T Nation

Labral Tear in Shoulder ?

  • Minor or Major?

Seems there are a few post with injuries, so I guess this is the place for it. Anyway:

26 y.o.
190 lb.
4+ years lifting on and off, with some muscle inbalances, most notably internal rotation of humerous.

I injured my shoulder about four years ago doing dumbbell flat bench. Went a little lower than 90 and tried to ‘muscle’ it out. I never saw a professional for this, and it eventually went away. So about a month ago I get pains and inflammation in my shoulder telling me something isn’t right. So I go to a sports doctor who tells me he thinks its a labral tear (iirc, not sure about the physiology). And if so that they can go in arthroscopically and repair it. Now I’m under the impression that 1) some doctors jump at the chance to operate, and 2) most people are never the same after surgery. The MRI I have scheduled is going to cost me 700 out of pocket. THis is ridiculous and I’m sure that the surgery will be much more, but if it fixed the problem it would be worth it to me.

Here’s the real question: I have been working out somewhat consistently and without incident since it “healed” on its own years ago. In early 2005 I had a wrist injury that kept me from doing upper body exercises esp. the shoulder. Then in late 2005 I stayed out of the gym for almost 6 months for another reason. So that adds up to about a year or nonconsistant work. Then after about a month or so of taking it easy, I decide I’m ready to lift as heavy as I can, and this is where the recent symptoms started. I should mention that there are no real range of motion problems, and I can finish my workouts, its just that it starts hurting more and I have this innate feeling that I should go home. If I take Ibuprofen, it goes away in 2-4 days depending on how heavy I lift, but that’s really way too long to recover for someone who actually is looking to progress.

It seems that there is something to this, and that maybe I can rehab it without surgery. I mean, why could I work out without a problem for 2+ years? I just don’t want to end up at this juncture in the years following as I get older. I plan to lift weights as long as I’m living.

Does any one else have this labral problem? Thanks in advance.

I’ve posted about this in another thread in the “Over 35 Lifter” forum. I may need to go back and find that post, as I listed my situation with a labral tear and what I’ve done to get around it.

First off, don’t go in for surgery unless you have such intense pain that you can’t sleep at night, or unless you have other shoulder injuries that need to be repaired by surgery. I’ve spoken to various physical therapists about the labral tear (and yes, I had an MRI to confirm mine), and they all said that it’s actually pretty common among most weight lifters.

It can be fixed by surgery, but you may never be the same again and could definitely have range of motion problems. I’ve been dealing with this for about 6 years now. I’ve been seeing a chiropractor and massage therapist and getting ultrasound and muscle stim therapy as needed. That has definitely helped, but the pain is off and on and can be intense at times.

Some days I have to take several Aleve and ice the hell out of it. Other days, I feel perfectly fine and have no issues.

I’ve also had to watch what exercises I use in my training, as certain chest and shoulder exercises cause immediate and intense pain. Unfortunately, that does mean that I have trouble working my chest and shoulders the way I would prefer, but if it saves me pain, then that’s what I have to do.

You can definitely work around it, and you can still make gains in strength and size (I have). You will have good days and bad days, but try to avoid surgery unless it’s absolutely necessary.

I found the original one:

http://www.T-Nation.com/readTopic.do?id=776034

I too am a member of the torn labrum club…tore it when i was 17 (25 now) Didn’t opt for surgery just physical therapy…I have to be very careful as to what exercises/positions I put my shoulder in as once every 6 mos. or so I suffer the joint going out of socket. WORST PAIN EVER, however it really only happens when I get lazy or negligent about stretching it or warming up properly…One thing I do miss however is the ability to throw a baseball or football as hard as I can.

[quote]Nate Dogg wrote:
I’ve posted about this in another thread in the “Over 35 Lifter” forum. I may need to go back and find that post, as I listed my situation with a labral tear and what I’ve done to get around it.

First off, don’t go in for surgery unless you have such intense pain that you can’t sleep at night, or unless you have other shoulder injuries that need to be repaired by surgery. I’ve spoken to various physical therapists about the labral tear (and yes, I had an MRI to confirm mine), and they all said that it’s actually pretty common among most weight lifters.

It can be fixed by surgery, but you may never be the same again and could definitely have range of motion problems. I’ve been dealing with this for about 6 years now. I’ve been seeing a chiropractor and massage therapist and getting ultrasound and muscle stim therapy as needed. That has definitely helped, but the pain is off and on and can be intense at times.

Some days I have to take several Aleve and ice the hell out of it. Other days, I feel perfectly fine and have no issues.

I’ve also had to watch what exercises I use in my training, as certain chest and shoulder exercises cause immediate and intense pain. Unfortunately, that does mean that I have trouble working my chest and shoulders the way I would prefer, but if it saves me pain, then that’s what I have to do.

You can definitely work around it, and you can still make gains in strength and size (I have). You will have good days and bad days, but try to avoid surgery unless it’s absolutely necessary.[/quote]

Thanks for posting that link. I was looking for it, and refreshed my page and you had posted it. So surgery is out, as I feel that my case is the most benign out of all the posts in your thread and most there didn’t get it. But should I continue with the MRI to confirm the torn labrum? 700 is alot of money, but confirmation would be nice. I’ll try that DC broomstick rehab too. Thanks for taking time out Nate Dogg.

[quote]Pauliewalnuts wrote:
I too am a member of the torn labrum club…tore it when i was 17 (25 now) Didn’t opt for surgery just physical therapy…I have to be very careful as to what exercises/positions I put my shoulder in as once every 6 mos. or so I suffer the joint going out of socket. WORST PAIN EVER, however it really only happens when I get lazy or negligent about stretching it or warming up properly…One thing I do miss however is the ability to throw a baseball or football as hard as I can.[/quote]

Do you still do ROM exercises? What stretches do you do, and can you still overhead/incline press?

I suffered a labral tear in a car accident one year and a month ago. It’s not into the biceps tendon, so it’s not a severe case.

If you chose the surgery you’re looking at 3 months of post surgical rehab and up to a year until you are lifting nomral again.

I didn’t chose that route. I’m a self employed chirorpactor and couldn’t afford the time off for 3+ months. Yes, I might get a big award, but it would be to disruptive to my practice.

Here’s what I did : 1. rotator cuff and scapular retractor work, starting with bodyweight to one lb weights.

  1. ART, laser therapy, myofascial release, aleeve, fish oil for motion, therapy, inflammation and pain control.

  2. No throwing at all. I threw the football last weekend and have soreness, though reduced. Anything overhead will aggravate the supraspinatus tedonosis that I have.

  3. For app. 4-6 moths I used the safety squat bar and cambered squat bar because of shoulder pain. I also do not do any full rom benches, except for one warmup with the bar. The rest of benching is done 2-5 board.

At this point , and as long as I follow the rules, I am complaetely pain free. If I don’t the repetition will aggravate the area. Repetitive motion at a full rom is your enemy. Overhead lifting or throwing is your enemy. Do it on the conservative side of never.

[quote]tom63 wrote:
Here’s what I did : 1. rotator cuff and scapular retractor work, starting with bodyweight to one lb weights.[/quote]

I highly recommend this. One thing that does help me is cuban presses and muscle snatches, along with a few other prehab/rehab exercises (face pulls, internal/external rotations, etc.).

Yep. The more you can do to help treat the area, the better.

How could I forget about that. That was the first thing I noticed after having a torn labrum. I could no longer throw a ball without pain. I’d get one good throw and then be done! However, I can still toss the frisbee because it’s a different movement! :slight_smile:

I’ve had no problems squatting, and for the most part, I can bench with no pain. But many overhead exercises (some, but not all) and any type of flye or pec-dec movement KILL me!

Agree completely.

Thanks for all the great information, guys. I’m cancelling the MRI.

[quote]YoungElias wrote:
Thanks for all the great information, guys. I’m cancelling the MRI.[/quote]

Not so fast, my friend. I had a tear in my labrum for several years (2001-2005). I thought I could avoid it by therapy and not doing painful exercise, but I was wrong. At the time, I didn’t know I had a tear. I just thought it was severe inflammation. Several doctors took MRI’s and told me that I had no tear. Yet I could not throw a ball, had shoulder instability (it constantly felt like it wanted to roll out of the socket), and couldn’t do most exercises.

In general, I just couldn’t do much with my right arm. It was very frustrating. It got so bad that I finally decided that I wanted to get a cortisone shot to kill the pain, but when I went in for that, I was referred to a sports orthopedic surgeon. When he told me I had a tear I was relieved.

That was Sept. '05 and I scheduled surgery for Dec. '05. The first four weeks are hell, but after that, things get better very quickly. Finally, by May '06 I would say that I was at 90% and now I lift regularly, including incline benches and standing presses. I can throw a ball and pretty much do anything.

I’m still very careful with it out of habit and occassionally it gets sore, but it is nowhere near as bad as it was. In short, I’m VERY glad I had the surgery done.

My take on the situation is this: If you are young (and it sounds like you are) then there is no reason to just deal with it. If I was a 40 year old guy, maybe I’d leave it alone. But I was 23 at the time and too young to live with that. In fact, it was a physical therapist who recommended the surgery. She was doing some massage therapy on my shoulder and said, “You ought to get this fixed with surgery. You’re too young to live with a bad shoulder.”

I would therefore have to respectfully disagree with the above posters. I think rehab and careful exercise selection is fine for strains and pulls, but a TEAR is a completely different animal and needs surgery IMHO.

My advice: Go see a sports doctor. They will know much more about this than your average doc. My doctor used to play college football and still lifts hardcore, so he knew exactly where I was coming from and wanted to go.

I hear what you’re saying. It seems as if my situation (knock on wood) is not as bad as yours or the other posters. I have full range of motion, the shoulder doesn’t hurt if I don’t lift, and I can squat and deadlift without a problem. Now I know I don’t know anything about this area, but I’m going to try some noninvasive stuff first. If it doesnt’ work, then I’ll proceed with the MRI and so forth.

Further comments are welcome.