T Nation

Asymmetry Following SLAP Tear in Shoulder (Labrum)


#1

I debated whether to post this in the Injuries forum or the Bodybuilding forum, and decided it was probably most appropriate here. Basically the issue is this:

I tore the labrum in my right shoulder about two and a half years ago. Had it diagnosed as a SLAP tear, but was not in a position financially to get the surgery (I still am not). In that time, I managed to rehab it relatively successfully, and have recently even improved to the point that I can do slow dumbbell shoulder presses and pushups with feet slightly elevated. I worked my way up to this methodically using rotator cuff exercises and a very gradual progression in terms of exercise selection.

So now to the problem. I started off with a lifelong disparity between the left and right sides of my whole body, really. Just every muscle has always looked slightly better, fuller, and larger on the left side than the right. However, at its worst, my right arm would measure about a half inch less than the left.

Being accustomed to this disparity might be why I didn't notice the issue sooner, but just today I caught a glimpse of myself in the mirror, and was blown away by the size difference in not only my arms, but even my shoulders. The injured side is just insanely smaller than the non-injured side. Measuring confirmed this, as the right arm is now just over a FULL INCH smaller than the left: actually smaller than the largest it has been in the past despite the fact that the rest of my body is larger than ever before.

To the question: is it possible to address this issue through training, or is it truly the injury just flat out preventing this arm from growing any larger? I was thinking of at least trying to do more volume on the right side, but am I just wasting my efforts and setting myself up for injury?

I once saw the surgery as optional--particularly after recovering so well with diligent physical therapy and hard training--but I now realize there is no avoiding it. Furthermore, I would now consider the surgery an absolute must if you participate seriously in the iron game.

Thanks for reading and thanks in advance for any input.

ChrisPowers


#2

I had the same surgery done 5 years ago and I had the same problem. I had it done on my right shoulder and I've had some noticeable differences too. What's strange is that my left shoulder was significantly wider than my right, but my right arm is much bigger than my left. I think my right arm was overcompensating for my shoulder and the left shoulder is getting worked as it should, taking the stress of my left arm. Who knows.. Anyway, I fixed this problem doing a few things.

-Work out only using dumbbells. Never use a barbell for anything besides necessary exercises (squats, deadlifts, etc.) I'm sure you already know this but it helps out with lagging body parts.

-Use a partner if you can. I had my friend watch my form when I worked out shoulders and chest and he said my form was extremely uneven. I had no idea this was the case. I even had him videotape certain exercises I was doing and I was shocked how much I was using my left arm instead of the shoulder (especially for lateral raises, overhead press, etc). I can almost guarantee you've been subconsciously overcompensating with your stronger shoulder. Also, the labrum surgery restricts full motion in the affected shoulder to prevent another injury, so it changes the way you lift. Have somebody watch your form and see what's going on.

-Use uneven weights for workouts until they're caught up. I.E. if you're doing lateral raises, use a 30 for the weaker shoulder and a 25 for the stronger shoulder. This will keep your stronger shoulder at a "maintenance" level but your weaker shoulder should catch up as its getting worked harder.

-Last but not least, make sure you're doing external rotation and rotator cuff stretches AFTER workouts. If you do it beforehand, you'll pre-exhaust the rotator cuff and you won't be able to work your whole shoulder as intensely or as long as you would like.

I know how much a pain in the ### it is to catch up, but its not something you're stuck with. I'd make sure to figure out what's going on with your form before you keep working out or it'll only get worse.


#3

I tore my SLAP and long bicep in my right arm 2 years ago and was pretty much out of training for 6 months thereafter.

In that time i rehabbed it using nothing more than 2kg-6kg DBs just simply doing your standard front raises, rotator cuff moves etc and although frustrating when i eventually started to train again it was from scratch as i'd lost pretty much all my strength and once i started training there was always some imbalance and pain but after aboiut 6 month or so everywhere was pretty much on par except the right front delt which looked noticeably smaller than the left due to the tear i'd imagine!

From time to time now i still get a kind of sharp pain in the shoulder but through proper stretching and rotator cuff work at the end of each workout it seems to have been brought up to par symetry wise as the weights have increased.

try a higher rep range on the arm that needs work but with the same weight but try not to exceed the 12-15 rep range, for example try 10 reps on the stronger arm and 15 reps on the other on thos days for about 6 weeks and see if there's any difference!


#4

Your post was extremely helpful to me. I tore my cuff 15 months ago. Surgery a little over a year ago. Now pieced together with five anchors. I have the SAME physiology. Surgery on right shoulder. Left shoulder broader. Right arm bigger. Funny, eh?

I've been doing my cuff exercise before my normal program work. I will change that as what you say about pre-exhausting makes sense to me.

And I have avoided DBs because of the instability. But I must force myself to do them to bring up my weaker side.