Labrum Tear, Looking for Ortho/PTs who have worked with Climbers in CA

MRI confirmed a torn labrum last week at my Ortho in Santa Barbara. I'm debating surgery and wanted to get a second opinion from an Ortho/PT who has worked with climbers before (my guy works with lots of athletes, but no climbers).

Has anyone seen an Ortho/PT they liked who had some climbing knowledge for shoulder injuries in the past? Preferably in CA but I can get the MRI report faxed just about anywhere if they take remote appointments.

Thanks!

Not a doctor, but curious.. How bad is the tear? Did you dislocate? Rotator cuff damage as well?

Doc says it looks like I probably dislocated shoulder years ago and tore it. Says it looks like a pretty big tear of the anterior labrum, posterior looks good. Partial tear of supraspinatus as well that he thinks is just regular wear and tear and likely unrelated to labrum issue (and he thinks probably isn't causing any significant discomfort). 

I don't remember ever dislocating my shoulder, but I did injure it ~4 years ago catching myself on a hold in the gym when I was a newer climber. Hurt a lot and couldn't climb for a little while. He thinks I might have dislocated it and it popped right back into place. He says he's only ever seen tears like this from dislocations, definitely doesn't look like a "general wear and tear" thing.

Here's the language from the MRI report: "Tear of the anteroinferior labrum with high-grade thinning of the adjacent anterior glenoid articular cartilage and adjacent medially-directed cluster of paralabral cysts; elsewhere the labrum appears intact"

Not a doctor, but wanted to provide input from a recent SLAP tear+repair. (SLAP = superior labrum anterior and posterior, a.k.a front to back)

32-year-old male, who had VERY healthy shoulders before the accident. Prior to the injury I was leading 11+ outside, and bouldering v7/v8 in the gym.  

I had a 12-to-6 (half) Labrum Tear, this past February while snowboading. I had imaging done and the doctor suggested surgery if I ever wanted to do anything intense or active, e.i do anything I enjoy doing; climbing, mountain biking, weightlifting, etc. He said that if I was 60+ years old and wasn't as active, I could live with this torn labrum and just not lift anything heavy overhead.

I had surgery at the end of April '24. I had 5 anchors put in, 2 more than the average of 3 which are usually used in the Bankart/SLAP repair.

I had the Surgery on April 26th, and was back to climbing by September... I did about a month of resting, weeks of increasing intensity PT, and I am now finally in a place where I feel comfortable doing pullups, overhanging climbs, and I barely consider it anymore. So ~6-months to get back to what I consider "baseline". I am not back to flashing v8 (indoors) yet, but I feel comfortable on static v4/v5. Very limited dynamic climbing, at least on my left arm. I am also golfing, backpacking, and other shoulder-adjacent activities (no biking yet out of fear of falling on it still). 

I do the "Pitchers 10" religiously and will continue to do so for a while. 

My son did a almost complete tear. He's hoping to pitch NCAA D1 in a year. No surgery. 12 months of serious rehab and strengthening. He may need surgery when he's older, but the facts presented at the time did not put surgery as a 100% fix. Glad we gave the non-surgery route a go. He's back,  stronger than before.

I know too many athletes who can no longer perform, even after the surgery. 

x15x15 wrote:

My son did a almost complete tear. He's hoping to pitch NCAA D1 in a year. No surgery. 12 months of serious rehab and strengthening. He may need surgery when he's older, but the facts presented at the time did not put surgery as a 100% fix. Glad we gave the non-surgery route a go. He's back,  stronger than before.

I know too many athletes who can no longer perform, even after the surgery. 

Could you share any details on what that rehab looked like? There's tons online about post-surgery rehab for labrum tears, and of course all the usual rotator cuff stuff, but I haven't found much about strengthening and rehabbing around a torn labrum. 

I would certainly love to avoid surgery if I can. 

Jaxon Stuhr wrote:

Could you share any details on what that rehab looked like? There's tons online about post-surgery rehab for labrum tears, and of course all the usual rotator cuff stuff, but I haven't found much about strengthening and rehabbing around a torn labrum. 

I would certainly love to avoid surgery if I can. 

Since pitching is my son's passion, we found a sports doctor that would work with us. This doctor pushes the least intrusive treatments and would only go for surgery once everything else was exhausted. So, we got referred to a sports rehab center that worked with our doctor. 3 times a week we would go to the clinic, and the other 4 days a week he worked at home, or at his gym.

Find a sports doctor who understands the needs of an elite athlete. There seems to be a huge discrepancy in treatment between a regular ortho and a sports ortho.

Dr Hirahara in Sacramento

Some of the best doctors and surgeons I have found are at Stanford Hospital. You might check them out. I haven’t had orthopedic surgery by them but I have had a couple of major surgeries that were done by them and was highly impressed with the level of care and post op follow up that I received. They blew all my previous doctors out of the water and made me regret not going there sooner.

Good luck. 

I tore my anterior labrum years ago (2017?) and saw Dr Vaughn with Stanford medicine (seconding the recommendation from Roo above, I’ve been lucky to have great care at Stanford when it comes to orthopedics). Don’t remember him being climbing specific as you asked for but he works with athletes and I think was at least aware of what climbing was when I talked with him... As for recovery I’m not too certain on details as this was a while ago but I think it  took me about 4-5 months total to feel great about climbing again and I think I spent over 2 months of that doing physical therapy a couple times a week. No surgery, just strengthening the surrounding shoulder areas that support that joint. Shoulders are weird and PT helped me figure out how to engage and build muscles I never really noticed I had before haha. But now years later I rarely think about it and often forget it happened. Every so often I do some of the exercises from PT to make sure I’m keeping those stabilizing muscle groups strong, and I guess I use my shoulders a little differently now but I feel like it’s in a better way which relies on muscles rather than the joint itself. Anyways hope this helps and good luck.

Just to throw another data point out there, at different points in time I tore my labrum in both shoulders, confirmed with MRI. Both took 2-6 months of PT to feel better and stop hurting. 4+ years later, one works good as new, the other is a bit clunky and lacks control and ROM without a significant warm up. I don't climb hard enough to wish I'd gotten surgery on it, I'm happy to spend an extra few minutes warming up for harder sessions.

Thanks for the replies everyone. I ended up consulting 3 PTs (2 climbing specific, 1 not) and 1 Orthopedic surgeon, and they all recommended surgery. I'll be getting my repair on Thursday so fingers crossed!

For the reference of anyone else who finds this thread: the advice I got consistently was that this would not require surgery in many cases. I could continue with easier climbing and day-to-day life just fine with the tear, but that PT could not "heal" the labrum, just stabilize and strengthen all the muscles around it. I boulder up to V9 and sport climb 12d, and the opinion of the climbing PTs was that if I wanted to continue to climb harder projects, I would need surgery and would most likely continue to re-injure the shoulder if I did not. This is basically what the last 4 years have been, alternating periods of rehab/extensive PT, shoulder then feels good for a bit, then re-injury (either catching a hold or in a gaston position), and repeat the cycle. 

Huge shoutout to Emily Noe, a PT in Oakland. I can't recommend her enough, she helped me understand some parts of my anatomy that she's pretty sure have been causing my constant shoulder/elbow injuries.