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Thread: Torn Labrum - Recovery without Surgery?

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    Torn Labrum - Recovery without Surgery?

    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

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    Very Active Member FlyQueen's Avatar
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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by famelec View Post
    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.
    "I don't race to see who is the fastest, I race to see who has the most guts."

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    Re: Torn Labrum - Recovery without Surgery?

    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.

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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by FlyQueen View Post
    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

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    USMS Member since 2003 gull's Avatar
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    Re: Torn Labrum - Recovery without Surgery?

    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.

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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by TheGoodSmith View Post
    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.
    "I don't race to see who is the fastest, I race to see who has the most guts."

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    Re: Torn Labrum - Recovery without Surgery?

    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!

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    Re: Torn Labrum - Recovery without Surgery?

    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 . 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

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    sprint diva The Fortress's Avatar
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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by ehoch View Post
    - 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.

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    Re: Torn Labrum - Recovery without Surgery?

    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.

    Quote Originally Posted by The Fortress View Post
    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.

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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by The Fortress View Post
    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

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    Re: Torn Labrum - Recovery without Surgery?

    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!"

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    Re: Torn Labrum - Recovery without Surgery?

    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. 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.

    Brian

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    Re: Torn Labrum - Recovery without Surgery?

    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.

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    Re: Torn Labrum - Recovery without Surgery?

    What causes a labral tear or 'Slap'?

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    Re: Torn Labrum - Recovery without Surgery?

    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?

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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by Mookie View Post
    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

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    Re: Torn Labrum - Recovery without Surgery?

    Does anyone know a website that has exercises designed to combat torn labrum symptoms?

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    Re: Torn Labrum - Recovery without Surgery?

    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.

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    Re: Torn Labrum - Recovery without Surgery?

    Quote Originally Posted by TheGoodSmith View Post
    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.

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