Should Labral Tear, Distal Clavicle Edema, AC Joint Arthritis! Help!

I am 34 years old and have been lifting religiously for 8 years.

8 weeks ago today I felt some slight bicep pain after a hardcore chest and shoulder workout. I weigh 206lbs and declined 315 10 times and threw some heavy dumbbells up for military..then about a dozen more exercises.

I backed off for a few weeks but my biceps started to hurt toward the top of the shoulder. I went to a sport's doctor (big mistake..should have went to ortho instead) and was told I have bicep tendonitis. So I had to stop going to the gym and started the at-home exercises with bands and little weights.

This PT at home felt worthless and made my injury worse. I begged for an MRI and after several more weeks I finally got my MRI. Here are the findings

1) Rotator Cuff tendonitis and Bursitis (No tears..thank god!)
2) Small posterior Labral Tear and fraying (oh no!)
3) AC joint arthritis
4) Degenerative bone marrow edema of distal clavicle (bone bruise caused by the labral tear or tendonitis)

I finally got the Cortisone shot in each joint.... this took 95% of the horrible pains away within 48 hours... only side effects is insomnia. My therapist was pissed that it took them 7-8 weeks after injury to give me the shot.

Today was my first day of PT... basic exercises with 3 and 5 lb weights, ultrasounds, and icing. The therapist said I have 4 more weeks of PT and then I can start back up at gym. I can not do anything push related for another 3 months...and when I do start bench pressing I have to use a narrow grip (less than 1.5x shoulder width) for life. She suggested that decline DB and close grip incline would be the best for my shoulders.

I was told that I should not get surgery and that I can deal with all the systems with PT and the cortisone shots.

Has anyone experienced and injury like this? It feels like a hot knife is being jabbed into your shoulder after just 1 push up. Needless to say I have had severe depression and this is my first major injury. This sucks.

Anyone help these injuries would be greatly appreciated.

Thanks

I had a slap repair January 5 for a torn labrum. If I had to to do over again at this point i would have not had surgery. I might feel different in a year. I was released to start lifting again in May. Well after my forth week back lifting my shoulder started not feeling right and was getting really sore. I laaid off for a few weeks then tried it again and its was still bothering me. I went back to the Dr today and he didnt seem too concerned but i am having another mri next week to confirm nothing is wrong. Before I had my surgery it basically bothered me with pull ups and my bench got weaker. My shoulder would also fatigue real easy and it would hurt sometimes reaching for things. Also playing softball if i had to back a sudden grab overhead it would hurt like hell. If you can deal with the pain and its not keeping you from doing anything id just deal with it. But its not going to heal on its own and cortizone shots are only going to make it worse in the long run. I delt with mine for two years before surgery due to misdiagnoses. Let me know if you have any questions

Oh and i injured mine doing military db press. The first dr told me i had tendenitis too. Your labrum is what attaches your bicep to your shoulder is why you bicep hurts.

I have done countless hours of research on the possible problems with my shoulder. The sport's doctor told me that she hasn't been practicing in awhile and has been focussing on "women's issues"...that should have been my first clue to get out of dodge. But I just changed jobs (I am a teacher) and my insurance will run out in 5 weeks and I am moving 2.5hours away..so I was eager.

My girlfriend's dad is a PA for an ortho and so he had to give me the shots. I just sent the ortho a copy of my MRI scans and hopefully they see things differently. I have 100% full ROM and no motions hurt. My should only hurts after pressing.

What did your Slap tear feel like?

When it first happened when i would reach out for something it felt like my shoulder was going to disclocate and it was hard to sleep on that arm. The sleeping thing is usuially the red flag of a slap tear. It also can cause the shoulder to feel unstable like my reaching issue. It doesnt sound to me like its a labrum tear.

I sure hope it's not a labral tear. From after talking to another orthopaedic surgeon, he stated that labral tears are very hard to see on an MRI without using contrast (injected dyes). He has seen it being diagnosed wrong 50% of the time.

The rotator cuff tendonits has been absolutely horrible! I never realized how painful it was. The edema (bruising of the bone) has caused my collarbone by my shoulder to be killer.

You could see mine pretty clear on mri but i also have pictures of the surgery to back it up. The mri im having done next week will have contrast though.

[QUOTE=croneypony;922373523]You could see mine pretty clear on mri but i also have pictures of the surgery to back it up. The mri im having done next week will have contrast though.[/QUOTE]

How bad was your slap tear? Do you have an mm or cm size? Mine is just a few millimeters and I frayed some of the edges as well.

I started a new PT and I was lifting 3lb weights and the 5lb bands in the corner at my new gym. I ran into a guy that had a similar injury as me and he said he had to do 4 weeks of PT and then took a few months get some decent weight on lifts. This guy went from bench pressing 500lbs Raw to having a spotter for the 45lb bar after his injury. He now stays away from flat bench, but loves DB incline.

i just got diagnosed w/ a minor labrum tear and bone edema of the acromion. the doc. and i both feel like the edema is causing the pain. no surgery needed.
seems like you have a similar issue, what is the timetable for recovery the doc. gave you? and what kinda PT are you doing exactly? which exercises?
so glad i found this thread

[QUOTE=SwaggyTime;922427603]i just got diagnosed w/ a minor labrum tear and bone edema of the acromion. the doc. and i both feel like the edema is causing the pain. no surgery needed.
seems like you have a similar issue, what is the timetable for recovery the doc. gave you? and what kinda PT are you doing exactly? which exercises?
so glad i found this thread[/QUOTE]

I agree 100% that the edema is causing most of my pain. I injured myself 8 weeks ago and haven't went to the gym in 4 weeks because of the run around about my injury. PT will be 4 weeks (twice a week), but I do my at-home exercises everyday.

The PT includes mostly rotator cuff exercises to strength this area... if the RT area gains more stability then the Labrum tear will be protected.

Do a good search on Rotator Cuff exercises to find mainly the ones I do.

Mine also consists of bench pressing a 10lb band, standing rows with this band, short ceiling punches toward the ceiling (elbow close to chest at 45 degrees), and all the pendulum swings. The pendulum swings (small circles, reverse circles, horizontal, and vertical) look ridiculous, but these have helped the most to relieve the edema pain. It's actually amazing how great you feel from doing all those 20 min wimpy PT exercises.

PT will take 4 weeks, then I will be allowed to start using free weights....my girlfriends dad is a PA for an orthopedic and he said an edema takes at least 3 months to fully heal, but the pain goes away with exercises within the first few weeks or so.

Make sure to take advil all day long, especially before your workout. You have to ICE the area immediately after working out to keep the edema under control. I went from being the strongest guy at the gym to being the guy lifting 3 and 5lb weights. You have to reset your mindset and accept your injury. I believe that is the hardest thing of all. Also, make sure to get some cardio to keep blood flow pumping through your body..thus increasing the healing. Also, I have found that Animal Cuts makes a great vitamin pack for your joints and I load Fish oil all day long as well to help with the inflammation.

Also, make sure to do 5 slow shoulder rolls at least 5 times a day to help with your tear. These are the reverse rolls with your shoulders going back first. These really help my shoulder feel much better.

Good Luck

[QUOTE=jutsinger;922628963]I agree 100% that the edema is causing most of my pain. I injured myself 8 weeks ago and haven't went to the gym in 4 weeks because of the run around about my injury. PT will be 4 weeks (twice a week), but I do my at-home exercises everyday.

The PT includes mostly rotator cuff exercises to strength this area... if the RT area gains more stability then the Labrum tear will be protected.

Do a good search on Rotator Cuff exercises to find mainly the ones I do.

Mine also consists of bench pressing a 10lb band, standing rows with this band, short ceiling punches toward the ceiling (elbow close to chest at 45 degrees), and all the pendulum swings. The pendulum swings (small circles, reverse circles, horizontal, and vertical) look ridiculous, but these have helped the most to relieve the edema pain. It's actually amazing how great you feel from doing all those 20 min wimpy PT exercises.

PT will take 4 weeks, then I will be allowed to start using free weights....my girlfriends dad is a PA for an orthopedic and he said an edema takes at least 3 months to fully heal, but the pain goes away with exercises within the first few weeks or so.

Make sure to take advil all day long, especially before your workout. You have to ICE the area immediately after working out to keep the edema under control. I went from being the strongest guy at the gym to being the guy lifting 3 and 5lb weights. You have to reset your mindset and accept your injury. I believe that is the hardest thing of all. Also, make sure to get some cardio to keep blood flow pumping through your body..thus increasing the healing. Also, I have found that Animal Cuts makes a great vitamin pack for your joints and I load Fish oil all day long as well to help with the inflammation.

Also, make sure to do 5 slow shoulder rolls at least 5 times a day to help with your tear. These are the reverse rolls with your shoulders going back first. These really help my shoulder feel much better.

Good Luck[/QUOTE]

thanks so much, repped. i've actually been having shoulder pain for almost a year now before i finally got that MRI. but i'm going to start the PT as you suggested. can you show me a visual of pendulum swings? also, after 4 weeks of PT how do you plan to ease back into free weights?

Unfortunately since I don't have many posts on this forum, I cant insert links or pictures for the pendulum swings. But go to youtube and search "shoulder pendulum exercises"...the video is 1:37 in length and uploaded by cervelo58..shows a PT doctor showing the exercises. These are the ones I do several times a day to keep motion. They look worthless...but work wonders.

I am not for sure how I will ease into weights after PT... I think I will write a log through PT and try to increase band weights each week...so hopefully I can start out with some sort of weight. I will def keep on adding weight until I have any type of sharp pains. I have never had an injury like this before..so this will be a slight trial and error for me. I will talk to a few guys at the gym that had the same injury and see how they got back into it.

[QUOTE=jutsinger;922689063]Unfortunately since I don't have many posts on this forum, I cant insert links or pictures for the pendulum swings. But go to youtube and search "shoulder pendulum exercises"...the video is 1:37 in length and uploaded by cervelo58..shows a PT doctor showing the exercises. These are the ones I do several times a day to keep motion. They look worthless...but work wonders.

I am not for sure how I will ease into weights after PT... I think I will write a log through PT and try to increase band weights each week...so hopefully I can start out with some sort of weight. I will def keep on adding weight until I have any type of sharp pains. I have never had an injury like this before..so this will be a slight trial and error for me. I will talk to a few guys at the gym that had the same injury and see how they got back into it.[/QUOTE]

found the video, thanks man!! i just signed up for some PT, but in the meantime i'll be doing the exercises you said. you said that the edema takes at least 3 months to heal, so are you sure it's safe to get back in the gym after 1 month of PT? anyway if you make a log let me know and i'll definitely subscribe. appreciate it man, let's get through this injury and get back in the gym!!

[QUOTE=jutsinger;922400183]How bad was your slap tear? Do you have an mm or cm size? Mine is just a few millimeters and I frayed some of the edges as well.

I started a new PT and I was lifting 3lb weights and the 5lb bands in the corner at my new gym. I ran into a guy that had a similar injury as me and he said he had to do 4 weeks of PT and then took a few months get some decent weight on lifts. This guy went from bench pressing 500lbs Raw to having a spotter for the 45lb bar after his injury. He now stays away from flat bench, but loves DB incline.[/QUOTE] Not sure the measurements but it was torn 10 to 2. Ill try and post pics.

This is the tear and the repair.

Swaggytime... I asked a few people at the gym and the doctor about my edema and returning to the gym. The information I got was that the edema takes 3 months to heal 100%, but heals to to a good point after 4-6 weeks. So you should be good after 4-weeks of PT, as long you build back up with weights.

I injured myself 9 weeks ago, haven't been to the gym in 6 weeks, and just completed week 1 of PT. I am still sore from the edema, but my shoulder pains have went down dramatically. I ice as much as I can, and the Dr had me drop my doses of Advil since I was 2400mg at day. I already had the cortisone shot, and he feels that the Advil is just masking any slight pains I have. I dropped the dose to 800mg a day on non-PT days and 1600 on PT days (800mg before I workout).

I am very sore around the location of my edema (end of my clavicles). I also have some pain from the tendonitis...man I hate tendonitis.

I had another conversation with a monster guy at the gym that had the same injury. He didn't get surgery (minor Labrum tear, edema, tendonits) and he rested a few weeks and then had 4 weeks of PT. He said that it took him 1 month to lift 20% of his normal weight, 50% of his normal lifts after 8 weeks, and and after 3 months he can lift 90% of his normal lifting weights. He does not even dare to do heavy Bench, shoulder press, and dead lift. He also daid that after 8 weeks he thinks he would have lifted a lot more...but he was concerned when he started feeling the pulling at his should joint.

I have another Ortho taking a look at my MRI and I should have his thoughts this week. It just sucks that I will be sore for a few days if I lift anything slightly heavy working around the yard. What is insane that the worst pain radiated from my upper chest muscles. I am sure that has something to do with my clavicle edema.

[QUOTE=croneypony;923646933]This is the tear and the repair.[/QUOTE]

Those are some neat pics. Thanks for sharing. I will find out this week exactly the location and size of my tears.

[QUOTE=jutsinger;923861453]Swaggytime... I asked a few people at the gym and the doctor about my edema and returning to the gym. The information I got was that the edema takes 3 months to heal 100%, but heals to to a good point after 4-6 weeks. So you should be good after 4-weeks of PT, as long you build back up with weights.

I injured myself 9 weeks ago, haven't been to the gym in 6 weeks, and just completed week 1 of PT. I am still sore from the edema, but my shoulder pains have went down dramatically. I ice as much as I can, and the Dr had me drop my doses of Advil since I was 2400mg at day. I already had the cortisone shot, and he feels that the Advil is just masking any slight pains I have. I dropped the dose to 800mg a day on non-PT days and 1600 on PT days (800mg before I workout).

I am very sore around the location of my edema (end of my clavicles). I also have some pain from the tendonitis...man I hate tendonitis.

I had another conversation with a monster guy at the gym that had the same injury. He didn't get surgery (minor Labrum tear, edema, tendonits) and he rested a few weeks and then had 4 weeks of PT. He said that it took him 1 month to lift 20% of his normal weight, 50% of his normal lifts after 8 weeks, and and after 3 months he can lift 90% of his normal lifting weights. [B]He does not even dare to do heavy Bench, shoulder press, and dead lift.[/B] He also daid that after 8 weeks he thinks he would have lifted a lot more...but he was concerned when he started feeling the pulling at his should joint.

I have another Ortho taking a look at my MRI and I should have his thoughts this week. It just sucks that I will be sore for a few days if I lift anything slightly heavy working around the yard. What is insane that the worst pain radiated from my upper chest muscles. I am sure that has something to do with my clavicle edema.[/QUOTE]

i owe you reps for life man. thanks so much for that info, i honestly couldn't find much about it online. right now my shoulder pops and cracks a lot around the area of my edema..do you think that will go away once the edema heals?

also, should we avoid lifting heavy, like in the 5 rep range, forever? and just work @ the 8-12 range? and do you plan to switch from barbell to dumbbell bench and shoulder press?

sorry about all the questions man, i really appreciate the help. and about your upper chest muscles, i'd definitely get another consult to make sure there's no issues with your chest. but for what it's worth, my acromion edema is also affecting many muscles in the nearby area - my deltoids, traps, scapula, etc are all experiencing some pain. so i think that your chest pain may be related to the edema.

[QUOTE=SwaggyTime;924371643]i owe you reps for life man. thanks so much for that info, i honestly couldn't find much about it online. right now my shoulder pops and cracks a lot around the area of my edema..do you think that will go away once the edema heals?

also, should we avoid lifting heavy, like in the 5 rep range, forever? and just work @ the 8-12 range? and do you plan to switch from barbell to dumbbell bench and shoulder press?

sorry about all the questions man, i really appreciate the help. and about your upper chest muscles, i'd definitely get another consult to make sure there's no issues with your chest. but for what it's worth, my acromion edema is also affecting many muscles in the nearby area - my deltoids, traps, scapula, etc are all experiencing some pain. so i think that your chest pain may be related to the edema.[/QUOTE]

My shoulder pops and cracks like crazy all day long too. It doesn't really hurt, and actually feels better after I roll by shoulders and crack them all. I have read that much of the crackling is from slight tendonitis and/or bursitis of the shoulders. As long as your shoulder doesn't pop out of the socket frequently..you will be ok. I know a lot of guys at the gym that have shoulders that sound like rice krispies crackling. My shoulders crackle about half as much as they did 9 weeks ago. I think as long as they don't hurt when it crackles, you should be ok. I read an article the other day that says that its a good thing to hear some crackling around your joints. The crackling is from scar tissue on your tendons being stretched and releasing pressure.

Yeah, I think I will be doing mainly high reps for awhile to get back into lifting and to get ripped again.... I feel like a bloated pig by not having my 2 hour workouts. I will definitely switch to dumbbells for awhile on almost all lifts. I don't see me doing anything other than light arnold presses for shoulders for awhile as well. My favorite lift is decline bench and I will dry and do these with dumbbells when I get back into the game.

My shoulders are feeling a ton better with just 1.5 weeks of PT. I have went up dramatically on the rubber bands weights and I think I am almost ready for light weights at the gym. If you ever feel a sharp pain then you instantly stop and walk away. I would hate to injure and go through all this again. I did watch some good tv this summer though. lol.

I went to PT yesterday and they increased my weight and I got to do a lot more stuff. I have no pain today. I am cleared to go back to the gym next week! I just have to take it easy and increase by 20% each week on most lifts. I have to keep all sets at least 10 reps for several months too.

I was injured 9 weeks ago and have been out for over 6 weeks so far. Its also been 1.5 weeks since the cortisone shots and start of the new PT.

I finally got the results of the 2nd opinion from the local ortho. He said that the MRI doesnt look bad and no surgery is needed. The tear is in the Labrum is very small and thus I can work around it as long as I dont go nuts on weights.

My shoulder is worse than yours and I rehabbed it, took 3.5 months of PT though. Bad bicep tendonitis, 100% torn labrum (old injury), partial thickness RC tear, bad impingement impacting the AC joint, bone spur, calcium deposits, etc. Got an MRI taken, went to a good local orthopedic surgeon who got me into PT. Had the cortisone shots too.

Same as you, started PT with getting the ROM back then we worked on strength. Had pages of shoulder exercises to do at home too. The bicep tendonitis had to be worked out with massage to free it up, that was painful. I was out of the gym basically for 5 months, did some exercises at PT, but nothin' heavy.

Keep sticking with the PT, I had a blind faith approach to it and it paid off.

Rob

[QUOTE=jutsinger;925393523]I went to PT yesterday and they increased my weight and I got to do a lot more stuff. I have no pain today. I am cleared to go back to the gym next week! I just have to take it easy and increase by 20% each week on most lifts. I have to keep all sets at least 10 reps for several months too.

I was injured 9 weeks ago and have been out for over 6 weeks so far. Its also been 1.5 weeks since the cortisone shots and start of the new PT.

I finally got the results of the 2nd opinion from the local ortho. He said that the MRI doesnt look bad and no surgery is needed. The tear is in the Labrum is very small and thus I can work around it as long as I dont go nuts on weights.[/QUOTE]

great to hear man, good luck! i'm starting PT this week, hopefully i'll be back in the gym by late august!! do you know how we can avoid edema in the future? i honestly have no idea where/when i got injured exactly, but i don't want it to happen again

just went to the PT today, got the exercises i needed. do you think it's normal for there to be some slight pains while i'm doing these exercises? should i just push through it unless the pain is actually bad?

[QUOTE=SwaggyTime;926344893]just went to the PT today, got the exercises i needed. do you think it's normal for there to be some slight pains while i'm doing these exercises? should i just push through it unless the pain is actually bad?[/QUOTE]

Discuss this with your PT person, they may have a better way to treat you. I had pain with my exercises often and they did ice me up before I went home.

Rob

Yes, I had pain at the beginning was I was doing PT. The pain was consistent and did not spike. The PT told me that if the pain every spiked or was a sharp that I stop immediately. It was actually pretty painful doing the 5lb bands for the first week.

I had a good PT workout last night and now I can use 3-4 bands together for each exercise. I decided to not ice (got busy on the phone) and now today has totally sucked. I am very sore.

For my PT they use the ultrasound laser on my tear, then I work out, and then they strap the ice vest on each shoulder (machine that pumps icy water over my shoulders).

[QUOTE=jutsinger;926644093]Yes, I had pain at the beginning was I was doing PT. The pain was consistent and did not spike. The PT told me that if the pain every spiked or was a sharp that I stop immediately. It was actually pretty painful doing the 5lb bands for the first week.

I had a good PT workout last night and now I can use 3-4 bands together for each exercise. I decided to not ice (got busy on the phone) and now today has totally sucked. I am very sore.

For my PT they use the ultrasound laser on my tear, then I work out, and then they strap the ice vest on each shoulder (machine that pumps icy water over my shoulders).[/QUOTE]

i woke up today and was really sore from my PT. but i supposed its normal, because the shoulder's weak and i've taken weeks off the gym. my current plan is continue taking 800mg advil daily, and only doing PT when the shoulder is no longer sore. sound like a plan? and how's your recovery coming along?

[QUOTE=SwaggyTime;926796633]i woke up today and was really sore from my PT. but i supposed its normal, because the shoulder's weak and i've taken weeks off the gym. my current plan is continue taking 800mg advil daily, and only doing PT when the shoulder is no longer sore. sound like a plan? and how's your recovery coming along?[/QUOTE]

I woke this morning to be extremely sore as well. My PT guy upped the weights big time on several cable exercises I normally wouldn't do. I take 800mg in the mornings and then another 800mg before PT.

My PT also looked at the MRI and he stated that the tear in Labrum is in the back of the joint...thus I should avoid any exercises with pushing above my head and any bench press action that causes my arms to go below 90 degrees (below my chest). Thus I will have to do towel bench if I decide to use barbells. Absolutely no dips, military presses, or anything that extends my chest (so on chest flys I have to limit how far I go).

My soreness is not fun at all. He also used kineseology tape on my AC joint (that colored take that most athletes wear)...and I got to say it felt great.

It's so strange to be so weak on these exercises and shaking like crazy. I can feel the blood flow rush to my shoulders. I havent lifted heavy in almost 7 weeks now.

He told me that I can start lifting at the gym next week... but I am restricted to only light weights and do 2-3 sets of 30 for every exercise. He said he will write a program (he is also a trainer and has had the same injury as us) in order for me to get back into lifting. I used to laugh at the guys lifting light weights 30 times....and now I am that guy. lol

in your OP you said that you couldn't do anything push-related for 3 months..are you still sticking to this? also, how's your recovery coming along? i've done a good week and a half of PT and i'm definitely feeling better

I was horribly sore from the PT on the 3rd...the soreness lasted 5 days and made it impossible to even do my little rubber band exercises. I went back to PT on Friday and told him about it and said it was normal to feel that way after my first "heavy" PT workout. He added reverse cable crossovers and straight arm crossovers to the PT session that caused all the bruising. He told me that the bruising pain is just my shoulders getting used to working out again.

It felt like he re-injured my arms again and I wanted to kill. So that next PT session he put me on the bicycle looking machine for arms. So I rowed for awhile and warmed everything up. He then had me do a mini workout with all exercises I have done at PT all in this one session. He also added a ton of weight compared to the previous sessions (I was doing 5 and 10 pounds for the rotator cuff exercises...and he cranked it up to 60-70lbs for 3 sets of 10). I was to stop if I felt major pulling or pain spikes. The workout went great.

The right side is now sore and my left shoulder feels 99% fine. This is because the PT only does the ultrasound laser on my left shoulder. He wont use it on my right since the Dr only ordered the MRI for my left..thus have tear in left shoulder. I just hate how insurance works sometimes. Even though they feel both shoulder's have torn labrum... since it was a lifting injury..they only needed an MRI from one side.

I asked him again about the pushing exercises and he said that I healed much better than expected. So I can do pushing exercises with dumbbells and if I do barebell I am to use a large towel (to stop the bar 4-5 inches above chest)...but I have to keep everything light and see how my shoulders fell. He def said that no dips or any lifts where my elbows go above my shoulders for many months. I am fine with that. I am to also be careful with heavy bicep curls...since the long head of the biceps are help down with the Labrum..I have to be very careful. He stated that I should stick with dumbbells on almost all lifts for awhile.

I just moved for my new job and I will get a gym membership this week. I will let you know how it goes.

awesome, good to hear you're coming back strong.

i've done PT for about 2 weeks now, and although my shoulder feels stronger than it was two weeks ago, it's in slightly more pain that it was before i did any PT. was this the case for you too?