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I kicked my own @$$ (Non-surgical advice for Herniated Disk and Labral tear???)
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By Mr. Holmes
From Cascade West
Nov 26, 2012
#2

After over a decade of guiding and proffesional route setting I developed a Labral tear in my right Shoulder (since 2004)and just recently learned of an "acute Herniated Disk at C6-7.

I have put off sergury thus far with a strong decipline of Phys Therapy, E-Stem, and various other rehabs and am climbing stronger than ever. However, the chronic pain is getting old and am looking into a permantant fix.

Any suggestions on what has or has not worked for those of you with Med backgrounds or simular experiences? New procedures out there or altnernate options?

I'm not looking for the Dr. Web to fix me I just know what my docs have said and don't want to wander into a surgury blind if that is in fact what needs to happen.

Thanks in advance!


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By rock_fencer
From Columbia, SC
Nov 26, 2012
Myself placing a a blue/yellow offset MC to protect between Bolt 2/3 just post crux . <br /> <br />Picture credit goes to eric Singleton, and many thanks to Josh Bagget for the great belay.

MRI will give you a lot of information on how acute it is. As for treatments, i'll let the folks who have direct experience. The cervical vertebrae aren't a great place to herniate disc's at.

Best of luck with it. and happy healing either way


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By tharlow
Nov 26, 2012

Have you looked into plasma rich protein injections?


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By Mr. Holmes
From Cascade West
Nov 26, 2012
#2

Here's the MRI... Pretty acute, eh? You can see C5-6 isn't happy either.



@ Tharlow: Yes it was offered but at $700 a pop and seeing as how it was a long term injury I wasn't super excited or convinced it would actually fix anything at this point.

Have hear good things about the WEI
patches though- any experiences out there?

MRI- Note dark space mid right of vertabrae @ C-5-6 & 6-7
MRI- Note dark space mid right of vertabrae @ C-5-6 & 6-7


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By tharlow
Nov 26, 2012

that looks like a fairly sizeable central herniation with cord compression. Im sure you have heard this before, but Im not sure what the longterm prognosis is without surgical intervention. Unfortunately, neck positions required with climbing can make this condition worse. Have not hear of or read studies on the patch. Looks interesting, looking forward to learning more about it. Whatever you do, best wishes for your recovery. Do you use traction with your physical therapy?


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By rock_fencer
From Columbia, SC
Nov 26, 2012
Myself placing a a blue/yellow offset MC to protect between Bolt 2/3 just post crux . <br /> <br />Picture credit goes to eric Singleton, and many thanks to Josh Bagget for the great belay.

i'm not a doctor yet, but even i can see that is acute...i'm surprised you havent noticed any impairment beyond just pain...

I guess if the PT isnt working anymore i'd take that MRI and get a few opinions on surgery options...i doubt there is much non-surgical that can be done to alleviate that. Its clearly starting to affect the vertebral bodies as well.


As for the labral tear. PT the crap out of your rotator cuffs. Amazing how weak they can be even in climbers

Best of luck.

Be curious to hear your outcome


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By Mr. Holmes
From Cascade West
Nov 26, 2012
#2

Thank you! I have an appt with a Nuero surgeon on 12/11

My guess is that the pain is not linked to the Labrum as I am still climbing .13 - (Ijust pay for it the next day.) Hopefully in fixing the disk I will be able to keep up the theraband/rehab on the shoulder and not have to take drastic action there.


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By Erik W
From Bay Area, CA
Nov 26, 2012
North face of Ama Dablam - taken on approach to Kongma La.

Looks juicy! I'm looking at a lumbar fusion myself in the near future, so I feel for you. While I know a lot about lumbar surgeries, I don't know a thing about cervical surgeries, so I won't spout off like I do. But anecdotally, one of my best friends had C5-C6 fused about 4 years ago and is doing absolutely great. He initially hurt it by landing on his cranium off a snowboard jump and just dealt with the pain for years before the nerve tingling and numbness down his arm got too much. They performed the fusion thru the front of his neck and really his range of motion isn't affected much at all. Good luck to you. Get it done before the neuropathy gets bad.


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By rock_fencer
From Columbia, SC
Nov 26, 2012
Myself placing a a blue/yellow offset MC to protect between Bolt 2/3 just post crux . <br /> <br />Picture credit goes to eric Singleton, and many thanks to Josh Bagget for the great belay.

Mr. Holmes wrote:
Thank you! I have an appt with a Nuero surgeon on 12/11 My guess is that the pain is not linked to the Labrum as I am still climbing .13 - (Ijust pay for it the next day.) Hopefully in fixing the disk I will be able to keep up the theraband/rehab on the shoulder and not have to take drastic action there.



look up Brachial Plexus -- cord levels from C5 - T1 - basically innervation of arm, shoulder, and some chest. Perhaps a correlation between your herniated and bulging disc and your shoulder pain!

Cheers


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By ErikaNW
Nov 27, 2012
Rapping off the Matron October, 2010

rock_fencer wrote:
look up Brachial Plexus -- cord levels from C5 - T1 - basically innervation of arm, shoulder, and some chest. Perhaps a correlation between your herniated and bulging disc and your shoulder pain! Cheers


Yeah... my thought as well - especially if shoulder specific intervention hasn't been helping the shoulder much.... definitely could be referral from the c-spine. That is a big bulge, and if it correlates to your symptoms surgical intervention is probably where you are headed. If your signs/symptoms do not correlate to C5/6 - C6/7 however (nerve distribution patterns) and it is general 'neck pain', I would be hesitant to have surgery without first failing aggressive conservative treatment - although sounds like you have done that.

Good luck!


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By Mr. Holmes
From Cascade West
Nov 27, 2012
#2

Thank you, Thank you all!

It's definetely been a long road. I've learned to train smarter, coach smarter and as I said am climbing stronger than ever so I just don't want to lose that.

Myu wife had a C-spine fusion that did NOT help and in fact made things worse thus my outreach and reservation at getting cut.

I appreciate the feedback and will post results as they come.

in the mean time... I climb cuz that's what we do!


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By Mr. Holmes
From Cascade West
Dec 12, 2012
#2

I go in for an "artificial Disk replacement" next weds.

Apparently, this new technology retains total strength and movement of the vertebrae and has a very short recovery period.




Say Hello to my little friend!
Say Hello to my little friend!


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By SMR
Dec 12, 2012

Where did you get the photo of the TDR cervical? It looks like ceramic? Do you know someone at Amedica?


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By Mr. Holmes
From Cascade West
Dec 12, 2012
#2

SMR wrote:
Where did you get the photo of the TDR cervical? It looks like ceramic? Do you know someone at Amedica?


I googled Artificial Disk replacement images :)

found here:https://www.spinemd.com/blog/exploring-the-alternatives-to-s>>>


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By Old and Busted
From Centennial, CO
Dec 12, 2012
Stabby

Have you considered amputation? Just thinking outside the box....


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By Mr. Holmes
From Cascade West
Dec 12, 2012
#2

Mike Lane wrote:
Have you considered amputation? Just thinking outside the box....


Yes, but then I loose my "lead head" ;)

I will tell you this though:
DO NOT read the surgical blogs prior to a surgery- now I'm totally freaked out...
...Pretty sure I am going to come out with a ducks head, attached, malaria, and broom sticks for arms !


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By tallmark515
From San Francisco
Dec 13, 2012
Red Zinger - Red Rocks

my experience with a labral tear:

I'm in the last stages of recovery from surgery for a labral tear, specifically a Bankart tear. I was lucky, as I only had a Bankart, but it's pretty common to also have a Slap tear... or so I'm told by my Ortho Doctor.

My doc told me that for really minor tears (or bigger tears in non-climbers), one can strengthen the shoulder (PT) to compensate for the loss of stability. But for climbers, surgery is most always the recommended solution and without surgery, doc says that you're at 80% greater risk for dislocation when you climb (slightly less with PT, depending on how bad the tear is).

Doc also told me that the only way to see how big the tear is and what (if anything) is torn is by getting an MRI.

The surgery is pretty minor (arthroscopic, 2 or 3 little incisions, I did mine with only 2). I did PT for 6 weeks before surgery to strengthen my shoulder and for 3 months post surgery (+1 month of relaxation immediately after surgery) and I'm back to leading four months after surgery. Four months is considered above average recovery time. Recovery from surgery is painful.

However, if you're cranking .13- with a supposed labral tear, then maybe you don't actually have a labral tear or maybe it's VERY minor and you could be okay with just PT or something else all together. When mine was torn, I could tell when I climbed that something was wrong, certain motions (gastons, static hangs, really anything that required my arm to be straight up over my hear) would trigger pain, overall vmy shoulder felt loose and floppy and dynamic moves were out of the question.

Hope that helps.


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By rock_fencer
From Columbia, SC
Dec 13, 2012
Myself placing a a blue/yellow offset MC to protect between Bolt 2/3 just post crux . <br /> <br />Picture credit goes to eric Singleton, and many thanks to Josh Bagget for the great belay.

RockyMtnTed wrote:
Oh.... Well how close are you to finishing medical school? Oh you started this fall... so you arent even CLOSE to becoming a doctor yet. Thanks for clearing that up for us all.



@ RockyMtnTed Your welcome...i wouldn't want anyone to think that i can provide helpful information, or state obvious observations, and my opinion on the internet.

To the OP good luck with the surgery!

Cheers
T


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By ErikaNW
Dec 14, 2012
Rapping off the Matron October, 2010

Good luck with your surgery! Thanks for the update and hope you have an uneventful and easy recovery!


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By Bart Paull
From Boulder, CO
Dec 14, 2012

Good luck with your surgery. As the neurosurgeon probably told you, the surgery is mainly going to help prevent further impingement and thus your symptoms from getting worse - additionally it might improve some of your current symptoms. It sounds like a good element of your shoulder pain is probably referred from your spine, hopefully that will diminish somewhat with the surgery. Good luck!


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By Mr. Holmes
From Cascade West
Dec 14, 2012
#2

tallmark515 wrote:
my experience with a labral tear: I'm in the last stages of recovery from surgery for a labral tear...


Thank you for this! I was told similar things. I have an MRI of the labral tear showed "3-6 o'clock" (i.e. front side from apex top to upper arm pit +/-)

I agree that the pain is prob in association with the disk and not the tear and hope to be cruising the vertical again by mid Jan (the Optimist comes to mind ;)

Thank you, thank you to all you well wishers out there in TV land! Nice to participate in a thread without banter!


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By Mr. Holmes
From Cascade West
Dec 30, 2012
#2

So if anyone is still following this saga here's the results:

Went in for surgery on Wednesday December 19th at 5 am. I received a disk replacement (small surgical steel ball and socket that fits between the vertebrae.
By 8 am I woke up from anesthesia rolled my arm a few times and promptly got dressed (no nerve pain whatsoever)

By 9 am I was at a greasy spoon diner eating their version of Denny's Grand Slam and was setting and climbing V-6/7 on 26th!
Went Snowboarding in wast deep powder yesterday and feel a little stiff but good.

Impact falls (boulder/ Kickers on snow) hit the Mid-Thoracic nerve a bit so I am taking it easy and I am also noticing the inferior muscled re-igniting but are severely anemic at this stage having been over compensated for seven years. Thus some P.T. and TLC are in order...
Thanks again to all for the best wishes; They worked not only for me but, from what I can see, in creating one of the most positive threads on MP in recent history!

All in all super successful.


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By rock_fencer
From Columbia, SC
Dec 30, 2012
Myself placing a a blue/yellow offset MC to protect between Bolt 2/3 just post crux . <br /> <br />Picture credit goes to eric Singleton, and many thanks to Josh Bagget for the great belay.

Excellent news. Glad the surgery went well and you are back at it.


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