Ulnar Nerve Entrapment - S.L.A.P Tear

Has any one had this ? was wondering how long recovery is after surgery ?

Also how about a SLAP TEAR ?? thanks guys

We need a lot more information.

For the ulnar nerve entrapment - is it a bony entrapment or soft tissue? Is there ongoing damage to the ulnar nerve from the entrapment? Loss of muscle function in the hand/fingers or just shooting pain and numbness tingling?

For the SLAP tear - what is the size and severity of the tear? Complete/majority or partial avulsion of the biceps tendon? How did it happen? Surgical vs non-surgical course of treatment? If surgical, what type of surgery being done? Any other procedure being done with the SLAP repair (capsular shift, rot cuff debridement, etc)?

[quote]LevelHeaded wrote:
We need a lot more information.

For the ulnar nerve entrapment - is it a bony entrapment or soft tissue? Is there ongoing damage to the ulnar nerve from the entrapment? Loss of muscle function in the hand/fingers or just shooting pain and numbness tingling?

For the SLAP tear - what is the size and severity of the tear? Complete/majority or partial avulsion of the biceps tendon? How did it happen? Surgical vs non-surgical course of treatment? If surgical, what type of surgery being done? Any other procedure being done with the SLAP repair (capsular shift, rot cuff debridement, etc)?[/quote]

Ok the Ulnar no muscle loss/function as of yet just bad numbness and ‘popping’ I do not know if its bony or soft tissue ,Ill see if I can find out…I do know if I tap on my ‘funny bone’
it hurts…

as far as shoulder heres what the report says… SIZE ITS 1.3 X 0.5 CM type II SLAP LESSION wish an adjacent paralabral cyst,Intact biceps labral complex,Rotator cuff tendinosis with no tear of the tendons,mild degenerative arthritis of the AC JOINT TYPE II acromion subacromial-subdeltoid bursitis .small amount of fluid in the subcromial subdeltoid bursa.

I thought I recognized your name. You have posted about this before and have gotten my responses, so for more detailed responses please read back on my previous responses.

But for quick responses, here is my take:

Ulnar nerve
The “funny bone” is the ulnar nerve. Find out what is causing the impingement. Have you tried the soft tissue work that I suggested before? If not, why? If yes, did it help? IMO, I would first try the conservative method of Rx anti-inflammatories (for acute resolution of the inflammation/numbness/tingling) and soft tissue work. Though you may have a subluxing nerve rather than an impingement, so you need to figure that all out.

SLAP
From your MRI results, they basically say you have a tear with a nearby cyst. The cyst may be what is causing more of the problem than the tear. The biceps tendon is fine, rot cuff has tendinosis, arthiritis in the AC Joint, Type 2 acromion which leads to more impingement symptoms.
I have worked with athletes who have had significant labral tears and with proper rehab and therapy, are back to full, asymptomatic activity without problems, but have also worked with ones who have required repair to resolve their issues.

In terms of recovery from surgery, it just depends on what they do. With the cysts location, that may be what is causing your problems, so if they go in for surgery to remove that cyst, they will probably repair/debride the labrum. They also may shave down your acromion process to decrease impingement.

[quote]LevelHeaded wrote:
I thought I recognized your name. You have posted about this before and have gotten my responses, so for more detailed responses please read back on my previous responses.

But for quick responses, here is my take:

Ulnar nerve
The “funny bone” is the ulnar nerve. Find out what is causing the impingement. Have you tried the soft tissue work that I suggested before? If not, why? If yes, did it help? IMO, I would first try the conservative method of Rx anti-inflammatories (for acute resolution of the inflammation/numbness/tingling) and soft tissue work. Though you may have a subluxing nerve rather than an impingement, so you need to figure that all out.

SLAP
From your MRI results, they basically say you have a tear with a nearby cyst. The cyst may be what is causing more of the problem than the tear. The biceps tendon is fine, rot cuff has tendinosis, arthiritis in the AC Joint, Type 2 acromion which leads to more impingement symptoms.
I have worked with athletes who have had significant labral tears and with proper rehab and therapy, are back to full, asymptomatic activity without problems, but have also worked with ones who have required repair to resolve their issues.

In terms of recovery from surgery, it just depends on what they do. With the cysts location, that may be what is causing your problems, so if they go in for surgery to remove that cyst, they will probably repair/debride the labrum. They also may shave down your acromion process to decrease impingement. [/quote]

1 thing,how bad is it if I keep putting it off ? my shoulder has good days n bad,but for the most part,I lift,and still punch…the elbow,not much pain really,jut numbness,mostly at night,and tingling when certain potions…
thanks my man…I can not find the post…thank you again

[quote]fightu35 wrote:
1 thing,how bad is it if I keep putting it off ? my shoulder has good days n bad,but for the most part,I lift,and still punch…the elbow,not much pain really,jut numbness,mostly at night,and tingling when certain potions…
thanks my man…I can not find the post…thank you again[/quote]

Without examining you, it is impossible to say “how bad it is if you keep putting it off”. But when you have a pathology (whether it be structurally based, mobility deficits, or muscular imbalances) and there is associated pain, neurological, or other symptoms present, there is always a risk of increased issues if the problem is not corrected. Now I am not saying that you need to have the surgery to fix the problem. With your shoulder situation, knowing you have the Type 2 acromion and also knowing that the bulk of MMA athletes that I have worked with have overly tight pecs, poor posture, and kyphotic positioning, there is a possibility that your pain is not coming from the SLAP tear, but rather from an impingement occurring due to the combination of the acromion process shape and the tight pecs, etc. You can’t change your acromion process shape without surgery, but you can do something about the tight pecs, poor scapular kinesis and positioning, etc.

Again, without a physical exam, I can’t tell you if those are your exact issues, so I will again recommend finding a good practitioner who can do a full ortho assessment as well as a movement quality and postural screening to determine where your shortcomings are located.

And here is your original post from earlier last year: http://tnation.T-Nation.com/hub/fightu35#myForums/thread/3862203/0

[quote]LevelHeaded wrote:

[quote]fightu35 wrote:
1 thing,how bad is it if I keep putting it off ? my shoulder has good days n bad,but for the most part,I lift,and still punch…the elbow,not much pain really,jut numbness,mostly at night,and tingling when certain potions…
thanks my man…I can not find the post…thank you again[/quote]

Without examining you, it is impossible to say “how bad it is if you keep putting it off”. But when you have a pathology (whether it be structurally based, mobility deficits, or muscular imbalances) and there is associated pain, neurological, or other symptoms present, there is always a risk of increased issues if the problem is not corrected. Now I am not saying that you need to have the surgery to fix the problem. With your shoulder situation, knowing you have the Type 2 acromion and also knowing that the bulk of MMA athletes that I have worked with have overly tight pecs, poor posture, and kyphotic positioning, there is a possibility that your pain is not coming from the SLAP tear, but rather from an impingement occurring due to the combination of the acromion process shape and the tight pecs, etc. You can’t change your acromion process shape without surgery, but you can do something about the tight pecs, poor scapular kinesis and positioning, etc.

Again, without a physical exam, I can’t tell you if those are your exact issues, so I will again recommend finding a good practitioner who can do a full ortho assessment as well as a movement quality and postural screening to determine where your shortcomings are located.

And here is your original post from earlier last year: http://tnation.T-Nation.com/hub/fightu35#myForums/thread/3862203/0[/quote]

thanks my man…im gonna re-read the other post…

just wondering if you knew I already had LABRAL Repair same shoulder,they shaved something down…also put 2
TACS in…they said this tear is in a different spot…

Yup, I was aware of your previous surgery from the information you gave. What did they shave down? From the information you gave, I am assuming this is a different pain than the pain you got from the injury that resulted in that prior surgery?

Where is your current pain located and to what degree is it?

[quote]LevelHeaded wrote:
Yup, I was aware of your previous surgery from the information you gave. What did they shave down? From the information you gave, I am assuming this is a different pain than the pain you got from the injury that resulted in that prior surgery?

Where is your current pain located and to what degree is it? [/quote]

I remember the report saying theY shaved down to the bleeding bone… the pain is kinda the same
anything in the over head ,or behind back position…I think the surgeon said this is in a different area of the labral then my last surgery, not sure if this helps but.1 day bam out of no where (I had lifted heavy that day) I could not lift my arm at all,pain was real bad…could not even shift my car out of park…it was like that maybe 3-4 days…and since then its not to bad…some throbbing no n then…and some pain,but livable,as I said I can lift,and still punch I just hope Im causing more damage,I Dr gave me an injection though my back near scapula …worked but not for long…I have done nothing else as Im holding off on any surgery If I need it… Thank you for your time…

Just from that last entry, I would lean more towards an impingement issue being the root cause of your pain. It can be from the type 2 acromion and/or the subscromial bursitis. Without physically assessing you, I can’t say for certain, but it seems to be a big part standing out.

It very well could be from the labral damage or the paralabral cyst. But since you are not looking into surgical intervention right now (which I think is the right move), I’d say to just start with some scapular work, thoracic ROM, pec major/minor soft tissue work and lengthening, pretty much anything to restore proper posture and scapular positioning.

How are your pecs and your posture btw?

[quote]LevelHeaded wrote:
Just from that last entry, I would lean more towards an impingement issue being the root cause of your pain. It can be from the type 2 acromion and/or the subscromial bursitis. Without physically assessing you, I can’t say for certain, but it seems to be a big part standing out.

It very well could be from the labral damage or the paralabral cyst. But since you are not looking into surgical intervention right now (which I think is the right move), I’d say to just start with some scapular work, thoracic ROM, pec major/minor soft tissue work and lengthening, pretty much anything to restore proper posture and scapular positioning.

How are your pecs and your posture btw?[/quote]

No probs in my chest at all,posture is normal…I’ll prob have my reg dr,refer me…so who
should I go ? chiropractor ? massage… ? PT ? So I can have him send me,again I thank you for your time…
side note…cna u fix the paralabral cyst. with out all the ‘surgery’ talk about pain,a labrum repair wow ! and Ive had others did not hurt,the screw in my hand was a cake walk…carpal tunnel cake walk…thanks again

I had a subluxing ulnar nerve that bothered me for a couple of years before it was properly diagnosed - my regular doctor kept insisting it was elbow tendonitis. Eventually I was sent to the orthopedic surgeon who treats the Red Sox pitching staff, and he properly diagnosed the problem in about a minute. Fortunately, the tests showed no material loss of function or conductivity in the nerve, despite the prolonged nature of the condition.

I had surgery to correct it a couple of years ago, and my advice to you is to avoid the surgery unless it is absolutely necessary. Although it was ultimately successful, the procedure was far more invasive than I anticipated (the incision is about four inches long and curves under my elbow) and it was more than a year before my elbow was normal again.

Are you seeing a orthopedic surgeon for your shoulder? Hopefully one that specializes in shoulders? If not, have your physician refer you to a shoulder orthopedic specialist. Other than that, I’d say a physical therapist/athletic trainer would be your best bet if you want to do non-surgical and rehab it.

I’d recommend finding somebody who can do a dynamic movement analysis (Functional movement screen) and a static postural assessment. Although you probably think you are ok, you would probably be better off getting it done.

As for the cyst, really not much to be done for it besides surgery to remove it. Doc’s may be able to try and inject it to shrink it down, but that is doubtful.

[quote]LevelHeaded wrote:
Are you seeing a orthopedic surgeon for your shoulder? Hopefully one that specializes in shoulders? If not, have your physician refer you to a shoulder orthopedic specialist. Other than that, I’d say a physical therapist/athletic trainer would be your best bet if you want to do non-surgical and rehab it.

I’d recommend finding somebody who can do a dynamic movement analysis (Functional movement screen) and a static postural assessment. Although you probably think you are ok, you would probably be better off getting it done.

As for the cyst, really not much to be done for it besides surgery to remove it. Doc’s may be able to try and inject it to shrink it down, but that is doubtful. [/quote]

Thanks for all your help…so the goal is everything BUT surgery…Im gonna look into it,than ks again

hello my friend,old post but just about ready to have surgery on SLAP tear and ulanr.I was wondering your opinion which would you have done 1st ? seeing its the same arm and the info you gave me was great and worked,I was able to hold out as long as I could so thank you again

[quote]LevelHeaded wrote:
Are you seeing a orthopedic surgeon for your shoulder? Hopefully one that specializes in shoulders? If not, have your physician refer you to a shoulder orthopedic specialist. Other than that, I’d say a physical therapist/athletic trainer would be your best bet if you want to do non-surgical and rehab it.

I’d recommend finding somebody who can do a dynamic movement analysis (Functional movement screen) and a static postural assessment. Although you probably think you are ok, you would probably be better off getting it done.

As for the cyst, really not much to be done for it besides surgery to remove it. Doc’s may be able to try and inject it to shrink it down, but that is doubtful. [/quote]