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  1. #1
    Registered User nvandenberge's Avatar
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    My Posterior Labrum Tear Experience

    Hello everyone, my name is Nick and this is recovery blog from my posterior labrum tear repair surgery. Unfortunately I had a nagging shoulder injury for two years that kept me from working out at 100%. I spent over $3,000 in physical therapy over a year and a half trying to fix it until had an MRI in March 2017 which showed a 2 cm posterior labral tear in my left shoulder, some bursa fluid, and cyst formation. Seeing as how this issue is common in athletes/weightlifters, I wanted to start this blog to track my journey from surgery to recovery and hopefully help anyone going through the same issue. Please feel free to ask any question you may have and I will try to answer them as best as possible.

    Quick background:
    - 25 years old/Male
    - 6’2” / Around 250lbs
    - I’ve been lifting for 8 years, about 3 of them serious.
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  2. #2
    Registered User nvandenberge's Avatar
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    I know having this surgery made me nervous as hell because of the post-op pain, therapy, and gym life after therapy. I’m sure anyone who has gone through this surgery or is about too may be nervous as well. I wanted to make a descriptive log of my experience in hopes that I can help you in your recovery and answer any questions you may have. At this moment I am about 2 weeks out and will be updating when I can.

    I had surgery on Tuesday June 6th, 2017 by Dr. Layug.


    Surgery Day / Day 1:

    - Check in to the surgery center at 7:00am.
    - Surgery began at 8:00am.
    - I decided to get the nerve block (highly recommend)
    - Woke up around 11:00am with minimal pain. I felt like a slight burning tingling sensation on the back of my shoulder, but tolerable. The nerve block had my entire arm numb.
    - 11:30am the nurse gave me a Percocet and some crackers then I went home.
    - I haven't seen the surgeon yet or had the chance to talk him about the surgery, that appointment is next week. The only thing I know about it is that the surgeon told my mom he put 2 anchors to reattach the tear and that I should make a full recovery. Surgery lasted about an hour total.

    6 hours after surgery:
    - No pain cause my arm is still numb. I’m able to walk around and lay down with no pain.
    - Lots of sleep and rest
    - Super hungry so I am eating everything.
    - Ice 30 min on / 30 min off as much as possible while awake for first 24-48 hours.

    * I am resting/sleeping sitting up as you can’t lay on your back. I do not have a recliner chair so I bought a back pillow wedge to prop me up. I needed something sturdy since i’m a big guy and didn't want a pillow I would just sink into. So I bought the follow item from eBay, it was about $100 dollars but totally worth the comfort. Mine is called “Jobri Spine Reliever Bed Wedge”.

    10 hours after surgery:
    - It's about 6pm now, still no pain, nerve block still working.
    - I started taking 2 oxycodones (5mg/pill) to stay ahead of the pain curve.
    - Able to walk around without issues.

    16 hours after surgery:
    - My hand and arm have been tingling for the past few hours with a “pins and needles” feeling which means
    the nerve block is wearing off.
    - I can start to feel a little bit of pain, but nothing crazy.
    - I took 2 oxycodones (5mg/each) every 4 hours throughout the night to keep the pain away.

    * I will admit that the nerve block was a little weird as my arm and hand were completely dead. It was weird that I couldn’t move my wrist or fingers no matter how hard I tried, it was like being paralyzed. However the feeling does come back!

    Day 2:
    - Woke up around 6:00am and HOLY MOLY, my biggest fear came true. The pain is a solid 9/10. Shoulder is throbbing, oxy doesn't seem to help very much. My last dose of oxy was at 4:30am so I can't take anymore at the moment.
    - I took one Aleve around 6:30am and started icing again 30min on and off all day.
    - Pain was tolerable and I could rest easy after about an hour and a half to two hours.
    - The surgery center called me that morning to see how I was doing. I told them about the unbearable pain I
    had for a couple hours in the morning and they said I can take Aleve or OTC meds like (ibuprofen) as
    long as I staggered with the oxy. So take the oxy, then 2 hours later take an OTC med if needed. (HIGHLY
    RECOMMEND TO COMBAT PAIN)
    - Pain got a lot better throughout the day, iced on and off all day long as the first 48 hours are the most crucial!
    - It hurts to make certain movements like getting out of bed, but it is very tolerable and I was able to walk my dog twice without any issues.
    - I was able to poop at the end of the day, I have been taking fiber pills and eating high fiber foods to combat the constipation. If anyone’s been on painkillers before you know what that first “porcelain cracking” poop feels like and I wanted to avoid that.

    Day 3:
    - I had surgery Tuesday and it is now Thursday. I slept a lot better last night cuz my awesome girlfriend came over to keep me company. I
    took 2 oxys throughout the night (every 4 hours) to keep me asleep.
    - Woke up and not in very much pain at all! The bulk of the pain is expected to subside after first 48 hours. -- Only needed 1 oxy this morning after a 6 hour period instead of a 4.
    - Able to type with both hands if I position the keyboard correctly. Things are looking up and i'm feeling better every day.
    - I haven't been able to shower yet, surgeon advised me to wait till Friday to remove bandages and shower (3 days after surgery) then put band aids over the incisions after shower to keep from infection.

    My thoughts so far:
    Overall, I am happy with the results as of now. I think the biggest fear i had was dealing with the pain that comes with this as I know any shoulder surgery is painful. Most people who talk about this surgery describe this pain as being really really awful. Besides the little episode of pain I had after waking up the first morning, the pain really hasn't been that bad at all!

    I got the nerve block which I HIGHLY RECOMMEND if you’re trying to avoid severe pain right after. I took my painkillers ahead of the nerve block wearing off so the pain didn't hit me like a train. I took Aleve twice a day (about 12 hours apart) between oxy doses to help with the pain and iced 30 min on and off using a timer 10-12 times daily for the first 48 hours to help with swelling.

    In addition to all this, I am keeping up with vitamins. I started taking Bromelain 500mg (2-3 times daily) for 2 weeks leading up to the surgery and will continue 2 weeks afterwards. Bromelain is a protein enzyme found in the core of pineapple to aid with digestion and inflammation. I did notice the swelling went down very quickly after surgery. I can't prove that the Bromelain helped me a lot with the inflammation, but I like to think it did (certainly didn't hurt). I am also taking Vitamin C, Vitamin D, and Zinc everyday as well.

    Day 4
    - Woke up with a tiny bit of pain, sleeping is getting easier as I can move and wiggle a little bit without having pain.
    - No painkillers this morning, I just took some Aleve and have been fine.
    - FINALLY able to shower today! I took my bandages off to see 3 small incisions. One on the front, side, and back of shoulder. Nothing crazy or disgusting looking.
    - It hurts to raise your shoulder laterally to wash the armpit of the operated arm. I learned if you lean forward and let your arm hang in front of you, you can wash it without pain.
    - Able to shower, dress, and put band-aids over my incisions by myself!
    - No pain when at rest and very little pain when moving around. Really the only time there is pain is when I move my shoulder which is expected.
    - Still a little swelling in the shoulder.
    - Follow up appointment with surgeon is set for Wednesday 6/14.
    - I am really starting to notice a difference everyday.

    * I work a desk job job so I spend most of my day sitting and typing. As of now it's not very difficult for me to type as long as I keep the keyboard close to me. I plan on returning to work next Thursday which would be 9 days after surgery.

    Day 6:
    - Still no need for painkillers. A couple dull aches here and there but nothing bad.
    - Really feel I’m making progress every day.
    - Taking the sling off a few times a day and letting my arm hang to my side. Not trying to push the limits and raise it in anyway but just kind of letting it breath from the sling since its annoying. I’m allowed to move my elbow, I just need to keep my shoulder stable while the labrum repairs itself.

    Day 7
    - Feeling better.
    - I can lay down on my back without any discomfort, but still sleep on a slight incline.
    - I can also sleep on my right side now.
    - Shoulder is a little sore upon waking up, but goes away once you start moving around. I expect it be a little sore every morning for the next couple weeks.
    - I see the surgeon tomorrow and will be back to work on Thursday.

    Day 8
    - Went to see surgeon today, he removed my stitches, did some tests moving my arm around, showed me the pictures from surgery.
    - He explained he put 2 anchors in posterior labrum, bicep tendon and rotator cuff looked good, and he did some tightening as there was a gap in my shoulder from the tear.
    - Gotta wear the sling for 3 more weeks (4 weeks total). He stressed that I need to be very careful with my arm. Just because it feels better that doesn't mean I should wear my sling less or try using the arm more. The internal sutures could break as they are still fresh. It does take 4-6 weeks for cartilage to re-attach to bone. I can take it off to type, shower, and if i'm sitting on the couch. Other than that I should wear it all times. The more I leave it off, the more I will forget my arm is injured and try to use it in a way I shouldn't.
    - I was cleared to go back to the gym to do leg machines and cardio on stationary bike/elliptical (grabbing the non moving arms in middle of machine to stabilize). I did go to the gym today and some stationary bike and leg machines which felt great!
    - Instructed to start pendulum swings. 15 rotations clockwise and counterclockwise twice a day as well as gently move my elbow around.
    - Follow up in 3 weeks (on my 4th week) and start real PT after that.


    Day 17
    - Nothing new besides feeling a little better everyday
    - Been going to the gym and doing stationary bike and leg routines as well as working on hip mobility and flexibility.
    - No bad occurrences of pain. If I feel like any pain is coming on cause sometimes it does at the end of the day, I take some Ibuprofen.
    - Still need to wear this stupid sling for 2 more weeks! I hate wearing it but i make myself so I don't forget overuse my bad shoulder.
    Last edited by nvandenberge; 06-22-2017 at 11:53 AM.
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  3. #3
    Registered User nvandenberge's Avatar
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    Quick update...

    - Still in a sling for 6 more days till I see the surgeon for one month follow up.

    - Going to the gym 5-6 days a week doing abs (mainly situps), leg machines, and cardio. Riding that stationary bike like i'm Lance "OneArm"strong!

    - Atrophy hasn't been too bad. I'm keeping calories basically around maintenance and have lost about 6-8 pounds. Even though I can feel the muscles in my left arm have gotten a lot smaller but mass wise it doesn't look as bad as i thought. Been doing a lot of cardio too and can tell I lost a little fat in my stomach and legs so I don't think the weight loss is all muscle related.

    Question: Does anybody have any insight on what range of motion I should have at this point (3 and half week out)? I've been doing my pendulum swings and elbow flex exercises everyday. When my shoulder is kinda loose in the middle of the day I can raise it in front of me and laterally about 90 degrees before I feel a hard stretch, is that normal? Should I be able to lift it higher before I feel a good stretch? I understand that I won't have my full range of motion right away or for a while and i'm not worried something is wrong, just curious about other people's experience who didn't start ROM therapy until 4-6 weeks after surgery.

    Thanks!
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  4. #4
    Registered User sowilson's Avatar
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    don't worry about it. Your PT will be taking plenty of measurements of your range of motion in a few different planes. You'll know soon enough.
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  5. #5
    Registered User nvandenberge's Avatar
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    **1 Month Follow-up**

    - Just visited the doctor yesterday for my 1 month follow up. He moved my arm in a few directions to check my range of motion which he said looked good and was right where I needed to be. (A little over 90 degrees in front and laterally).

    - FINALLY I don't have to wear the sling anymore! However I do still need to be careful. I was advised to avoid reaching across my body, and behind my back.

    - Since I've seen a lot of forums and questions about anchors coming out (I had a few scares myself), I asked my surgeon what the chances were of this occurring. He said it would really only come out if I had a hard impact like raming my shoulder into something, falling on my shoulder, falling with my arm reached out, or lifting something too heavy. I did fall once but I fell on my good side thankfully and no damage was done. So anyone who is concerned about there anchors coming out, I wouldn't worry unless you have a hard impact. I had a few instances where I heard a loud pop or I reached in the wrong direction and pain followed for a short period afterwards but always went away within a few hours. It is normal to hear a little bit of popping as your arm is mostly not in use and there's scar tissue buildup.

    - He did not use dissolveable screws because they were finding that the dissolveable screws were actually dissolving some of the bone as well which was causing cyst formations down the road. So he used plastic screws that are in there forever but I won't notice them as there are buried into the bone.

    - So now I have about 5 weeks of ROM therapy before I go back for another followup appointment. The doctor explained that I wouldn't be able to do much especially cause its a posterior tear which is not as common as an anterior tear. If it were anterior I would be able to do a few more things in therapy earlier, but a posterior tear you gotta be a little more careful and take a little extra time.

    - Starting physical therapy tomorrow. I was told I only had to go once, maybe twice a week. Since there isn't too much I can do I just need a couple sessions to get the movements down and then do it on my own until I go back again for strengthening.

    - The doctor's instructions for the physical therapist are the following: "Active Assistance ROM (AAROM) in Frontal Flexion (FF) and Abduction. No rotation or cross body ADDuction."

    - On top of not lifting anything upper body for the 3 months leading up to the surgery, I still have to wait another 3-4 months before I can do light lifting. It is mentally taxing cause all I've been doing for the past 4 months is legs/abs/cardio so it's not always exciting/motivating to go to the gym, but I suppose its better than nothing. Slow and steady will win this race.



    ** Apologies if the bullet point format makes it harder to follow along. It's easier for me to just write in complete thoughts rather than paragraphs.
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  6. #6
    Registered User nvandenberge's Avatar
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    1st Physical Therapy Session

    - 4 and half weeks post-op.

    - Sleeping way better without the sling on. THANK THA LAWD!

    - I had my first PT session today. They assessed my ROM moving my arm while laying on my back. The therapists would basically move it until I felt a stretch and hold it for 10-20 seconds till it felt loose then repeat until I got to the point of pain which was the stopping point.

    - Overall she said I already have a very good range of motion and it shouldn't be too hard to get it back. (Hopefully that's true) I don't remember all the measurements but I do remember going straight back above my head we got my arm to 155 degrees which is great!

    - I will be going back once a week. I was given stretching exercises to do once/twice a day which consists of lying on my back, grabbing any type of stick object (baseball bat, lax stick, broom, an actual stick, etc.) with the injured arm and use good arm to push my injured arm in a couple different directions away from my body until I feel a stretch (NOT PAIN). Hold stretch for 10 seconds, repeat for 10 reps, and do 1-2 sets for each direction. The directions (3) are above the head, elbow bent at 90 degrees placed against body and push externally, and bent at 90 degrees but move arm up to a 45 degree angle as opposed to right next to the body and push out.

    - In addition she gave me some exercises that are basically pushing/pressing my arm into a wall/door frame at 25% power in a couple different directions to activate shoulder muscles. Push and hold for a quick second, 10 reps, 1-2 sets.

    - I will be doing these exercises over the next 4 weeks until I see the doctor again and will update with my progress periodically.
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  7. #7
    Registered User nvandenberge's Avatar
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    **7 weeks post op**

    - Feeling great! Still working on my ROM which is coming back very quickly. When I started therapy three weeks ago I could barely raise it to about 90 degrees in front of me (standing). Now I can I raise it about 150 degrees before I feel a little stretch, however I can push to 180 degrees while feeling a good stretch but no pain at all.

    - I wake up a little stiff every morning and sometimes with a small dull ache that subsides quickly. I expect this to occur for at least a few more months.

    - Still hitting cardio and legs multiple times a week as that is still the only thing I can really.

    - The atrophy in my left arm sucks. There's little to no definition and it appears to be jiggly and flabby now. Growing impatient and dying to hit upper body but I know I must wait! Before surgery I was about 252lbs and now I'm hovering around the 240lbs. Diet is still in check, eat around maintenance. Yes some pounds are muscle but also losing fat from all the cardio. I figured I would take this time to try and drop as many pounds as possible cause once I can lift again, I plan on doing a lean bulk and EVERYDAY IS ARM DAY! (with the exception of one leg day for maintenance)

    - Next doc appointment is Wednesday August 9th. (9 weeks post op)
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  8. #8
    Registered User nvandenberge's Avatar
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    Anyone have any experience with a dull ache in the bicep and top of forearm after this surgery? I'm 7 weeks post-op and doing all my therapy but from time to time I'm getting this dull ache in those areas. It concerns me because I had this problem in the same exact areas prior to surgery expect the ache was a lot worse. The surgeon told me the surgery would get rid of that pain. I believe the root cause it a tight/weak infraspinatous. Perhaps i'm jumping the gun too soon since i still have many months of therapy to go but I was wondering if anyone else has had this issue after labrum surgery?
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    Registered User sowilson's Avatar
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    make your PT earn his money on the next visit. I've been playing more banjo recently and my right forearm is sore 24/7. I've taken to doing stretches before and after I play and it helps a lot. The point is that you should find something that will give you relief and your PT should be able to help you get there.
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    Registered User nvandenberge's Avatar
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    Haven't posted in a while cause I was dealing with radiating pain down the arm I had surgery on. I visited the surgeon as I had this issue before surgery. I found out it was unrelated to the surgery and the injury. Although we were unable to confirm the exact issue since there was no x-ray/MRI, the surgeon believed it was a pinched nerve, (prolly C6) and prescribed me heavy anti-inflammatories to take for a few weeks. 2 week after my arm pain was mostly gone and the surgeon believed it may of occurred due to poor posture at my desk job, or that my shoulder was not stable/strong enough so my trap was compensating thus creating a lot of tension in neck and pinching the nerve.

    Other than that, things are going great! I'm about 11 weeks out now. It does feel kinda tight in the posterior of my shoulder but getting better. Been working on activating/strengthening the rear delts, rotator cuff muscles, and lower traps. Surgeon said once I hit week 13 I can start doing two upper body exercises with VERY LIGHT weight, a few sets each exercise. Switch up the exercises everyday, and add on two more exercises per week for 4 weeks.

    After this I will have hit the 4 month and have my last monthly follow up with the surgeon which he plans on giving me the green light to start full routines everyday with no restrictions, but to be SMART, lift LIGHT, and progress SLOWLY.
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    Any long term updates? I've had the same surgery back in 2013 and was curious how you're doing now.
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