Hi. I was wondering if there was a general consensus on recovery from a fairly severe slap tear repair. I’m mid 40s and have (had) decent strength in the joint prior to is acting up.
I made a full recovery from a distal biceps tendon rupture repair, although that was 13 years ago. I don’t know if that’s a useful indicator.
We’ll need a little more information here. Most often SLAP surgery has good outcomes when it comes to getting back to lifting but as with most surgery there are a host of factors at play. When was the surgery and what have you been doing in regards to rehab? What do you mean by “acting up”?
Thank you for the reply, Derek.
For clarification, I have not had the surgery yet. The MRI indicated that the tear was severe and the ortho seemed to have no reservations to do a surgical repair.
In regards to the “acting up”, after a session, specifically one involving overhead work, I would get severe pain at the top of the shoulder and base of the trap that would at times radiate down to my elbow. I’d also get a lot of clicking, popping, and grinding that was much more prevalent than normal until a few days later when the inflammation would die down.
The ortho also did a quick test where I had my arms out in front and tried to resist downward motion. If my hand was palm up, no problem. Palm down, pain shows up.
I was given the option of a course of PT, a cortisone injection, or surgical repair. I’m dithering between PT and surgery, but PT won’t heal the tear.
Alright, so this is a bit of a horse of different color. A tear labeled as “severe” doesn’t really give any additional information. We can definitely get some in regards to where you are experiencing symptoms in terms of workload. Overhead work is a pretty typical place to experience symptoms and often we can control for this/improve upon them with some load modification and supplementary work. You are correct in that PT won’t heal a labral tear but arguable time and load management will elicit some improvements. If I were to make the con case against surgery, if you do elect to undergo the procedure you’ll likely be in a sling for 6 weeks and not cleared for overhead pressing for another 6 minimum. That would be three months where you are likely not getting any stronger, not making any gains and while your shoulder may be “healing” it is likely not to surpass the current strength it is at for quite some time.
Specific to SLAP tears, I would try not to let your imaging get to you. If you take MRI’s of asymptomatic professional baseball pitchers 79% of them had an abnormal labrum on imaging. There’s a high likelihood these guys were throwing over 90 with this, so there is likely no reason you couldn’t be pressing without issue as well. The “clicking and popping” is also relatively normal and I would guess if we moved your other shoulder around we could elicit some of the same noises. One of my shoulders will click every time I internally and externally rotate my arm and my top press set was 245# yesterday. I’ve also had the episodes of pretty significant pain that took me away from heavy pressing for a while. The emphasis here is on the heavy word. I was still about to train and even have come back from injuries to PRs on more than one occasion because I spent time doing the technique work and ancillary training I was more prone to put off when everything was going well.
There are plenty of things you can do with which to train through/around this. If you want surgery, it is ultimately your choice. It will be a very slow rehab process and once that you could probably manage with the same heuristic of slow process without the surgery.
Also, under no circumstances would I recommend a corticosteroid injection for this.
Agreed. The ortho mentioned it but does not recommend that procedure. His mention of it was simply for pain mitigation.
I am working with Charlie Dickson to set up a consultation. To update the post, I have snipped out the radiologist’s report and copied them below.
Trying to help clarify things a bit more, the popping I mention is well beyond normal crepitus. It’s probably better described as a “thud” where it feels like the joint returning to normal position with a sharp pain following.
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