Labrum Tear (SLAP Tear): My Experience

[bbergsteinsson]

Wanted to do a write up on my experience with a labrum/SLAP tear since reading threads on BB helped me a lot as I was researching and trying to learn more.

This is a long write up, but I want to be thorough. I know for me it really helped to read about others experiences, so I wanted to provide the same. I tried to divide it into sections to make it a little easier to follow!

About me:
I am a 31 year old who is fairly active at the gym. I work an office job, and the gym is usually my lunch escape to break up the day (or sometimes after if I have too many meetings). I usually make it 5-6 times a week for about an hour of hard lifting. Prior to this I played NCAA and masters water polo and had some shoulder pain during that. Also swam for 1 season NCAA but stopped to give my shoulders a break. Years ago I had gone through one round of cortisone injections in both shoulders during one of my college seasons. For the past few years though my shoulders have been relatively pain free.

How/When it happened:
Back in January of this year I was doing bench press with a long (2-3 sec) pause. I went heavier than I should have, my elbows flared too wide and I felt a "pop" in my right shoulder. Immediately I knew something bad had happened. I heated/iced and took some pain killers. I also started researching and found every worst case scenario that the internet could present. After a few days of bad pain I decided it was time to see a doctor.

Doctor #1, First Doctor Visit:
After about a week I made an appointment with a local "sports" ortho with fairly good reviews. I arrived, had an x-ray, and after some discussion he decided I needed an MRI so we could really figure out what was going on. Bonus, he did say I could keep going to the gym and doing things that didn't hurt. That didn't leave me much I could do, but allowed me to physically keep going to the gym. For me, this felt like a minor mental victory. Still very bad shoulder pain.

Doctor #1, Visit 2. I "need" surgery:
Went back to the same "sports" ortho with my MRI results about a week later. Still in significant pain, although it felt like it was slightly better. I hadn't discovered what a SLAP tear was fully, but I was researching shoulders quite a bit and was worried. After the doctor reviewed the MRI he told me that I had a SLAP tear and it required surgery. I was surprised he jumped right to surgery when I read so much about physical therapy (PT from now on) online. When I asked about PT, he simply shrugged it off and said that if I didn't have surgery I would be lucky to put on a jacket on pain free and that is the best I could expect for the rest of my life. He explained it would be a 6 month recovery time and suggested booking surgery the following week.

Needless to say I was devastated. My wife commented a few times on how she had never seen me like this before. For me, being able to workout had become a huge part of my life and my way of dealing with stress. Hearing that best case it was 6 months until until I could do it again with any sort of intensity really put me in a bad spot.

Research, research, research. I don't want surgery:
Now I was in a really bad place and started researching all of the terrible aspects of shoulder surgery. Lots of people wished they had never done it, lots of people were so thankful they did. I didn't know what to do.

Everywhere recommends that you get a second opinion before going under the knife, that was common knowledge. One tip I saw on BB was to find the ortho for either a local D1 NCAA team, or better yet, a professional sports team. As long as they are in-network, it is not like it would cost you any more than some other doctor. Plus these types of doctors understand truly active people and athletes far better.

Thankfully, being in the Bay Area we have lots of solid D1 programs (Cal, Stanford, etc..) and even more professional teams (49ers, Giants, Warriors, Radiers, A's). I looked at a lot of their doctors (on team rosters) and decided on one I really liked. Dr. Isono was the official team ortho for the Warriors, a professor at Stanford, a Team USA olympic ortho and was an ortho for the IronMan. With a resume like that I was VERY excited to see him. The only problem was that since he was a professor in addition to ortho, he was booked over for over a month out.

Time for a 3rd doctor, PT only:
Since my first doctor tried to put me under the knife immediately and the professional teams ortho was booked over a month out, I wanted to try my hand at PT to see if it helped. I seeked out a doctor who I was clear with in that I was only looking to do PT and not surgery with him. We ended up coming up with an aggressive at-home PT routine with some chiropractic "adjustments" in-office occasionally. This doctor was a crossfitter, so he understood being active.

After every day PT at home for a month I was making some improvement. There was still pain, but it definitely was getting better and it was a little easier to sleep through the night (pain kept me up if I moved wrong). Lots of different exercises, but overall it was a very aggressive PT plan. One huge mental bonus is that it took away the total feeling of "helplessness" that I had prior. I did have a setback a few weeks in where I threw a towel underhand with my right hand and I felt a "pop" again. Lots of pain for the next week, but it started getting better again.

Doctor visit with Team USA/Warriors/Stanford Doctor. A good day:
The day finally came around where I had my appointment with the team doctor for the Warriors, Dr. Isono. I was really excited for this to finally come around. I could do a whole write up on him, but he was simply the best doctor I had ever been to. He took around 40 minutes talking me through how a shoulder worked, what this injury was, his thoughts on it and options I had. I felt like I was a student in one of his classes. The cliff notes was that he thought I had probably had this injury since college and it had just gotten worse. He told me that the best course of action in his opinion was aggressive PT. He said that in his experience 85% of SLAP tears do not require surgery, and it should be up to the patient if they want to proceed. If it didn't majorly impact life in a big way, he recommends against it, despite the high success rate of the operation.

One big thing I had read about online a little, but he reaffirmed is that a large percentage of the population has SLAP tears and doesn't even know it. This is especially true in "overhead" sports where you are throwing a ball. The actual area of the labrum is low in nerve count and pain from other shoulder injuries/conditions are often attributed to it. You can have shoulder pain and a SLAP tear, but that doesn't mean they are always even totally related.

The next 6 months:
After meeting with the final doctor I continued with my PT at his recommendation. I progressively added in more and more exercises in my normal workouts at the gym and felt my self getting closer and closer to how I was originally. I dropped weights in some areas and really tried to not "ego" lift quite as much. I focused more on form and slowing things down and made sure I was always properly warmed up in my shoulders before lifting. I also relied far more on machines than I had in the past, which did drive me a little crazy at first, but allowed me to rebuild muscle without having to worry as much as tweaking my shoulder.

Current workouts and workout limitations:
Now 10 months after the injury I am very close to my old workouts and stronger in essentially every exercise than any other point in my life. The one thing I am choosing to still stay away from is flat barbell bench press. I am using more and more dumbbells instead and feel I can just have a better "feel" for things. I also generally stay away from barbell overhead press. I tried once a few weeks ago and felt it in my shoulder for a few days. I am totally fine with DB shoulder press, just careful when getting them into position, but once they are I have no problem repping 75lbs dumbbells, just typically don't allow my elbows to drop below 90 degrees.

Overall health and feeling:
After 10 months, I am feeling great. I couldn't be happier that I decided to get a second opinion and not jump into surgery. After the PT I was able to get back into my normal workouts and am stronger and fitter than ever. I have been able to drop my bodyfat 2ppt to 11.5% and have put on 10lbs of muscle since the injury and now sit at 205lbs (6'1" tall). I even added 50lbs to my max deadlift while recovering from my SLAP tear (pulled 455lbs, which for me is pretty good!).

Tips:
-Always get a second opinion
-Do your research
-Find a ortho for a professional sports team near you. If need be, it is worth the drive.
-Always try PT first. It helps you feel in control of your situation.
-There is hope, it sucks but will get better.
-Even if you need surgery you will know you covered your bases first. I read about too many people who said they wished they didn't do surgery. If you try PT, see multiple doctors, etc... if it comes to surgery you can feel confident you are making the right decision.
-Keep training if you can!

If anyone has questions related to my experience, please let me know!

Tl;dr. SLAP tears aren't fun. Do PT before surgery. Get a second opinion. Find a professional sports team ortho near you. I am almost 100% now without surgery.

[ryanomac]

Wanted to do a write up on my experience with a labrum/SLAP tear since reading threads on BB helped me a lot as I was researching and trying to learn more.

This is a long write up, but I want to be thorough. I know for me it really helped to read about others experiences, so I wanted to provide the same. I tried to divide it into sections to make it a little easier to follow!

About me:
I am a 31 year old who is fairly active at the gym. I work an office job, and the gym is usually my lunch escape to break up the day (or sometimes after if I have too many meetings). I usually make it 5-6 times a week for about an hour of hard lifting. Prior to this I played NCAA and masters water polo and had some shoulder pain during that. Also swam for 1 season NCAA but stopped to give my shoulders a break. Years ago I had gone through one round of cortisone injections in both shoulders during one of my college seasons. For the past few years though my shoulders have been relatively pain free.

How/When it happened:
Back in January of this year I was doing bench press with a long (2-3 sec) pause. I went heavier than I should have, my elbows flared too wide and I felt a "pop" in my right shoulder. Immediately I knew something bad had happened. I heated/iced and took some pain killers. I also started researching and found every worst case scenario that the internet could present. After a few days of bad pain I decided it was time to see a doctor.

Doctor #1, First Doctor Visit:
After about a week I made an appointment with a local "sports" ortho with fairly good reviews. I arrived, had an x-ray, and after some discussion he decided I needed an MRI so we could really figure out what was going on. Bonus, he did say I could keep going to the gym and doing things that didn't hurt. That didn't leave me much I could do, but allowed me to physically keep going to the gym. For me, this felt like a minor mental victory. Still very bad shoulder pain.

Doctor #1, Visit 2. I "need" surgery:
Went back to the same "sports" ortho with my MRI results about a week later. Still in significant pain, although it felt like it was slightly better. I hadn't discovered what a SLAP tear was fully, but I was researching shoulders quite a bit and was worried. After the doctor reviewed the MRI he told me that I had a SLAP tear and it required surgery. I was surprised he jumped right to surgery when I read so much about physical therapy (PT from now on) online. When I asked about PT, he simply shrugged it off and said that if I didn't have surgery I would be lucky to put on a jacket on pain free and that is the best I could expect for the rest of my life. He explained it would be a 6 month recovery time and suggested booking surgery the following week.

Needless to say I was devastated. My wife commented a few times on how she had never seen me like this before. For me, being able to workout had become a huge part of my life and my way of dealing with stress. Hearing that best case it was 6 months until until I could do it again with any sort of intensity really put me in a bad spot.

Research, research, research. I don't want surgery:
Now I was in a really bad place and started researching all of the terrible aspects of shoulder surgery. Lots of people wished they had never done it, lots of people were so thankful they did. I didn't know what to do.

Everywhere recommends that you get a second opinion before going under the knife, that was common knowledge. One tip I saw on BB was to find the ortho for either a local D1 NCAA team, or better yet, a professional sports team. As long as they are in-network, it is not like it would cost you any more than some other doctor. Plus these types of doctors understand truly active people and athletes far better.

Thankfully, being in the Bay Area we have lots of solid D1 programs (Cal, Stanford, etc..) and even more professional teams (49ers, Giants, Warriors, Radiers, A's). I looked at a lot of their doctors (on team rosters) and decided on one I really liked. Dr. Isono was the official team ortho for the Warriors, a professor at Stanford, a Team USA olympic ortho and was an ortho for the IronMan. With a resume like that I was VERY excited to see him. The only problem was that since he was a professor in addition to ortho, he was booked over for over a month out.

Time for a 3rd doctor, PT only:
Since my first doctor tried to put me under the knife immediately and the professional teams ortho was booked over a month out, I wanted to try my hand at PT to see if it helped. I seeked out a doctor who I was clear with in that I was only looking to do PT and not surgery with him. We ended up coming up with an aggressive at-home PT routine with some chiropractic "adjustments" in-office occasionally. This doctor was a crossfitter, so he understood being active.

After every day PT at home for a month I was making some improvement. There was still pain, but it definitely was getting better and it was a little easier to sleep through the night (pain kept me up if I moved wrong). Lots of different exercises, but overall it was a very aggressive PT plan. One huge mental bonus is that it took away the total feeling of "helplessness" that I had prior. I did have a setback a few weeks in where I threw a towel underhand with my right hand and I felt a "pop" again. Lots of pain for the next week, but it started getting better again.

Doctor visit with Team USA/Warriors/Stanford Doctor. A good day:
The day finally came around where I had my appointment with the team doctor for the Warriors, Dr. Isono. I was really excited for this to finally come around. I could do a whole write up on him, but he was simply the best doctor I had ever been to. He took around 40 minutes talking me through how a shoulder worked, what this injury was, his thoughts on it and options I had. I felt like I was a student in one of his classes. The cliff notes was that he thought I had probably had this injury since college and it had just gotten worse. He told me that the best course of action in his opinion was aggressive PT. He said that in his experience 85% of SLAP tears do not require surgery, and it should be up to the patient if they want to proceed. If it didn't majorly impact life in a big way, he recommends against it, despite the high success rate of the operation.

One big thing I had read about online a little, but he reaffirmed is that a large percentage of the population has SLAP tears and doesn't even know it. This is especially true in "overhead" sports where you are throwing a ball. The actual area of the labrum is low in nerve count and pain from other shoulder injuries/conditions are often attributed to it. You can have shoulder pain and a SLAP tear, but that doesn't mean they are always even totally related.

The next 6 months:
After meeting with the final doctor I continued with my PT at his recommendation. I progressively added in more and more exercises in my normal workouts at the gym and felt my self getting closer and closer to how I was originally. I dropped weights in some areas and really tried to not "ego" lift quite as much. I focused more on form and slowing things down and made sure I was always properly warmed up in my shoulders before lifting. I also relied far more on machines than I had in the past, which did drive me a little crazy at first, but allowed me to rebuild muscle without having to worry as much as tweaking my shoulder.

Current workouts and workout limitations:
Now 10 months after the injury I am very close to my old workouts and stronger in essentially every exercise than any other point in my life. The one thing I am choosing to still stay away from is flat barbell bench press. I am using more and more dumbbells instead and feel I can just have a better "feel" for things. I also generally stay away from barbell overhead press. I tried once a few weeks ago and felt it in my shoulder for a few days. I am totally fine with DB shoulder press, just careful when getting them into position, but once they are I have no problem repping 75lbs dumbbells, just typically don't allow my elbows to drop below 90 degrees.

Overall health and feeling:
After 10 months, I am feeling great. I couldn't be happier that I decided to get a second opinion and not jump into surgery. After the PT I was able to get back into my normal workouts and am stronger and fitter than ever. I have been able to drop my bodyfat 2ppt to 11.5% and have put on 10lbs of muscle since the injury and now sit at 205lbs (6'1" tall). I even added 50lbs to my max deadlift while recovering from my SLAP tear (pulled 455lbs, which for me is pretty good!).

Tips:
-Always get a second opinion
-Do your research
-Find a ortho for a professional sports team near you. If need be, it is worth the drive.
-Always try PT first. It helps you feel in control of your situation.
-There is hope, it sucks but will get better.
-Even if you need surgery you will know you covered your bases first. I read about too many people who said they wished they didn't do surgery. If you try PT, see multiple doctors, etc... if it comes to surgery you can feel confident you are making the right decision.
-Keep training if you can!

If anyone has questions related to my experience, please let me know!

Tl;dr. SLAP tears aren't fun. Do PT before surgery. Get a second opinion. Find a professional sports team ortho near you. I am almost 100% now without surgery.

You can thank Youre lucky stars I had stabilisation surgery this time 7 or 8 years ago and I’ve been ruined since ,I had to have 7 anchors in my shoulder and have been left with arthritis since the surgery ,degenerative changes to the joint confirmed by mri ,also a year after my surgery I was tore my right labrum also !
Obviously I was overcompensating for the left shoulder and was supposed to go in for surgery for it afew weeks ago but got cold feet as you can imagine !
My advise is be very careful with shoulder ops ,I’ve went from benching over 100 kg to now not even being able to do a push up !
Even brushing my teeth can be difficult ffs ,but I still train legs core and I’m able to use a seated row machine for a back workout so that’s something .
I blame the surgery it’s finished me I’m fked unless I take a chance on the surgery again but after what happened last time I’m having to think long and hard ,The pain is more of an annoyance and sometimes the shoulder feels unstable but the stiffness from surgery creates other issues

[shoulderrehab]

Hey bberg, can you give me a summary of your PT plan? And did you take any steps back during your 10 month journey? I am a few months in with rehab, and my slap tear has gotten better but it's still sketchy. I've had a few weeks with 0 pain but then I do one thing wrong (like pick up a box awkwardly) and I'm back to where I started. Any advice? What do you mean by "aggressive PT" vs. "PT"?

[SpeedCheeser]

Curious about what your PT plan was like also. I haven't seen a doctor yet, but I've had some pain in my shoulder for a while now. Right on the front of it. And with it never seeming to go away, thinking it might be time to address it.