T Nation

Breaking Up Scar Tissue in Shoulder

Im 90days out from slap tear repair after 30days of PT my gains in ROM are not so great. My doc wants to put me to sleep and break the tissue by putting my arm where its suposed to go.

Then the would shot up the joint with cortisone or whatever to block inflamation ect… To me it sounds to archaic so I opted for one more month of PT… Have any of you guys done this? It sounds like something else could tear to me…

Would it not be better to find a good soft tissue therapist?

It is a legitimate treatment.

It is a pretty standard operation, but if you want to see if another month of stretching helps, go for it.

Thanks yes I know its pretty standard but my fear is once they jack it around something new may tear. I’ve heard some athletes use ultra sound to break it up but Im not sure my insurance will cover that. I uped my pt to 3x per week and am doing my home program 2-3x per day I think now that Im more dedicated recovery will be faster. If anything the “manipulation” would be less taxing if I can get progress on my own. Have any of you guys done one of these manipulations before?

I had a SLAP repair with 3 anchors 2 years ago. You should have been having forced range of motion stretching at 6 weeks post op. If you are paying for PT they should have been doing this for you as part of the recovery process. It is the greatest pain and discomfort I have ever experienced. In retrospect I was lucky in that the chiropractor that did the manipulations had under went a similar surgery and understood what it takes to accomplish the recovery. You need to find a chiro or PT who is willing to do what it takes for you to recover your range of motion.

Your physio therapist should be doing cross fiber manipulation to manage scar tissue and forced ROM. You or your insurance policy is paying them, so have them actually do their job for that high hourly rate. The laser and ultrasound might help, but does little compared to physical manipulation. Having just gone through a major tear and surgical repair (muscle and tendon…not exactly the same as slap but close enough) I can say that stretching and ultra or the laser will only take you so far.

The minute I started insisting cross fiber was done, and also did so on my self at home (ice first to dull the pain) my progress in therapy sessions (forced ROM and stretching) jumped significantly. Forced ROM and managing scar tissue through physical manipulation is key. Forced ROM is not an enjoyable experience…but i would take that approach to gradually recover your range and flexibility over being put out and having one giant crank into full flexion. Good luck.

Ultrasound won’t do anything. It is basically a placebo treatment.

[quote]seekonk wrote:
Ultrasound won’t do anything. It is basically a placebo treatment. [/quote]

Ok. I was not sure about ultrasound…but I am definitely sure the laser therapists use does absolutely nothing.

The forced rotation is sometimes done for frozen-shoulder conditions, which is where you are right now. Your regular PT after the surgery probably should have pushed you a bit harder. See what a month of PT does for you, but go over it first with your surgeon to see if he thinks it will worth it.

Rob

[quote]seekonk wrote:
Ultrasound won’t do anything. It is basically a placebo treatment. [/quote]

LOL true. Most modalities do very little, but patients can’t do them themselves at home so they are impressed with them.

[quote]jweinstein wrote:
I had a SLAP repair with 3 anchors 2 years ago. You should have been having forced range of motion stretching at 6 weeks post op. If you are paying for PT they should have been doing this for you as part of the recovery process. It is the greatest pain and discomfort I have ever experienced. In retrospect I was lucky in that the chiropractor that did the manipulations had under went a similar surgery and understood what it takes to accomplish the recovery. You need to find a chiro or PT who is willing to do what it takes for you to recover your range of motion.[/quote]

Yes they have been doing the forced ROM its horible. Ussually at PT we start out with a warm ups stretches then forced ROM. After that sometimes we do light weightwork or bands. Gennerally they always cap it off with a 10min forced stretch with a heat pad. At home ive been trying negative lifts and holding 10lb weights to failure. I do this along with bands and all the other shit. I find that if I do my rehab morning, noon, night I stay loose all day and after 2 weeks Im probably 85% on my ROM now. My PT says I will probably be able to avoid the manipulation now… I think a round of cortazone shots and PT for another month or two and Im straight…

I have a bit of a different shouilder injury history.

Started with separation of both AC joints, and then a sublaxation in my right shoulder from hockey.

Although I havent had my MRI done yet it appears I got away without tearing anything due to “looseness” in the joint with regards to how the humerous sits.

But post injury (subluxed in early December), I found either to inflammation or due to scar tissue in the joint that I was experiencing lack of ROM and/or that the shoulder joint wasnt moving freely.

So what I have been doing is wedging a tennis ball between the back of my shoulder and the wall and manipulating the posterior side of the labrum to keep its elasticity and to also break up any other restrictive issues. Works like a charm. I end up sleeping on my side so when I wake up it feels like the joint is compressed togeather. After 20-30 seconds of massaging the labrum with the tennis ball the shoulder movement is essentially unrestricted and any pain has been removed.

Not saying this will totally remove your shoulder issue, but I think its worth a shot.

Best of luck.

Ohhh and before I forget I also got deep tissue massage on my traps, pec major, and bicep on the injured side. Any tension in those muscles will cause the shoulder to line up shitty. After those sessions the joint instantly tracks better.