putting you through a procedure with a long recovery time. To be sure the only way to find out is ask him when you have the chance. Darn these summer holidays!

In any case, you're going to want some bands. The exercises in Ido's band routines are classic rotator cuff exercises and a good place to start.

first of all thanks for all the help guys!

Well my surgeon is known for not communicating very much so he basically told me i should start going to the gym again to strengthen everything, that the only info he gave me. I didnt even tell my to go see a FT just go to the gym and start working on my overall strenght.

I just noticed some pain one day in 2011 i have to say that my shoulder flexibility was horrible on my injured arm at that time, the pain has become less ( i dont wake up anymore at night, well before the arthroscopy and my flexibility has improved alot. Now i can call my FT again for the sixth time to ask if i can start training again but i really dont know. Although i have been doing alot of rehab exercises:

- Band work as shown by ido portal

- band work shown by slizzardman

- scapula pushups

- cuban rotations

- some int/ext rotation work with bands

But iam eager to do standard gymnastics stuff again --> dips, pullups pushups and handstands. Only iam worried that this will further injure me :S

Based on everything you've said, you should be ok to do those things.

Of course ease into it.

Start in the horizontal plane, then move to vertical, with rows and push ups at first set up with your hands higher than your feet. This will help keep some mechanical stress off the torn area.

And listen for that instability, if it feels like it's going to pop get out of the position immediately but other wise just work to stabilize in movement, that's what the RC does and what the band work is helping to develop. It's why RC specific work is very important with labral tears.

I'd be extra careful with HS, make sure you have not only been doing the scap push ups, hanging shrugs and dipping shrugs but also those holds to 60s. Then ease into HS. I'd start with 45 degree stomach to wall HS. Be conservative with trying to open the shoulder angle with weight on it for a while.

well i think iam gonna try to have the surgery as most info i found state that the shoulder will not heal 100% I dont understand how i could have torn it as i never have dislocated my shoulder :S

hello everybody!

I have had a second opinion of a very good shoulder specialist, this surgeon told me that i cannot possibly have a tear! After analyzing my shoulder 2 times and consulting with his PT he basically told me that my chest, back and neck are tighter on the left side. So he advised me to go look for a good PT. they both didnt want to give me any specific exercises as, as they told me that i had to have a structured program instead of trying to manage it on my own. I cannot follow PT there as it's too far away. I have had allot of PT but those exercises havent worked and were useless in the surgeons mind. he explained that with raising my arm in front of my that my scapula doesnt completely rotate with my arm, so it basically stops around 150 degrees instead of the 180 of my right arm.

I have been doing alot of stretches and foam rolling and my flexibility has increased and shoulder pain has gone down significantly. Only i was hoping that you guys can give my some advise how to make my shoulder even better. I have been doing slizzardmans shoulder stretches, doing rotator cuff work and foam rolling only my shoulder still hurts after a day of desk work or after playing tennis. I can do pullups disp and pushups again which is totally awesome! but i need to ice it and do alot of stretches before i can start painfree

thanks!

beebob said:

he explained that with raising my arm in front of my that my scapula doesnt completely rotate with my arm, so it basically stops around 150 degrees instead of the 180 of my right arm.

I have been doing alot of stretches and foam rolling and my flexibility has increased and shoulder pain has gone down significantly. Only i was hoping that you guys can give my some advise how to make my shoulder even better. I have been doing slizzardmans shoulder stretches, doing rotator cuff work and foam rolling only my shoulder still hurts after a day of desk work or after playing tennis. I can do pullups disp and pushups again which is totally awesome! but i need to ice it and do alot of stretches before i can start painfree

thanks!

You're going to have to start learning how to use your scapula again. I wrote some responses recently that describe the process fairly well. This is a very individual process, like counseling. Every person is different, and not all people understand the same approach. Perhaps some people can link you to my recent posts that address this issue.

I'm sorry you got such crap communication from your surgeon, that's unacceptable.

Bankhart lesion: Tear in the anterior aspect of the labrum. Does not heal on its own.

Options:

1) Surgery. This has an extraordinarily high rate of excellent results if you actually follow the therapy and post-op protocols to the letter. If you don't, you'll hurt yourself all over again.

2) Conservative management: You will have to do this for the rest of your life. If you stop for even a week, you will be able to tell the difference.

Conservative Management: Rotator cuff work. External rotation, internal rotation, supraspinatus work. Usually, initial focus is more external rotation than internal.

This management will make the shoulder capsule more stable, but will not re-train the scapula. You will need to focus on both for a while.

thanks for the information Joshua! the fact is that my shoulder is getting better and better. Pretty funny how you described tightness and poor posture as main shoulder injury factors, I am a prime example! Although i dont need surgery, i was hoping that someone could provide some more concrete information on exercises that can help me move my scapula better. I just finished moving, so i am really eager to start training more again. I basically need to stretch my whole shoulder girdle, but specific exercises for improving scapula movement are hard to find for me. I was also thinking about starting PT again but i kinda lost trust in PT