rehabilitation after surgery (labrum repair)

by Jamie Boyle
(UK, London)

Hi, I have recently had a labrum repair on my shoulder (almost 12 months ago), however my shoulder is very very slow in recovering. My range of movement is about 70% of what it should be and the shoulder capsule is still very tight. prior to the surgery i had several subluxations, and then dislocated once. had i a frozen shoulder after the dislocation then had the surgery 5 months after (the shoulder was about 85% at that stage). could you please offer some advice on how to further increase my range of movement (particularly the external rotation). I do several stretches twice a day, do not do any strength work though.


thanks

Oct 14, 2008
by: Bart - SII


Restoring your motion is likely going to be a challenge. After 12 months, the tissue has become fairly strong and any adhesions that have formed are well set. The fact that you only had about 85% of your motion prior to surgery will also have an effect on what you will be able to return to.

You might benefit from to some light strengthening activities, especially with multi-direction movements, such as diagonals across the body and other directions that mimic normal everyday life. Sometimes if you can increase the muscle function, the body will make adaptations and can increase your motion.

You may also benefit from therapy for joint mobilizations - this will stretch the joint capsule and can sometimes break up adhesions in the shoulder. Stretching on your own will likely not significantly improve your motion as it is very hard to stretch the capsule effectively. Joint mobilizations can be painful, and again, at 12 months might not make much difference.

Bart


Oct 15, 2008
by: Jamie Boyle


hi bart , thanks for the quick response to my other question. So i was also wondering what other techniques such as acupunture and injections may do to help increase a little more of the movement? I have read these may be useful in releasing tension and breaking down tissue in the shoulder.

thanks
jamie


Oct 15, 2008
by: Bart - SII


Acupuncture may be of benefit - I am not familiar with all of its uses so I can't say for sure. Injections would likely not have much effect.

If motion is severely restricted, physicians may perform a manipulation under anesthesia (MUA). Basically they put you under and force your arm into full range, breaking the adhesions. This is usually only done after conservative treatments are failed and if there are significant restrictions that are limiting normal daily life. It requires rehabilitation after the procedure to maintain the motion.

Bart

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Partial Torn Rotator Cuff Surgery and Labral Debridement

I am 18 years old and have just had arthrosopic surgery for a partial torn rotator cuff(50%) and labral debridement. I am on a college baseball scholarship as a pitcher. What are my chances of returning to play at 100% after rehab?


Oct 14, 2008
by: Bart - SII


If you go through the rehabilitation process and everything goes well - if you have good scapular function, normal range of motion, and good stability, you should be able to get back to very close to where you were prior to surgery. It is a long process and will likely take at least a year if not longer. It can be done though, with the right people helping and a lot of motivation.

Bart

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Anterior Labral Tear From 12 O'clock to 3 O'clock Position

by Motty Bar-chaim
(Boca Raton, Florida )

I just received the MRI results on my left shoulder after four weeks of agonizing pains in my left upper arm and my left back shoulder blades. I cannot recall any incident or major/drastic physical movement which could have caused this tear.

I had in the past back shoulder blade pains but never as severe and spreading to my upper arm down to my elbow with some numbness and occasionally pins & needles in the finger. Could you ascribe/suggest what are my alternative treatments.

Many thanks,
Motty Bar-chaim


Jun 13, 2008
by: Bart - SII


A 12 o'clock to 3 o'clock tear in the anterior labrum is a fairly significant sized tear. Some labral tears will respond well to conservative treatment with just rehabilitation, however surgery is often needed for the best results.

Arthroscopic surgery to repair the torn labrum would be one option. Obviously, this is something to discuss with your physician extensively to determine exactly what your outcomes will likely be.

The other option besides surgery is to go through rehabilitation and see what kind of relief that will provide. Many times you can eliminate some of the pain with daily activities, but may still have limitations as to what you can do - ie. overhead type motions or lifting. Everyone will respond differently to conservative treatment.

Definitely discuss all of your options with your physician to determine the best course of action for you and your shoulder.

Hope this helps

Bart


Mar 05, 2010
by: Anonymous


Towards the end of December I had a basketball game. In that game I fell and landed on my right shoulder. I didn't feel the pain that night but when I woke up the next morning I could not put on my shirt. I went to the doctors but they said to just rest it.
After a month and a half of resting my arm the pain still did not go away. I then went to another doctor and he ordered and MRI. I got the MRI and he said that he thought I might have a labral tear. He then ordered another MRI but this one was with the contrast. The day after my MRI with contrast I found out that I have an antirial labral tear in my right shoulder.
Not only do I play basketball but I also play softball year round. I am not able to do that at this point in time. I go to a sports specialist and see what can bedone. If it is severe enough I could wind up having surgery. It's decastating but I would rather get it done and over with than being in pain the rest of my life or risking further damage.


Apr 29, 2010
by: Anonymous


I had a labral tear and got surgery on it. im 15 and play sports. i know it sucks but definetley get it. it feels better than ever. i just went to the doctor today and found out i tore my other shoulder, but i think physical therapy should heal the left one.

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Labral tear repair--now another apparent tear

by Rich Hayden
(Okinawa, Chatan, Japan)

I had repair of a SLAP lesion in May....still have some similar pain upon lifting and with certain activities. I am quite active and my surgeon feels that my age (51) is not really conducive to a full labral repair and is recommending a release of the bicep tendon and subsequent tacking (to prevent the "Popeye" effect).....I should add that I am deploying to Afghanistan (carrying a 9mm/M4 carbine) in March time frame and am not sure what to opt for.

I do feel that I would like to have full range and motion and be pain free, but also do not want to risk losing my upcoming deployment and also risk not getting any better....any advice or comments?

Sincerely,
R. Hayden, CDR, MSC, USN
Okinawa, Japan

Nov 19, 2008
by: Bart - SII


Do you know what type of SLAP lesion you had initially? If there was biceps tendon involvement, then that may be why your surgeon is recommending the biceps tenodesis. Often a SLAP repair that has biceps tendon involvement (Type 3 or 4) can lead to future problems and may best be treated with the release and reattachment of the biceps to the humerus.

This type of procedure should give you full motion and normal strength provided you go through the full rehabilitation process. Recovery is lengthy, with the arm in a sling and restricted from any active use of the biceps for the first 4-6 weeks. 4-6 months for full recovery is the norm, which may put your March timeline close.

Bart

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