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View Full Version : HELPP Torn Labrum, College Swimmer!



oacard
June 15th, 2008, 09:48 PM
Hi! So I am a serious competitive swimmer. I've been swimming since I was little (over a decade by this point) and I had never had any shoulder pain until this March. It was the end of my season and we were tapering down for NCAA's and all of the sudden my shoulder starting hurting more and more everday. Swimming backstroke caused the most pain (kind of a problem since I am a backstroker) and it got to the point where I couldn't take a stroke of backstroke without being in agony. I also couldn't sleep on that side. I took a lot of aleve and swam through it b/c I needed to be able to race at NCAA's. Once I stopped training backstroke the pain was less acute and more tolerable. I thought that with some time off it would go away. However, even with 2 full weeks of no swimming something still didn't feel right. As time has gone on (very minimal off season training) I've developed extreme tightness in my pec and all across the top of my back and neck.

I went to a sports doc at home and they did an MR arthrogram and diagnosed me with a Labral tear (he said it was a slight tear) and some impingement. My doc said that he thinks some of the pain I am experiencing could be related to the way my back and shoulder muscles have developed after so many years in the pool; but if that was the case it seems strange that my shoulder would all of the sudden start hurting like this. Anyway, he said that he doesn't think I need surgery at this point and I should be able to resolve the problem with physical therapy. I'm just worried that once I get back to serious training (4-5 hours and 12,000+yards a day in the pool plus dryland) it will just start hurting again and it will affect my season.

Does anyone know anything about/experienced this kind of problem? Especially serious athletes or swimmers? My hope was that I could resolve this over the summer so I would be ready to go once my college seasons starts up in the end of August. I was a 6 time All American this past season as a freshman so oviously I feel a certain amount of pressure to follow up on that with a great sophomore season. I have my first PT apptment on Monday but any advice or personal anecdotes would be great appreciated!

ehoch
June 16th, 2008, 12:51 AM
I had a torn labrum about 3 years ago - I am older (39 now) - but I never had even a sore shoulder from swimming - then all over sudden my symptoms started exactly like yours - related to backstroke, not terrible pain, but enough to cause some serious problems. I had surgery and a very long recovery - but I think my PT was way too conservative.

Here are some very good swimmers who had this -- Lenny Krazelburg (more than once), Natalie Coughlin (before 2000) and Nick Brunelli (last summer).

For sure contact Nick Brunelli through the Race Club Board - he will for sure give you his opinion + rehab schedule and all of that. He even posted a forum blog on race club about his rehab.

Not all torn labrum require surgery - but for swimmers most of them seem to have surgery (Coughlin did not - but also did not do any arm pulls swimming for I believe 6 months). Brunelli's rehab was quick - I believe he swam US open after doing the surgery in August.

Also go to another doctor - best one that deals with baseball players + throwing motion sports. This is not the end of swimming - but this is very serious for a swimmer. The problem is that - at least that's what they told me - the labrum does not heal on it's own at all --- so depending on how bad the tear is, you are somehwat limited in terms of options.

Let me know what else you need + where you are located -

Hoc

spudfin
June 16th, 2008, 08:48 AM
I have been involved as in Sports Medicine in one form or another for 25 years so I have a long experience with problems like yours. First and foremost go see an Orthopaedic Surgeon that sees a good number of these problems in the context of highly competitive athletes like yourself. All Docs are not created equal and those that see large numbers of competitive athletes give you the best chance for recovery. Even if you have to hop on a plane do it. Secondly, depending on your tear I have a bias toward rehab first with a GREAT Physical Therapist. Again not all are equal. If you do need Surgery it can be a mixed bag for you. We consider shoulder surgery a pandoras box. I would even advise you to look very long term and if need be get your head around a redshirt year as a last resort. Don't make a pressured decision just to get back in the pool for a sophomore season and regret the path you took in haste for years to come. Bottom line is you can get better with the right treatments and go on to great things, just may take a while.
Good Luck
Spudfin

The Fortress
June 16th, 2008, 09:41 AM
I tore my labrum in college and quit swimming. (However, I was burned out and it was fine.) I did some rehab. Later, when I returned as a masters swimmer, I immediately experienced shoulder pain. After struggling with PT, I had a arthrogram: micro tears in the labrum and SLAP lesion. I've continued to swim with a combination of PT (for awhile) and ART, www.activerelease.com. I never stopped swimming, but it's been a struggle. After trying many non-surgical options, the thing that has absolutely helped me the most is plasma regeneration therapy. I had 4 treatments, may have another one at the end of the summer. I feel fairly pain free now, although I am very careful and do a lot of kicking and vastly lower yardage than you. PRP is pretty cutting edge, but it is beginning to be used more by athletes. It works fairly quickly; you can go in for treatments every 3-4 weeks or so. If you're interested, check out http://www.treatingpain.com/?page=prpr-therapy. Unfortunately, there aren't many docs that do this procedure. For me, it's been pretty amazing. I know patients who say they are stronger after the procedure than before their injury. It may or may not be covered by insurance. You may have to fight to secure coverage. If not, it's very expensive.

Good luck. Wish you the best and hope you can keep swimming.

blainesapprentice
June 16th, 2008, 10:17 AM
If you are anywhere within the Connecticut or NYC regions I suggest looking up Dr. Jo Hannafin. She repaired my shoulders in two surgeries (1 for each shoulder) one in September and one in October. In December I won Rookie of the Meet at the ECAC conference championships. I was a unique case I realize that--I didn't have a labrum tear actually, I had muscle and tissue growth into the rotator cuff by some freaky fluke and she had to cut this muscle and tissue out of the joint and shave some bones and rebuild some areas--but everyone I know who has used her has had great results. She was an Olympic rower, her son is a college swimmer and she was the orthopedic on call at the Olympics in Athens.

Regardless, I definitely recommend seeing another doctor for a second opinion and make sure that they are just as concerned about your future as an athlete as you are. Make sure that they are going to be in contact with the PT that they recommend to ensure that you are getting the proper regiment at PT to get you back to the strength you need to stay healthy through the next season. That was the best part about my doctor--she called my PT at least once every two weeks to discuss my progress and she would fax or e-mail my therapist swimmer specific exercises to include in my rehab...that's so important that the doctor and PT understand the mechanics of swimming so they can understand what exactly needs to be strengthened

nkfrench
June 16th, 2008, 10:56 AM
My story - 20 years ago I dislocated my shoulder and tore the glenoid labrum so there was a long loose strip that kept getting pinched when I moved my arm. My arm would sublux out of the shoulder socket and it hurt to take a single stroke of freestyle. I had surgery to reconstruct the joint. My arm/shoulder was immobilized for a few weeks, then I had about 4 months of PT 3x/week for 4 hours at a sports medicine rehab center. When I started PT, I didn't even have strength to lift a 12-oz can of diet coke or to open a heavy door. PT was successful and I built strength back up to where I was able to benchpress my bodyweight. The surgeon thought that I might have some limits in external rotation, which would affect backstroke. Happily that was not the case but other patients at PT did, including a promising collegiate baseball pitcher who couldn't pitch any more. I did have to have a loose screw removed a year later which was causing pain while swimming. Loose screws were a common complication and I don't think the same procedure is used today.

Today I do not notice the shoulder when I swim. I avoid some weightlifting as it does irritate it -- military press, flies. It is uncomfortable to carry bags with the strap on that shoulder. It also tires rapidly when I carry a drink. I support it when I drive as it seems like it subluxes. I am supposed to continue doing some rehab exercises (particularly for the rotator cuff) to keep the joint stable.

Good luck with your shoulder.

zegmal
June 16th, 2008, 11:15 AM
I tore my labrum a year ago and opted not to have surgery. Shoulder surgery and the recovery is brutal and there is no guarantee that it gets you back to 100%. My doctor's advice was if the injury is a nuisance then live with it, if it is seriously limiting your ability to do things you love then get surgery. HOWEVER, that decision can only be made after several months of PT. Shoulders take a long time to heal. Your situation is a bit different because swimming is such a huge part of your life that doing PT for three or four months and then making a decision on surgery is probably hard to imagine. If you do rush into surgery you could be getting a procedure and all that risks that involves that you didn't really need. But unfortunately there is no way you'll know if you need it without waiting several months. Good luck.

jordangregory
June 17th, 2008, 04:16 PM
If I were you, I would take Spudfins advice. Everything he said is spot on with what I know about injuries. I used to work as an exercise physiologist doing rehab with a chiropractor and pain management doctor. We saw a good number shoulder problems before and after surgery. Those with bad doctors or those that wanted to keep working with slightly injuries shoulder often ended up with us for the long tern pain management. Those with good doctors stayed for a short time doing post surgical rehab.
I now work as a registered nurse, and I can tell you first had, just as Spudfins did, not all doctors are created equal. Those that do a lot of procedures and specialize in an area are much better that those that don't. Don't judge by bedside manner. Look at results. Find a good sports medicine/orthopedic surgeon to evaluate you. Make sure they have a lot of experience with your particular problem.
As a side note, 12,000 yards a day as well as dry land is a shoulder injury waiting to happen. Just my opinion. Especially if you swim events in the 50-200yard/meter range.
Best of luck.

swimcat
June 18th, 2008, 06:24 PM
My story - 20 years ago I dislocated my shoulder and tore the glenoid labrum so there was a long loose strip that kept getting pinched when I moved my arm. My arm would sublux out of the shoulder socket and it hurt to take a single stroke of freestyle. I had surgery to reconstruct the joint. My arm/shoulder was immobilized for a few weeks, then I had about 4 months of PT 3x/week for 4 hours at a sports medicine rehab center. When I started PT, I didn't even have strength to lift a 12-oz can of diet coke or to open a heavy door. PT was successful and I built strength back up to where I was able to benchpress my bodyweight. The surgeon thought that I might have some limits in external rotation, which would affect backstroke. Happily that was not the case but other patients at PT did, including a promising collegiate baseball pitcher who couldn't pitch any more. I did have to have a loose screw removed a year later which was causing pain while swimming. Loose screws were a common complication and I don't think the same procedure is used today.

Today I do not notice the shoulder when I swim. I avoid some weightlifting as it does irritate it -- military press, flies. It is uncomfortable to carry bags with the strap on that shoulder. It also tires rapidly when I carry a drink. I support it when I drive as it seems like it subluxes. I am supposed to continue doing some rehab exercises (particularly for the rotator cuff) to keep the joint stable.

Good luck with your shoulder.
wow, i can relate. in 2005, i suffered a 5th ac joint disruption. tore every ligament in tendon possible in a ski accident. i had joint reconstruction allograft. i have donor tendon in my shoulder. for 2 years, i couldnt do crap. gained weight, dropped cups, etc.. it took so long because i was first misdiagnosed as grade 1 injury. went to a sports ortho guy and he found out exactly what it was.
started swimming again in 2007, but am still behind in times, sometimes the arm goes numb. nerve damage.
now, i have a slap tear and tear in superspinatus. i don;t know how i have been swimming 4ooim.:cane: just started pt with a pt who is a swimmer.

spudfin
June 18th, 2008, 09:39 PM
Just an additional though about jordangregory's comment about bedside manner. Probably the nicest Ortho guy I have ever met was an abysmal Surgeon. Don't go with the guy or gal you like the most. Make them produce some empirical results for you. Questions to ask. How many of these problems do you fix each year? What percentage of your patients are athletes? Who cares if he returns a desk jockey back to work. What are your athletes return to competition rates? How many of them do you have to operate on multiple times? You want the one who does a high number and can tell you his/her results readily. Believe me the GOOD ones keep track and are not shy about telling you their numbers. If one of them gets huffy when pressed run don't walk away from the office. Lastly, if you can make a connection with an OR nurse or scrub tech that works with these guys that is the golden ticket. Perhaps an Anesthesia provider if you know one. Those folks know the score in the OR.
Regards
Spudfin