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View Full Version : Torn Labrum - Recovery without Surgery?



famelec
November 3rd, 2008, 04:52 PM
My doctor thinks I have a labral tear. It may not be torn too badly since apparently it wasn't obvious on the MRI. I took three months off of swimming before seeing the doctor - I figured it would get better on its own, but it didn't.

I've done about 4 weeks of physical therapy and will do another two before seeing the doctor again. My range of motion and rotator cuff muscle strength have definitely improved, but the impingement pain and shoulder clicking during freestyle recovery motion is still there. My doctor suggested that after 6 weeks of physical therapy he'd have a better idea if surgery would be necessary. Two weeks to go...

In searching this and other forums, it seems that physical therapy doesn't do the trick for most swimmers with labral tears, and they end up in surgery. Or maybe those that choose surgery just like to post more about it?

If you've recovered from a labral tear without surgery, let me know! I'm willing to do many more months of physical therapy if I think I can avoid surgery!

Brian

FlyQueen
November 3rd, 2008, 06:11 PM
My doctor thinks I have a labral tear. It may not be torn too badly since apparently it wasn't obvious on the MRI. I took three months off of swimming before seeing the doctor - I figured it would get better on its own, but it didn't.

I've done about 4 weeks of physical therapy and will do another two before seeing the doctor again. My range of motion and rotator cuff muscle strength have definitely improved, but the impingement pain and shoulder clicking during freestyle recovery motion is still there. My doctor suggested that after 6 weeks of physical therapy he'd have a better idea if surgery would be necessary. Two weeks to go...

In searching this and other forums, it seems that physical therapy doesn't do the trick for most swimmers with labral tears, and they end up in surgery. Or maybe those that choose surgery just like to post more about it?

If you've recovered from a labral tear without surgery, let me know! I'm willing to do many more months of physical therapy if I think I can avoid surgery!

Brian


I had a SLAP tear and didn't have surgery. (Natalie Coughlin also tore her laburm and I think rotator cuff and didn't have surgery) LOTS AND LOTS AND LOTS of core work. You can definitely do it - I would suggest taking time off of swimming and just kick while you are rehabbing at least for the first 4-6 weeks. I found that through rehab and tinkering with my stroke to make it more from the core that I was able to come back pain free. You might want to find a knowledgeable coach or PT that knows swimming and have them review your stroke and see what changes can be made to take the pressure off of your shoulder.

zegmal
November 4th, 2008, 12:40 PM
I had (still have) a SLAP tear and did not have surgery. Shoulder surgery is a nightmare and there is no guarantee that you get back to a 100%. The thing about PT on a shoulder is that it TAKES LOTS OF TIME to get better. Give your PT several months before making a decision. At least six months. It only takes a couple sessions with a therapist to learn the exercises; once you do, do them every day. You also need to focus on posture, core, sitting position, sleeping position, all those little things make a huge difference. And when you get back to swimming, take it easy at first and learn to swim with your back muscles rather than your rotator. Again, give your shoulder and PT a lot of time before making a decision. I seriously thought about surgery, but am really glad I waited.

TheGoodSmith
November 4th, 2008, 01:59 PM
I had a SLAP tear and didn't have surgery. (Natalie Coughlin also tore her laburm and I think rotator cuff and didn't have surgery) LOTS AND LOTS AND LOTS of core work. You can definitely do it - I would suggest taking time off of swimming and just kick while you are rehabbing at least for the first 4-6 weeks. I found that through rehab and tinkering with my stroke to make it more from the core that I was able to come back pain free. You might want to find a knowledgeable coach or PT that knows swimming and have them review your stroke and see what changes can be made to take the pressure off of your shoulder.

Define "core" work please.

I am also suffering from a "slap tear" and had to quit swimming.

John Smith

gull
November 4th, 2008, 02:10 PM
A few years ago I thought I had a labral tear, but the MRI was negative. However, without an arthrogram a small tear could have been missed. Anyway, my orthopedist recommended six months of PT before considering surgery. After about six months of daily RC exercises my shoulder began feeling better. I did not take any time off from swimming. No pain or clicking now.

FlyQueen
November 4th, 2008, 02:14 PM
Define "core" work please.

I am also suffering from a "slap tear" and had to quit swimming.

John Smith

Core - your abs, back, and legs basically.

Lots of pilates type stuff. There's a ton of stuff you can do with the swiss balls/those big workout balls - ab work, planks on your elbows if you shoulder hurts to do them on your hands - or knees and elbows.

Strengthening your legs especially your quads and hammys. Working on things like posture.

I know my tear was small and it took a few months out of the water (even kicking hurt - even with my arms at my side) and three sessions a week with a shoulder guru before it was better. I had a PT that's a swimmer look at all 4 strokes and tweak them to take the stress off of my shoulder.

Building core strength will help a ton. If you have more questions I'm sure others (or I) can clarify/help.

The Fortress
November 4th, 2008, 03:59 PM
I had labral tearing and a SLAP lesion diagnosed with an arthrogram. As I've said in other threads, before the diagnosis, I used ART (www.activerelease.com) and PT to keep it under control, but the pain always flaired back up. What worked best for me was getting four PRP treatments (plasma regeneration therapy, see www.treatingpain.com). Now, I'm pretty pain free IF I baby my shoulder, do my RC exercises, lift weights, and don't get overly stupid with 100 fly sets (which I did recently, idiot that I am). Lifting seems to have helped a lot; my ART doc says my shoulder muscles are not sheer mush anymore. However, insurance companies won't always cover PRP, as it's a relatively new treatment and quite expensive. You have to be a pain in the ass to get it covered.

GoodSmith, don't quit. Get treated!

ehoch
November 4th, 2008, 04:14 PM
I also had a SLAP tear in my shoulder and I did have the surgery - I did a lot of research on this and have talked to quite a few people about this -- here is what I came away with -

- this stuff is very difficult to diagnose - even with good MRIs (contrast) - they told me I had a labrum tear and a tear in the long head of my biceps tendon (that is a death sentence for competitive swimming) - when they went in, the biceps was fine

- it does not heal on it's own - ever ! Without surgery, you are basically trying to build all the muscles around that area to help you not feel the tear or to use your muscles in a way that the tear does not affect you. The tissue itself is closer to a ligament - so it does not heal on it's own.

- recovery with or without surgery is totally different from case to case -- I have talked to people that never got full range of motion back with the surgery and I have seen people swim meets 4 months after surgery (Nick Brunelli last year). Some people get help with PT only amd some people (like myself) feel no difference at all.

If you do the surgery -
- the rehab people are as important (or more) than the surgeon. Find somebody that understands swimmers and the range of motion our shoulder needs.

Personally - my rehab after surgery was long and almost hopeless at some point :badday:. I finally got better when I let the shoulder be on it's own for 6 months - but now I am swimming faster than before :D

The Fortress
November 4th, 2008, 04:21 PM
- it does not heal on it's own - ever ! Without surgery, you are basically trying to build all the muscles around that area to help you not feel the tear or to use your muscles in a way that the tear does not affect you. The tissue itself is closer to a ligament - so it does not heal on it's own.

I didn't have any luck with PT either. But PRP involves actual regeneration of the injured tissue and ligaments using your own blood platelets, which are injected directly into the effected areas. Many professional athletes use it.

david.margrave
November 4th, 2008, 04:28 PM
I'm not in the market for this (yet) but will keep an eye on it.

It reminds me of a treatment a guy I work with got for his knee. I forget the specifics but it involved tissue or cell harvesting/culturing of some kind to replace some of his knee cartilage, possibly using non-embryonic stem cells (I forget the exact details), and was a less invasive and better outcome option than conventional surgeries.


I didn't have any luck with PT either. But PRP involves actual regeneration of the injured tissue and ligaments using your own blood platelets, which are injected directly into the effected areas. Many professional athletes use it.

TheGoodSmith
November 5th, 2008, 10:52 AM
I had labral tearing and a SLAP lesion diagnosed with an arthrogram. As I've said in other threads, before the diagnosis, I used ART (www.activerelease.com) and PT to keep it under control, but the pain always flaired back up. What worked best for me was getting four PRP treatments (plasma regeneration therapy, see www.treatingpain.com). Now, I'm pretty pain free IF I baby my shoulder, do my RC exercises, lift weights, and don't get overly stupid with 100 fly sets (which I did recently, idiot that I am). Lifting seems to have helped a lot; my ART doc says my shoulder muscles are not sheer mush anymore. However, insurance companies won't always cover PRP, as it's a relatively new treatment and quite expensive. You have to be a pain in the ass to get it covered.

GoodSmith, don't quit. Get treated!


I have been seeing an ART specialist once a week, but the pain and range of motion has leveled off and is not getting better.

This is a really frustrating injury. I am about ready to follow ehoch's and other's advice and just get surgery. It doesn't sound like I have much to lose at this point. I am already unable to swim.


John Smith

Willow
November 6th, 2008, 08:08 PM
I'll be following this thread with keen interest. I am in the process of being treated for a possible labral tear, which seems so incredibly unfair, as I just learned to swim at 37. Right now I am all kinesiotaped up and pouting. My PT said I can do kick sets with my arms at my sides and breast only, no weights for now but very conservative Pilates ball work is okay.

I am so bored and I have a border collie staring at me 24 hours a day with his frisbee in his mouth glaring "J'accuse, Maman!"

famelec
January 16th, 2009, 11:05 AM
Well, my mid-November follow-up visit with my doctor has changed so many times it's now scheduled for Jan 30...

In the meanwhile I've continued to do the strength and range of motion exercises from physical therapy (though not very frequently now; I've gotten lazy...), and recently started swimming.:applaud: Started with just 500 meters easy, now at 2,000 meters with some decent intervals, and I'll go back with my Masters team starting next week. My shoulders are a bit sore afterwards so I'm building yardage slowly and limiting myself to two swims a week for now.

I was surprised that I could swim without pain on my first swim in December. When doing "air swimming" at home I still had (and have) a sharp impingement pain during recovery. But in the water I found if I concentrate on good rotation and high elbows during recovery, I experienced no pain at all. If I start swimming flatter, ouch!

I still can't swim backstroke without light pain during recovery, and I suspect fly will be very painful (kinda hard to rotate and keep elbows high in recovery!). No problem with breaststroke.

The good news is no surgery! Even if I can't swim fly or back again I'll probably not elect surgery. The bad news is that I suck at breaststroke. :afraid:

Brian

zegmal
January 16th, 2009, 10:22 PM
Try always icing your shoulder after workout even if it doesn't hurt. Also pay attention to how your hand enters the water--pinkie first.

Mookie
January 17th, 2009, 01:31 PM
What causes a labral tear or 'Slap'?

Mookie
January 17th, 2009, 01:36 PM
Got this good thread when trying to find causes
http://www.usms.org/forums/showthread.php?threadid=1831
It will help people currently dealing with this.
But, what causes it? How to avoid it?

famelec
January 19th, 2009, 10:16 AM
Got this good thread when trying to find causes
http://www.usms.org/forums/showthread.php?threadid=1831
It will help people currently dealing with this.
But, what causes it? How to avoid it?

In my case I'm fairly sure it was caused by a combination of lack of flexibility and lack of strength relative to my training load. Maybe some poor technique in there too, particularly when swimming tired.

I'm planning to maintain a stretching and strength program (light weights) this year to see if it helps. Hopefully it will...

Brian

bbpolhill
June 9th, 2009, 06:13 AM
Does anyone know a website that has exercises designed to combat torn labrum symptoms?

nkfrench
June 9th, 2009, 10:51 PM
I had a torn labrum with a long loose flap that didn't show up on the arthrogram and less invasive tests. It was finally diagnosed when the orthopedist explored it under general anesthesia with the arthroscope. I tore it when I fell backward onto an outstretched arm.

The reconstruction surgery, rehab, screw removal surgery all involved a lot of expense and downtime and some pain but definitely the outcome made the surgery very worthwhile.

Tom McCabe
June 10th, 2009, 02:00 PM
Define "core" work please.

I am also suffering from a "slap tear" and had to quit swimming.

John Smith

There was a good article in the Wall Street Journal about shoulder surgery awhile back. It stated most people typically don't start to feel normal until two years after the surgery. I had the surgery two years ago this May and just recently have more confidence in the water to race. It was not fun, but, it was better than giving up swimming altogether. When you look at how well the 60 year olds are swimming you have a lot to look forward to.

ehoch
June 10th, 2009, 07:18 PM
Does anyone know a website that has exercises designed to combat torn labrum symptoms?

Either it's torn or it's not ... usually not a gradual thing.

The people who opt not to do the surgery - don't swim for quite a while and do very very extensive shoulder strength excercises. And if you stop the strength work, the problems often come back...

Same for me with the 2 years although I have seen people (Brunelli come back much faster) -- a lot had to do with working through pain and trusting that the shoulder is back to normal.

bbpolhill
June 11th, 2009, 07:26 AM
Either it's torn or it's not ... usually not a gradual thing.

The people who opt not to do the surgery - don't swim for quite a while and do very very extensive shoulder strength excercises. And if you stop the strength work, the problems often come back...

Same for me with the 2 years although I have seen people (Brunelli come back much faster) -- a lot had to do with working through pain and trusting that the shoulder is back to normal.

Sounds like you are in the surgery camp.

My doctor gave me 3 options: surgery to fix it (sounded like a long rehab), rehab to alleviate the symptoms, or live with the pain. I opted for trying to rehab it before having the surgery, but was trying to see what was involved before I made that time and financial commitment.

matysekj
June 26th, 2009, 11:04 AM
Scott, my brother has had the biceps tendon tear away due to biceps tendinitis in both arms. He does have the "Popeye" arm effect now, but he is able to swim. The constant pain from the tendinitis was completely gone after the acute pain from the tear subsided. He does have to keep up the PT exercises to keep the other biceps tendon attachments from becoming a problem, but overall this seems to be working for him. YMMV

marksman
July 7th, 2009, 05:52 PM
I had surgery six weeks ago to repair a badly broken finger. I still can't move the finger, and my hand and joints swell up each morning and I spend the rest of the day stretching them.

Surgery is awful so please, please try to recover without it if you can. Otherwise, whatever you do post-surgery, make sure you take those anti-inflammatories for a long time, and keep icing the site as needed, and start with a (very experienced) physical therapist as soon as you can afterwards or you will have permanent issues. Always get a second opinion from a different surgeon too. It's worth the extra $200 for an independent consultation. If I had done this, I likely would have avoided a more complicated hand surgery and had a better recovery (it turns out that my original hand surgeon was wrong about needing to do a bone graft on my finger).

famelec
July 15th, 2009, 01:05 PM
I started this thread, so I figure I should give an update....

I never did the surgery. I did 2 or 3 months of physically therapy, then got back into the water in January, continuing with PT exercises also. Started with low yardage and frequency, then built slowly. I'm swimming 4x per week now (with a 5th really easy swim on my own) with no real pain. I'm pretty much back to the same shape I was in when I stopped swimming just over a year ago when things were too painful.

On the downside, if I swim fly I feel it a day or two later (though it actually feels fine while swimming), so I don't plan on swimming fly much. Sometimes swimming backstroke is bothersome. I still can't swim "air freestyle" without impingement pain, but then I suppose swimming freestlye while standing on land is much different from being horizontal in water. I'm skipping Zones this summer since I suspect that the stress of diving in and taking that first stroke or two will make the shoulder situation noticeably worse. I know I need to continue with the physical therapy exercises but I don't do them frequently as I should since I'm feeling pretty good in the water.

So I guess my answer to my original question is: Yes, you can recover from a minor labral tear without surgery, but the recovery will take months may not ever be 100% complete.

Brian

isobel
May 22nd, 2010, 09:17 PM
I was just diagnosed with torn labrum and bone erosion; surgeon said surgery was only option; PT won't heal the tear.

I have been doing PT since February. The pinching (impingement) is mostly gone, but my joint feels very off swimming, and PT said I should readjust my swimming goals to swim maybe 1500 to 2000 yards a few times a week and take up other sports.

Uh, Non! Swimming is so important to me! So I am thinking I will take the chance, have the surgery, and, according to the surgeon, I should be back in the water in 4 months.

I do worry about the intial pain.

Anyone out here have successful labrum repair surgery and now back to awesome satisfying swimming? I don't have to be Superwoman; I would just like to do workouts again. My arm hurts other times, too, like when washing my hair or in some positions putting any pressure on it.

I have done tons of exercises with weights/without weights throughout my 10 years of masters swimming, specifically to strengthen my rotator cuff area, but this pain came out of the blue. I also have used all my dance books/training to work on posture using imagery and core muscles. Yet, the pain persists. It's not destroying my daily life activities, but it has destroyed my swimming training, unless I need to be more patient and swim very little for very much longer, like a year. I have swum very little for 4 months and pretty much am going out of my mind. I also have seen no improvement by resting and cutting back to virtually no yardage. I kick a lot and do the elliptical and leg machines in the gym so maybe am getting a good butt and quads but I'd rather be swimming in my lane with my swim buddies.

Any really cool success stories out there? This surgeon is highly recommended by my coach and the surgeon's assistant says she is very conservative when it comes to recommending surgery.

But I am verrrrry scared.

isobel
May 24th, 2010, 11:00 PM
Here are all the PT exercises I have been doing to strengthen and stabilize my shoulder blades. I've gone on to some others: throwing a ball against a wall overhead and catching it out to the side (this is supposed to get the shoulder blade to stay close to the spine without conscious effort); snow angels (standing against a wall and moving my arms up and down as if making pointy snow angels); some others.

These exercises are hard to do if your core is not strong (especially the ones involving weights).

YouTube- Swimmer shoulder stability exercises, Part 1

YouTube- Swimmer shoulder stability exercises, Part 2

Also of course the ever-needed internal/external rotation exercises with Therabands or weights.

Alas, I still cannot swim after four months, though my shoulders and back are now very strong. TBD.

No one ever told me about shoulder stabilization exercises. I wish I'd known 10 years ago that these were important.

Also, as others have said, posture, core strength, posture posture posture.

Jimbosback
May 25th, 2010, 10:52 PM
Anyone out here have successful labrum repair surgery and now back to awesome satisfying swimming?

My swimming is not quite awesome, but ...

I dislocated my shoulder playing HS baseball in 1986. It ended my scholastic baseball career and messed up my last two years of swimming, though physical therapy made me a decent swimmer my senior year. The injury made me prone to dislocation, which I'd do regularly -- water polo, volleyball, moving furniture, etc. Doctors were no help -- just recommended I keep doing my exercises. This kept me from swimming in college, though I swam well enough to lifeguard, and I could throw a ball well enough to play softball.

Fast forward to 2002, and I was taking care of two kids and renovating our house. My shoulder started aching at first and then my arm just felt like it would fall off any time I relaxed it at my side.

I found a good orthopedic surgeon. He put me through x-rays, several MRIs, and strength tests. He could tell something was wrong but could not see exactly what on the images. There was tendonitis and bursitis and a little fraying around the joint. He wanted to go in arthroscopically and clean things up, and while in there thoroughly examine the area. Then if he found something he could not fix, he wanted to do it again after three months of PT. I told him I did not want to wait that long to be better and convinced him to do whatever it took to fix whatever he found the first time. In July 2004, he went in.

It turned out my labrum was completely detached in front. It required open surgery (I have a 4-inch scar) and several metal anchors to fix.

PT was supposed to take 3 months to be back to normal, but I was functional after 3 weeks, and after 2 months I could throw a ball like when I was 16. After 3 months, I could swim, though I only swam once in a while for fitness.

Various things got in the way of me swimming between then and now, but I decided about a year ago to start swimming again. When I got in the pool, I was not so good, but it had nothing to do with my shoulder. After a few weeks of stretching thing out, I was on my way to swimming well again. No problems with my shoulder. I am also coaching little league, and I can throw hours of batting practice.

I am pretty sure that if I had the time and made the effort right after surgery that I could have swam right after about 6 months -- three with therapy and three more with easy swimming and weights.

If the technology was there for me in 1986, I am confident I could have played ball or swam in college after this procedure.

If they can do it all arthroscopically, even better -- the hardest part for me was waiting for the incision to heal and then getting that scar tissue broken up.

Get this fixed, as it won't get better and might get worse. Trust your doctor, and take your time with recovery.

Good luck!

bbpolhill
May 26th, 2010, 08:58 AM
Anyone out here have successful labrum repair surgery and now back to awesome satisfying swimming? I don't have to be Superwoman; I would just like to do workouts again. My arm hurts other times, too, like when washing my hair or in some positions putting any pressure on it.

Any really cool success stories out there? This surgeon is highly recommended by my coach and the surgeon's assistant says she is very conservative when it comes to recommending surgery.

.

I had a torn labrum and slight tear in the rotator cuff which was diagnosed in June 2009. I started out with Physical Therapy and made mild progress, but I could tell that it was not good enough to be able to swim without pain so I decided to try the surgery. In the weeks before the surgery, my doctor allowed me to swim "because I couldn't injure it any more". I swam for a couple of weeks until the pain made it impossible to complete a workout. I had a labrum repair surgery while also having some bone spurs removed in September. By late December, I made enough progress with PT to get back in the water and started working out with the team at the beginning of January. At first, I was quite weak, but used Zoomers to keep up with my lane mates. By February, I was able to keep up with without Zoomers. I did not experience any pain that I can recall. By March, I was able to swim in a meet and far exceeded my expectations and even made some personal bests.

My overall assessment was that I really needed the surgery to fix the tear but also to get rid of the bone spurs. The Physical Therapy only worked after the surgery. I am back to swimming 5 to 6 times a week 3200-4000 yds per practice. Let me know if you need any additional information that would ease your mind.

marchse
February 23rd, 2011, 07:20 AM
Hi.. my mom do had labrum tore at her upper arm.. she has been asked to take up a surgery as the tear is some what severe, but is very scared of it, is there any option of get recovered from it without a surgery??

dontolbert
January 5th, 2012, 12:14 AM
The great question, surgury or not. I've been diagnosed with a Class III SLAP tear. A triathlete who took several bike crashes (tear probably happened Sep 2010). Shoulder pain while swimming, lifting weights, and when I wake up. PT no help.

I would like to hear from those of you who underwent surgury and whether you are better off or not.

Also is there a way to sleep that you wont wake up with a shoulder ache?