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By Old and Busted
From Centennial, CO
Jul 1, 2014
Stabby
I've been posting up here for years on having shoulder problems; contributing to others or adding my own. For a few years now I was under the impression that my sole problem was a bone spur on my acromion. However, a arthroscope MRI showed I have a 2 cm labral tear in my rotator cuff. Along with the email telling me are these bullet-points:
"You need to have it done. Over time tears can recede or atrophy; making repairs impossible and thus having no good solution"
"You have a difficult to repair tear"
"You will need to take 6 weeks off of work for a laborious position"
" I feel most people really struggle the first 2 weeks, then it calms down but still hurts significantly for another 4 weeks. By 6 weeks, you are usually able to sleep better. I feel it takes 6 months to fully recover and get back to normal"

I've read lots of shoulder threads over the years. What he is describing seems worse than what others have said.
I'm just scared. Anyone want to offer some rays of hope?
Thanks.

FLAG
By Alexander Blum
From Charlotte, NC
Jul 1, 2014
I had a labral SLAP tear, two spots. Had it repaired surgically, recovery wasn't bad. I don't mountain bike anymore (that's how I tore it), but I can climb just like before. It took me less than a year to get back to 100%.

Is this e-mail from your doctor? Shop around, find the best shoulder surgeon in your area. It's worth the wait/pain in the ass/etc.

FLAG
By Chad Volk
From Boulder, CO
Jul 1, 2014
My advice having had surgery on my ankle and wrist is to get a second opinion from a shoulder specialist. I hurt my shoulder last Fall and thankfully didn't need surgery, but I was going to go see Dr. Hackett at the Steadman Clinic.

Also, go see a PT who knows about rehabing climbers. There have been a few threads about the subject here on MP. They spend a lot of time with these type of injuries so they should have some good insight on the recovery process.

Good luck!

FLAG
By Old and Busted
From Centennial, CO
Jul 1, 2014
Stabby
Thanks! I have Kaiser, so I can choose whoever I want to do the surgery as long as it is this one guy. The quotes are from his uplifting email. Its hard to imagine walking into a place with an annoying zing in my shoulder and being rolled out to live with several weeks of pain.
I have been told by others they got off the serious meds after 3 days. I have a strong pain threshold, so if this is possible I could do it. The email infers 2 solid weeks of unbearable pain though.

The rotator tear is a surprise to both of us. He was leaning to a SLAP tear, I thought all I had was impingement from my acromion. I have full range of motion right now, the only test that hurts a little is arm straight up and twisting the wrist with resistance.

I have read (internet, ugh) that up to 40% of these surgeries yield no better results. I assume that is b/c of old people.

This injury is several years old now. I think the acromion spur cut the tissue, but not sure on that. It might be that it is constantly getting worse as the acromion digs deeper, IDK. Have not looked deep enough into this yet. Anyone seen this sort of thing before?

FLAG
By Jon Clark
From Philadelphia, PA
Jul 1, 2014
onsight soloing Atman
Do you have a labral tear, RC tear, or both? I've never heard of a labral rotator cuff tear. Many people can live with labral tears with or without some occassional aggravation. Symptomatic RC tears most often require surgery in active people. I think results these days are good provided that you follow through with PT.

FLAG
By Old and Busted
From Centennial, CO
Jul 1, 2014
Stabby
Jon Clark wrote:
Do you have a labral tear, RC tear, or both? I've never heard of a labral rotator cuff tear. Many people can live with labral tears with or without some occassional aggravation. Symptomatic RC tears most often require surgery in active people. I think results these days are good provided that you follow through with PT.

What he wrote:

CUFF STRUCTURES: Full-thickness partial width tearing of the distal
supraspinatus tendon at the level of footprint noted. There is
approximately 2 cm of AP gap. Partial-thickness
undersurface/intrasubstance tearing of the infraspinatus noted as
well. No gross retraction or atrophy.

LABRAL COMPLEX: There is abnormal morphology of the superior labrum
consistent with labral degeneration. Sub-labral sulcus of the
superior labrum is identified. No acute or unstable tearing
suggested.

BICEPS: Tendinosis of the intra-articular biceps tendon.

ACROMIOCLAVICULAR JOINT: Mild hypertrophic AC joint degeneration.
No significant undersurface osteophytes. Type II acromion noted.

My problem with hoping PT alone would work is I think my acromion bone spur did the tear.

FLAG
By Jon Clark
From Philadelphia, PA
Jul 1, 2014
onsight soloing Atman
I have had some shoulder injuries and deal with aggravating symptoms from time to time. However, if I had an RC tear that limited my climbing I would have it repaired. The bone spurs would be a concern of mine as well for the same reasons you have. I don't know how severe a 2 cm tear is, but the suprapinatus is a relatively small muscle. The corresponding tendon is small as well. Small strains and tears of the muscle can scar down respond well to PT. Unfortunately, I don't believe that a torn tendon can have a similar result. Get a second opinion. Ultimately, you'll need to weigh the demands of you lifestyle and work against your tolerance of symptoms and overall function of your shoulder.

FLAG
By BackAtItAgain
Jul 1, 2014
Last year I was in constant pain for months on end - finally got an MRI and the doc said there wasn't much he could do - 2nd opinion dude told me i had a laberal tear - possible RC tear and some fixable degeneration due to arthritis, probably from an old ski injury 20 years ago.

As weird as it sounds - I was delighted to hear this - wasn't stoked on the recovery - but scheduled the surgery right up. Has it on Aug 23rd - was climbing again by Jan 15th. Recovery wasn't bad at all. Never any pain really - a bit the first few days. Had an awesome PT to help me along.

Less than 1 year out - it feels amazing. SO glad i did it.

Just my 2 cents for what its worth. I was almost 49 when I had it done.

FLAG
By Brent Apgar
From Out of the Loop
Jul 1, 2014
Me and Spearhead
Hey O and B, just wanted to throw a little info your way.

The imaging report honestly doesn't paint a horrible picture. Sounds like you've just beat up your GH joint a bit. The spur may or may not be the primary issue. If you have the surgery done, chances are the surgeon is going to clean that up while he's in there.


The bigger concern is the labral tear. I'm saying labrum here because in practical terms you can't separate the labrum and the rotator cuff tendon structure. Essentially the labrum, joint capsule and rotator cuff tendons all form this crazy laminate structure that creates the glenohumeral joint. Surgeons just don't try to explain the complexity of this structure to folks and as far as repairing goes it doesn't change what they're going to do anyway.

The fact that it sounds like things are intact and not degenerating significantly will make the repair easier. I say that the labral tear is the bigger concern because it's not going to heal on it's own no matter what kind of physiotherapy treatment you do. Once the labrum is torn it's torn, much like the meniscus in the knee or intervertebral discs, they just don't heal on their own.

I'd say have the surgery done and get it out of the way. It may take up to a year to get back to pushing your absolute climbing max but once it's healed it should be as good as prior to the injury.

Disclaimer: I'm actually a doctor and have rehabed at least 4 shoulders for professional climbers and many more shoulders of weekend warriors. If you've got any questions in particular just pm me through the site and I'll be happy to answer what I can.
Good luck.

FLAG


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