T Nation

Training With A Torn Labrum

Hey all,

I dislocated my shoulder on a blown snatch on March 15th. This was devastating to me considering I’ve been making the best gains of my life for the last six months on a modified version of CT’s HSS-100. I’m using the basic template and have customized the movements over time.

I’m 26 and otherwise healthy. Never been injured in 13 years of competitive athletics. Diet is dialed in, I’m stronger, bigger, and leaner than I’ve ever been. The first doc I saw thinks it’s a torn labrum and has sent me for a contrast MRI, but I want a second opinion.

So far I’ve been jumping rope, doing farmer’s walks, split lunges with weight held at my side, and some chins, but the chins hurt a bit and don’t feel all that good on the shoulder. I squatted tonight but even with a low bar position it didn’t feel good since the tear is a posterior one.

What else do you guys think I can do in the meantime while I’m waiting for further workups?

Thanks so much in advance for your help. Any support and advice from the Nation would be much appreciated during this trying time…

WTF? I dislocated my shoulder March 18 and I’ve been wearing a sling the whole time. I can’t even see my ortho surgeon until fucking Thursday the busy asshole. Your surgeon is letting you continue to train!?!?!

So he wants to do surgery so he doesn’t care if you continue to work out until surgery?

I know mine was an anterior dislocation. The humerus was abducted and externally rotated when I dislocated it. I heard a big ass crunch and I figured I should just wear a sling until I see him as I’ve done all this to my left and was advised to wear a sling for about 4 weeks until it heals then start on light rotator cuff exercises.

Of course, I REALLY hope this isn’t the case as I’ve made the best gains of my life in the past 1.5 yrs. (I’m 24) and have gained about 30 pds. If I lose it all, AGAIN, that would really suck.

I’m just surprised your back lifting after just over a week. Once again, wtf?

[quote]markdp wrote:
WTF? I dislocated my shoulder March 18 and I’ve been wearing a sling the whole time. I can’t even see my ortho surgeon until fucking Thursday the busy asshole. Your surgeon is letting you continue to train!?!?!

So he wants to do surgery so he doesn’t care if you continue to work out until surgery?

I know mine was an anterior dislocation. The humerus was abducted and externally rotated when I dislocated it. I heard a big ass crunch and I figured I should just wear a sling until I see him as I’ve done all this to my left and was advised to wear a sling for about 4 weeks until it heals then start on light rotator cuff exercises.

Of course, I REALLY hope this isn’t the case as I’ve made the best gains of my life in the past 1.5 yrs. (I’m 24) and have gained about 30 pds. If I lose it all, AGAIN, that would really suck.

I’m just surprised your back lifting after just over a week. Once again, wtf? [/quote]

Sorry to hear about your shoulder. I’m not seeing him anymore since he was a tool. I have decent mobility since the shoulder only subluxated and wasn’t a full dislocation. It relocated immediately.

I can’t do most of the things I like to do, so it’s not as if I’m anywhere near 100%.

Anyhow, does anyone else have any advice? Thanks.

Rotator cuff exercises. Cressey has a lot of good articles on them. See an orthopedic surgeon man, not a doctor. There really isn’t much you should do until you get the results back from your MRI. If anyone tells you different, I’d be skeptical.

[quote]markdp wrote:
Rotator cuff exercises. Cressey has a lot of good articles on them. See an orthopedic surgeon man, not a doctor. There really isn’t much you should do until you get the results back from your MRI. If anyone tells you different, I’d be skeptical.[/quote]

I DID see an ortho surgeon. I didn’t like him. “Doc” is a generic term.

Thanks for your help. Been doing rotator cuff exercises since the injury. Still looking for more ideas on safe stuff to be doing. I’ve been reading Cressey’s articles for a long time, not a newb. But thanks anyway.

Well then I guess you are aware to stay away from overhead pressing, snatches (obviously), upright rows, and and most pressing movements. If you’ve read a lot of Cressey than I’m sure you know about the exercises to stay away from… anything that causes impingement. Also, any exercise that has your humerus abducted and externally rotated… might want to drop the barbell back squats as that is precisely the position that your shoulder is in.

[quote]markdp wrote:
Well then I guess you are aware to stay away from overhead pressing, snatches (obviously), upright rows, and and most pressing movements. If you’ve read a lot of Cressey than I’m sure you know about the exercises to stay away from… anything that causes impingement. Also, any exercise that has your humerus abducted and externally rotated… might want to drop the barbell back squats as that is precisely the position that your shoulder is in.[/quote]

Again, thanks. I’m trying to be nice about this, but I’m looking for a perspective other than yours. You kinda hijacked this thread. Let me get some other responses and rest your shoulder, k? Thanks.

To anyone else who might be reading this, I’m not looking for exercises to stay away from, I’m looking for ways to adapt what has been a very successful training period for me for a period where I will likely not be able to train that way at all.

So is it plyo/speed work? I just need some ideas of a new focus in my training other than adding upper-body size and strength that won’t irritate my shoulder.

As best I and the docs can tell, I have labral tears in both shoulders and have had them for 20 years. The MRI was inconclusive (there was a bloom right where they needed to see). My shoulders used to hurt regularly. When I started pulling my shoulders back with a scapular pinch all the time as part of a change in posture, the shoulder pain went away. I can bench if I keep the elbows in. I do Arnold Presses instead of regular dumbbell overhead presses. Pull-ups aren’t a problem and I almost never have pain. Of course, I don’t bench very heavy anymore but I might again. Bottom line is for me that I need to do exercises where I can keep the head of the humerus pulled tight into the socket and if I can, then it’s all good. Front and back squats aren’t a problem. Power cleans don’t hurt. I don’t do anything that takes my hands behind my shoulders when they are overhead. Hope this helps.

Dan

Dan,

Awesome. That’s great to hear that you’ve made it work without surgery. I read a really interesting study tonight about posterior labral tears in football players and how protracted shoulders are implicated in damage to the labrum…if that is true and your experience has been that retracting yours helps, it makes sense.

Here’s the link: http://www.ajronline.org/cgi/content/full/188/1/193?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=glenoid&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

And here’s the relevant passage at the end, if you want to cut to the chase: “The preponderance of labral detachments and articular cartilage injuries as opposed to labral substance tears and capsular injuries in these athletes was thought to be caused by a major compressive force due to protracting the shoulders in anticipation of contact. This results in a shear force directed at the glenoid and labrum. Multiple episodes of this form of microtrauma eventually lead to posterior labral detachment or tears.”

At least you don’t have a torn labia. 8)

[quote]RPC wrote:
At least you don’t have a torn labia. 8)[/quote]

Hehe. Go for the obvious joke. :slight_smile:

so are you currently seeing a “doc” or not at the moment? and did the ortho say what kind/type of labrum tear it is? because this can affect the type of exercises/rehab you should be doing. MRI’s reliability is pretty low and they bring up a lot of false positives and negatives, but they are pretty much the only diagnostic tool there is for labrum tears, besides looking at your movements etc.

[quote]Tome-Rx wrote:
so are you currently seeing a “doc” or not at the moment? and did the ortho say what kind/type of labrum tear it is? because this can affect the type of exercises/rehab you should be doing. MRI’s reliability is pretty low and they bring up a lot of false positives and negatives, but they are pretty much the only diagnostic tool there is for labrum tears, besides looking at your movements etc.[/quote]

MR arthrogram is Tuesday afternoon. I thought regular MRIs weren’t so good, but the contrast-dye ones were better?

I have an appointment with a new ortho surgeon April 7 to look at the results of the MRI.

My shoulder was abducted, internally rotated, and protracted when it subluxed, which (if I understand correctly) indicates a posterior dislocation. I talked to a chiropractor at the gym and he agreed-- the humeral head pushed back way too hard against the glenoid and slipped, and if it IS a tear I suspect a posterior tear.

Lots of American football players have posterior tears when they protract their shoulders prior to impact and force the humeral head back.

Whaddya think?

im not too sure what contrast dye ones involve, im guessing injecting some sort of dye into the affected area and then scan it? Ive heard they are slightly better than normal MRI’s. im only a physical therapy student so I cant say too much, so i’d keep going with the exercises they’ve got you doing and see what your new surgeon says on the 7th.

if you’re not happy with what they suggest/say, maybe TRY a physical therapist and maybe they can give you more/better exercises and maybe suggest a rehab/treatment plan suitable for you. this could involve anything from just the exercises, to injections, electrotherapy modalities and more.

sorry im not much help, lemme know how your getting on though. I’ll read up more on labrum tears etc and try find some good info.

good luck!

[quote]Tome-Rx wrote:
im not too sure what contrast dye ones involve, im guessing injecting some sort of dye into the affected area and then scan it? [/quote]

Here’s the deal: "Increasingly utilized in the last ten years, Magnetic Resonance Arthrography combines a standard arthrogram with Magnetic Resonance Imaging. While preparing the iodine contrast for injection into the joint, the physician adds a small quantity (usually less than 1 ml) of gadolinium contrast.

Once the joint has been injected and the traditional radiographic images have been obtained, the patient then undergoes an MR of the joint. The gadolinium in the contrast fluid yields a bright hyperintense signal and allows evaluation of quite small defects of the joint capsule, articular surface of the bones and of the labral cartilage.

MR arthrography is most often used in evaluation of the hip and acetabular labrum, of the shoulder rotator cuff and glenoid labrum, and less often in the wrist."