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rmncwrtr

Shoulder Posterier Labral Tear

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My 15 year old is scheduled to have shoulder surgery in a week and a half. She went over the handlebars in Sunriver in July. X-rays showed a minor separation, but it wasn't healing, she couldn't swim (competitive swimmer) and hurt to do a few basic things such as her hair. Recent MRI showed the tear.

 

I know nothing about what she'll be going through except 6 weeks in a sling, 6 months rehab and possibly back in the pool by May. Looking for any advice or info that can help me help her. Thanks!

Edited by rmncwrtr

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I had surgery for a Grade 3 separation in my non-dominant shoulder when I was about your daughter's age. Although it sounds like a posterior labral tear is a different injury, the recovery time sounds similar since I required 2 procedures. I have no lasting affects from the injury 20 years on.

 

Advice? Take it slow after surgery; follow doctor's and PT's advice. Do your research on your PT and find a well-referred one as this can be the difference in recovery. Set a conservative timeline and expectations and be psyched if your daughter exceeds them.

 

 

 

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Just follow your docs advice. It's good to tell them upfront that she is an athlete, because a lot of those orthos understand that and will tell you straight up what you can and can't get away with when trying to push a sports return. Labral repair can go different ways depending on where and how bad the tear was. She's young so hopefully the site of injury has good blood supply (the main factor with this issue) and keep your fingers crossed. I think she can come back faster if she can keep in shape and strengthen everything else while she's waiting for shoulder to heal. Good luck to her!

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Good advice above, especially about following the post surgical directions of Doc and Physical Therapist.

 

In 2009 I had shoulder surgery for a labral tear. My tear, and other issues, were extensive, and a reconstruction was necessary. I was 55 yrs old at that time. I got back to climbing and other activities ahead of the timelines the Doc had for me. Hopefully your daughter is able to do the same. Her age is definitely to her advantage.

 

I hope your daughter gets in to see a PT asap after surgery. I did not do this and suffered through complications because of it. I was told in post op not to move the shoulder much. In the intervening 6 weeks I had scar tissue build up in the shoulder. At the 6 week appt with the surgeon, he recommended another procedure to remove this. I declined, and insisted on getting in to the PT to help me break it down... This was very difficult, but we were successful. I should have been doing more initially under the supervision of a PT than I was...

 

One last thing. I don't like to take meds. But some of the best advice I got was not to scrimp on recommended doses initially or quit them too soon. Post op meds are really important and I was glad I did not try to get off of them too soon...

 

d

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I was a competitive swimmer for 12 years, I had one labrum repaired, and need to have the other eventually. The best thing I can share is to use it as an opportunity to refine her swimming technique. Lots of coaches love to hammer the yards at her age (and beyond), so with a surgically repaired shoulder she'll need to get her technique perfect-especially freestyle-to make it through without more shoulder pain down the road.

 

Also strengthening her back-rhomboids(I think? stabilizers). Swimmers tend to be overdeveloped in the front, good to equalize it out. At least that made all the difference in the world for me.

 

Good luck! Recovery takes forever, and like others said, take it easy.

-t

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I would have advocated a rehab first, combined with quitting swimming for a while, hitting the weights to rebalance the muscles. 95% of injuries like this can be fix without surgical intervention.

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Thanks all. Really appreciate all the replies/suggestions/advice. Surgery's scheduled for next week. Have the date, just waiting for the time confirmation.

 

Glassgowkiss - she stopped swimming back in early July. Started again for high school season in late August, but that only lasted a couple of days. It hurt too much. Doc talked about her doing rehab for another 6 months before having surgery, but after speaking with him, decided to go the surgical route.

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Considering the pain is affecting her ability to swim I think you have made the right choice about surgery. You get a really good look at the labrum once the scope is in and you can usually identify any problems that may have been more mysterious looking at MRI. Also, if there is minimal damage, the labrum can be "cleaned up" or even left alone entirely if the doc deems it to be unnecessary. Further, if there is truly a large tear, it will need to be fixed or no amount of PT will help.

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I have treated in the past 14 years dozens of shoulder injuries, trauma and non-trauma. Most of them resolve without need for surgery, some do need to be operated on. I have also seen some really bad surgical outcomes, where people end up totally screwed up for life. Surgery should be considered after all other options have been exhausted. I would have taken rehab option first.

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I got through a labral separation about five years ago with PT and no surgery. According to my ortho, these are hard to see on an MRI, so he wanted to do an "exploratory" surgical trip into the joint before the big event. I declined and went with PT. At its worst, I was unable to lift my arm to 90 degrees. Even putting deodorant on was a task. Took about three months of weekly sessions. The strengthening exercises actually made the pain worse at first, but the payoff eventually came. How did I injure it? Crossfit. Repeatedly hanging from a single, totally relaxed and extended arm while resting at the top of an inverted PVC/Rope ladder is not something I would recommend for shoulder health. Eventually, I felt something "move" inside the joint.

 

Good luck with surgery. Every case is different.

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Thanks again!

 

She had the surgery this morning and is resting/texting/repeat. She's in a sling with this device over it that delivers cold water through it so we don't have to deal with ice bags. The pain meds are working well.

 

The doctor gave us a bunch of pics from the surgery. The tear was bad. He said rehab would not have fixed. I asked about that. He also did more than planned in there. He'd treated her for a loose shoulder a couple of years ago. She did months of PT to get everything strengthened, but he said it was still very loose and could easily dislocate so he tightened up the front in addition to the work in the back.

 

Anyway, so far so good.

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The doctor gave us a bunch of pics from the surgery. The tear was bad. He said rehab would not have fixed. I asked about that.

A bit of a hogwash here. I f I showed you images of healthy on torn labrum, most likely you would not be able to tell which one is which. The power of suggestion. Second- if rehab would work or not- this is just physician's opinion, not a fact. Of course he will not say: "the shoulder would have rehabed just fine, but we did a surgery regardless". Again, physicians are not omnipotent and they present their opinions as "facts".

 

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