HAGL Lesion, ortho wants to repair it

12 months ago I felt a twinge while pulling hard with my right arm while bouldering in the gym. I quit climbing that day, and proceeded to do 10 months of PT, ice, cortisone shot x1, acupuncture, massage, and finally...MRI. I haven't been able to climb without significant pain since my injury.

MRI showed a posterior vs. complete tear in my inferior glenohumeral ligament, aka Humeral Avulsion of the Glenohumeral Ligament, or HAGL. My orthopedist would like to take the deltopectoral approach, divide the subscapularis, and suture the ligament to the humerus. Looking at 4-6 weeks in a sling and 4-6 months recovery total. He warns me that I will have to "change my way of climbing" because hanging from my right arm alone will "really piss it off" even after rehab is complete.

Anyone have personal or professional experience with this lesion? With surgery for shoulder instability in general? Any PT's out there rehabbed people after surgery for shoulder instability?

Hi I saw your post when searching HAGL Lesion.  I'm not a climber but a tennis player and have the same injury.  I'm wondering if you went through with the surgery and if it was successful.  Your explanation sounds exactly like what the doc described to me today.  I'm 56 but in reasonably good health and play tennis at the 4.0, 4.5 level.  Did you get range of motion back if you had surgery?  Would like to hear from you if you are so inclined.  Thanks so much.  KG

I did undergo repair shortly after that post. I was about 30 at the time. I talked my orthopedist into the subscapularis-sparing approach (open, not arthroscopic), which he was able to do, but was kind of annoyed by it as it made the operation much more difficult. He seemed pretty concerned about my axillary nerve post-op, but fortunately I didn't have any deficits. I had it done by a shoulder specialist at a large academic medical center, which I would recommend for such a rare lesion. This is not as common as a rotator cuff repair. You would probably be lucky to find a surgeon who does 2-3 of these a year.

The recovery lined up with my pre-op expectations above, with a lot of sling time followed by a LOT of PT focused on stretching and strength. I was able to regain full range of motion in that period and retain it to this day. 

With the above, and life getting very busy about a year post-op, I have never climbed as I did before. I probably could get back to climbing 5.10 but I was pushing 5.11c at the time of my injury, and I don't think I could pull that hard again without putting the repair at risk. I had more pain pre-op than post, and over the years the pain has faded to the point where I notice a twinge every couple of days, and with certain movements, but never feel the need to take anything for it. 

I am a bad tennis player but have never had trouble playing tennis after my surgery. I would not be thrilled to go kayaking, but I went rafting a few times last year without too much trouble. I do some yoga with no trouble.

Overall, I'm happy I went through with it. It was a tough recovery but my shoulder is much better off for having had it done. Good luck to you.

Thank you for responding.  This is great information and gives me hope for a full recovery!  KG

Hello!  I am so happy to have found this thread.  I have been diagnosed with a posterior HAGL tear and it has been very difficult to find information about this lesion.  Questions I have... what were you symptoms before surgery? MRI says HAGL tear, but surgeon is skeptical based on its rarity which is making me second guess what might be going on.  What was recovery from surgery like?  Why did you choose open vs. arthroscopic? Thank you for any information you may have.   

Hi foil,

I see you are located in St Louis. So am I. Was your surgery done at Barnes Jewish? Who was your surgeon? I’m looking at the same surgery.