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Torn labrum


fishing 101

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Has anyone tore their labrum in their shoulder? I was just diagnosed with this and told I need surgery with a recovery period of 3-4 months. Just curious if it actually takes this long or is this a "worst case" scenario? Trying to decide what months I wish to lose out on.

Thanks.

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I am not going to be able to help you, it does not sound so good to be out that long. I wish you well, and a speedy recovery! (when you decide to have it taken care of)

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I had a torn labrum, tear in the rotator cuff along with bone spurs (my shoulder was a mess). I had surgury (rip and tear) the day before Thanksgiving (8 years ago) and I was back playing volleyball 6 months later. I was pretty aggressive with my PT though.

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I am recovering right now from it, 6 weeks to the day, today. It all depends on what you do for a living, will determine how long you will be off, at the 6 week point I can move my arm fairly well, just cant lift anything heavy, or reach my arm sidways. Besides that I can fish, and do most normal things, what else do you want to do!

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I had mine repaired back in '99. If I remember correctly it was about 3 weeks or so in a sling after and then a lot of excercises and therapy. I was fairly aggressive with the therapy and I was back to "normal" in about 4 months so it sounds pretty accurate.

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Mine wasn't torn it was smashed. Surgery on friday and started physical therapy the following monday. Twelve weeks before I could go back to work.

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What does one of these surgeries cost if I might ask? I have insurance but it's an 80/20 deal and might be in the same (boat) parden the pun..

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i rolled a semi truck trailor in 99 had my first suregy and once i was getting better they gave me 25 pound restrictions was sitting on the floor and pick my son up off the floor he weighed 15 pounds at the time tore everything loose again another suregery and from start to finish 2 years went past before got the ok so ya depending on youre type of work will determine release and what ever you do BE CAREFULL AND LISTEN TO THERAPY

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I had an "impingement" or frozen shoulder surgically repaired several years ago. First orthopedist I went to told me he would do a "saber" cut and would not be able to move it for 6 weeks then do PT. I would be lucky to get 80% use/strength back after 6 months. Also misdiagnozed arthritis in the shoulder and was going to cut that out too. Got a second opinion from another orthopedist who did the surgery - by laproscopy so I have two scars about 1" each - and started PT immediately after waking up from surgery. Intensive PT for 8 weeks including work in a pool and I was back to full strength and range of motion.

Be careful and get a second opinion.

Daze Off

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I am not sure what it will cost, we just met our max out of pocket as we had a kid 5 weeks ago. But I have been putting up with this for 2 years. Went through physical theropy 2 different times as two different doc's thought it was my rotator cuff. Now I went to a ortho for this diagnosis. I will get a second opinion before the operation. I am in sales, so no physical labor. Right now I am planning it for the middle of Dec to 1st part of January to have it done if it takes 3 months. Was hoping to hear people were back to 100% in two months, then I would have it done in May yet. I am just sick of the constant throbbing.

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Each case is different when it comes to recovery time. My brother-in-law had his right shoulder done three times. The doctor screwed something up and my brother-in -law quit going to physical therapy becuse he didn't think it would do any good. If you do your therapy the way you are supposed to they will get you back in as little time as possible. I started physical therapy two days after my surgery. My brother-in -law did also and he had a doctor tell him that he shouldn't have started for a month. I guess you just have to trust your doctor.

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Your age is also a major factor in your recovery. Not sure how old you are but the older you are and the physical shape your in can play a big factor in your recovery. I speak from experience I just got done with my thrid surgery spread out over 25 years. If it was me I would go have it done sooner than later. Good Luck!

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Im not exactly sure what the totals are going to be, but I too have the 80-20, and my out of pocket has been about $2500, from the preop, to the checkups, to theropy, it will well over exceed my out of pocket limit of $3000. If your in sales, I would say get it done now, there isnt any sense of sitting throught the pain untill december. After surgery it hurt for a week, but had good drugs to compensate that. Its been 6 weeks not much pain now, just when Im stupid and do something dumb that I know Im not suppose to do, or if I sleep on it at night, I wake up and it will hurt. If your in sales and dont need to be lifting anything, and can work with 1 arm in the sling, you shouldnt miss more then a couple days of work. GET-R-DONE!

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Similar situation here, I just got my MRI results back and it showed rotator cuff tears in both of my shoulders. Decisions, decisions, I'm hoping to wait until winter for surgery as there are a lot less activities going on in winter than in summer. The only thing to do in the winter is ice fish and I figure I can use that as a method of rehab both jigging and lifting 12 oz's.

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I had that done about 12 years ago. Shoulder was very sore for about 2 weeks then I started working it out and it improved slowly. I was back to most normal activites after about 8 weeks although I had to knock of the racquet ball and softball for about 6 mos. It was sore for about 6 mos, but slowly improved till I had no pain at all. I would imagine with the new surgical techniques and improved pain medications the recovery time has to be improved.

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I had both shoulders done, and alot depends on how they fix it, and how they go in. If its arthroscopy, recovery will be MUCH faster, if they have to slice you open, you'll be out of commission a while. Will they tack the labrum back in place (if it's that bad) or just cut off the torn part that is causing the pain? Will they shrink your shoulder capsule, are any rotator cuff muscles damaged as well? You may have more problems than they know of, they will know more when they go in. The more problems you have fixed, the greater the recovery period; age, physician, and type of cut will all play roles in your recovery. If you have an orthopedic surgeon that is a hack, and is not gentle, your recovery time will be much greater. Where do you live, and who is your surgeon? My wife is a PT, she may know who it is.

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Although this isn't exactly the best place to get medical advice, as a medical professional I can tell you a couple of things. First of all, the labrum is essentially a ligament that attatches to the shoulder.Ligaments heal very slowly because they have next to no blood flow. The treatment of choice in Western medicine currently is a surgical repair. Nowadays they do it arthroscopically, using a flexible tube that is inserted through a tiny incision. It should be a day-surgery procedure. There are other options to consider before going under the knife. One that you might want to look into is acupuncture. I have seen acupuncture effect a repair of torn labrum thereby avoiding surgery.

In any event, be aware that there are other viable options you may want to consider before surgery.

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Also, doing PT for a living, I would suggest you get multiple opinions, research the orthopods in your area to see who has the best reputation for this type of surgery. Ask the right questions, can it be done with a scope? When can I start rehab, What type of weight restrictions is there for lifting, How long will I have it immobilized? Can I get a cpm unit to assist with the passive range of motion for home use. ect. Make a list of questions you want answered and take them with you to the appointment. Look into a presurgical strengthening program too, that can help speed your recovery after surgery! I like the accupuncture route prior to surgery, never hurts to try and could decrease the pain you are having. Good luck, I wish you a speedy recovery!

Tunrevir~

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I just want to add my 2 cents here. As others have said it is totally dependent on what they find in surgery. If it is just the labrum without a rotator cuff tear or biceps tendon involvement, it will be pretty good in two months for your activities. I had a young baseball player return to swinging in 3 months and throwing in 4. You would probably be in a sling for a week tops and allowed to move your arm on your own as tolerated. If the rotator cuff is involved it's only passive motion for 6 weeks, with the rest of the rehab to follow. Please don't expect accupunture to "heal" the tear in your labrum, which is a cartilage rim around your shoulder socket. It may help with pain prior to or after surgery, but it will not close the tear back up. Good luck with your surgery, I would find the closest thing to a surgeon with a specialty in sports med and shoulders, as he/she will have the most experience with this type of injury.

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With due respect Honker23, although the current standard treatment is surgery for a significant labrum tear (and I certainly am not dismissing that option), acupuncture actually can facilitate the healing process. It cannot magically repair a significant tear and although it is invaluable for pain relief, good acupuncture allows the body to heal. Obviously there are limits and boundaries to what acupuncture can do and I would never say that it could replace surgery. But the truth is that in certain limited instances, torn soft tissue can repair faster with acupuncture than without it.

Not wishing to hijack this thread, please feel free to contact me with any comments or questions.

Thanks,

Steve

[email protected]

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yup had it done two years ago end of this month. i can tell ya if it is done laprascopitictally (sp) it is the best way to go. you will be sore for a long time and getting your belt in the back loops of your trousers is a b----. i was actually out on a fishinhg trip two weeks after the surgery. dont even try to cast a line with that arm you will tear everything apart. did make a trip to vermilliom 6weeks post and still could feel the twinge init if i set the hook wrong. i did get a bit better casting with my left arm though.even now after two years i still feelit i tore mine hauling a huge 27 cu ft side by side refrige up a stairway by my self andd did not have the surgery done untill over four months later. not a wise thing to do but i didnt have much choice. i was not avail for work for four months and even then it was limited for use in my right arm. hope it all goes well for you and remember there is always icefishing season. but ya gotta watch that verticle hook set for a bit as well. ... paul

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Having had both shoulders done for different reasons, (one rotator cuff, the other... was broken, rotator cuff torn apart, and massive cartilege damage to the entire socket area) I can tell you that having the surgery is a pain, literally, but if you follow your doc's regimen,do your PT faithfully and push yourself, I can tell you that the recovery time will be much shorter than if you don't.

Another thing to remember is that we all heal at different rates, so it may be a shorter time for you than it is for some of us others, or it could be longer than others with similar injuries.

I can honestly tell you, though, as much as you think that you're back to normal after 4-6 weeks, you probably won't be better than 75 -80% for 6 months to a year, depending on what you do for a living and the stresses & strength in that area before you had the injury.

Find the best ortho surgeon you can, and don't be afraid to ask questions that you want to have the answers to.

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I'm in a brace as I type this with one hand, Just finished my second surgury on tuesday, I tore and stretched the ligiments in the back of my shoulder as well as tore all the cartilage in the front and chipped the back of my socket. First surgury was arthoscopic to remove 3 large bone chips, do a SLAP (no idea what it means) repair, and microfracture to stimulate cartilage scar tissue. That was 5 weeks in a sling, then 2 months of PT before second surgury which was a full incision to repair a tore ligament and a stretched one. 4 weeks in a gunslinger brace, then lots of PT. Not any fun. As for timing I chose to miss Opener and turkey hunting to be in better shape for summer. But I'm looking at being ready for college next year.

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Quote:

Also, doing PT for a living, I would suggest you get multiple opinions, research the orthopods in your area to see who has the best reputation for this type of surgery. Ask the right questions, can it be done with a scope? When can I start rehab, What type of weight restrictions is there for lifting, How long will I have it immobilized? Can I get a cpm unit to assist with the passive range of motion for home use. ect. Make a list of questions you want answered and take them with you to the appointment. Look into a presurgical strengthening program too, that can help speed your recovery after surgery! I like the accupuncture route prior to surgery, never hurts to try and could decrease the pain you are having. Good luck, I wish you a speedy recovery!

Tunrevir~


Not to get picky... But

But the Labrun is where the Bicepetal Tendon attaches into the Glenhumeral "Socket."

Ligaments attach bone to bone... Tendon's attach muscke to bone.

****

To the OP

I'm an amature Body Builder, and retired football player... I've seen more than my fair share of Shoulder injuries in the last 18 years...

I assume you had an MRI Arthrogram to confirm this diagnosis, and got it from an Orthopedic surgeon.

Some people simply go to GP's, give it a palpation test, shoot some bleary 2 point X-rays and give it their best guess... Patient goes blissfully along, thinking this wass expert advice.

Just wanted to make sure... As a veteran of these kinds of injuries I can tell you that nothing counts as final say unless it comes out of the mouth of an Ortho or at the very least a physio who's seen the arthrogram results.

***

As for the Labrun Injury itself, there are a 4 different grades... And each grade is going to varry in both procedure and recovery time... Which of course is going to influence cost.

For me on an 80/20... It was $4,200 over the course of 8 months... But I was also rehabbing and returning to moving some weights that the average guy doesn't need to do, so of course my rehab (Which was the spendiest part) took longer and was more involved. It took me another 8 months to be able to just bench 225 for 10 reps... And another 6 months beyond that for my scar tissue related issues to subside.

****

First off... You want to exhaust all your options before going under the knife.

There are two things that I've learned are true...

#1... Once you tear up a joint it will never be the same...

#2... Once you cut into a torn up joint it will never be the same...

Here are some treatment options and what I've learned from them...

-Chiropractic adjustment... In some cases is great... In your case it won't do anything.

-Acupuncture: Least effective healing procedure for torn connective tissue...

The reason is that connective tissue has high nerve density and low blood flow... Which is part of the reason why they hurt so much, heal so slowly and are so prone to scar tissue related issues.

All Acupuncture does is help alleviate pain... It can't Mysically reattach torn connective tissue... So what happens, you feel like your shoulder is much better than it actually is, and you go and do something like say pick up a ladder, or play wrestle with your kid, and you take a moderate amount of damage and turn it into a serious injury.

Cortisone...

-Cortisone is just like a diagnosis... If it's in a Joint, don't even let a GP think he's good enough to inject you... Only a true joint specialist has the expertise to be able to properly administer a deep joint injection of this nature.

I want to strangle all the GP's who thought they could inject me with cortisone only to inject it deep into muscle near the joint and "Hope it will seep in."

Couple of things to note about Cortisone...

#1... A Deep injection will hurt... I've been through some stuff that will make your stomach churn if you watch the video, and I tell you, every deep joint cortisone injection I've had, I saw stars and nearly passed out, because it felt like my joint was going to explode.

#2. Cortisone has the same affect that acupuncture does, in that you feel better, and can risk re-injury... It can't re-attach torn connective tissue.

#3... After having a cortisone injection you will have a period of 3-6 weeks where the connective tissue in the area will be weakened in it's integrity due to the anti-inflamatory properties of the Cortisone itself... This is a period where if you over exert, you could risk turning a partial tear into a complete and total disconnection.

*It's worth noting though that for the average joe this isn't as much of an issue... It was just a warning given to me because of the athletic nature of my lifestyle.

Physical therapy... If you just have a minor SLAP lesion...

For example, (In Layman's terms) Let's say that you tore 20% of the attachment in your labrum... Meaning 80% is still attached... If you work say an office job... It's possible for you to go through a rehab program where they target specifically to restrengthen that 80% of healthy attachment to be as strong as it was when you had 100% attachment.

HOWEVER... There is a small potential long term complication in osteophytes... The 20% of torn attachement can over time develop calcium deposits called "Osteophytes." These could potentially get jammed up in the socket and freeze your shoulder... To such a degree that it's a trip to the emergency room.

But that would happen to you down line at some random time (Most likely while wiping your butt.) laugh.gif And the percentage chance ot that is below say 15% (Last time I saw a study.)

***

The of course there's surgery... Which unfortunately is pretty much the final option to re-attach things as close as it used to be.

You'll want to consult your doctor... But the procedure should be an outpatient one... With 4-6 months of rehab and recovery.

If you do everything the PT tells you to, you'll have a 5 times better result than if you do just 90% of what they tell you to.

****

There is a procedure called "Prolotherapy." It's a procedure that's still in it's infancy, so it's pretty hard to find a doc who does it, and questionable as to how much insurance will cover it...

I didn't have it done... However I've read great results and I've met 3 guys who've had it done who despite being uncomfortable, they rave about how it was better than surgery.

I'm far from being knowledgeable about it...

But as I undersatnd it essentially over the course of several sessions over the course of something like 6 weeks, they inject your joint with large doses of Saline and other good doctor stuff, which increases blood flow, and "Something-Something" that encourages re-attachment.

It's only effective early on in an injury (Before scar tissue starts to form.)

But in cases when it's caught early and used, the doctors doing it are "SHOCKED" at how effective it has been for healing injuries previously thought to only be repairable through surgical intervention.

****

Good Luck!

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Thanks for the detailed information. Thats 10 times more info then I got from my dr before surgery.

Retired football player, pro? Anybody we know?

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From what I understand prolotherapy involves a glucose mixture designed to irritate the stucture to stimulate the inflammatory reaction your body goes through during the acute stage of an injury. I have heard miracle stories, but most have been with chronic muscle/tendon injuries, for example a hamstring injury in a sprinter. I've also read about adverse reactions to this where the athlete "thinks" it's all better then completely ruptures the structure in competition. Not sure it would be indicated for the labrum (cartilage), as this is a structure that cannot repair itself. But as you said it is way too early to know if this is a good option due the fact very little research exists on the science behind this and for what injuries it would be indicated.

To help summarize some of the info you've been given....Please go to a respected othropeadic surgeon and follow through with the rehab and you have an excellent chance of having no limitations down the road. Every shoulder is different and best case scenario you just have a labral tear, 6-10 PT visits, complete recovery in 3 months. Worst case, there's more damage than they thought, 20 visits of PT, still stiff, manipulation, 15 more visits, 1 year later it's about 80% and you are stuck with a stiff shoulder that lacks strength.

Or you can live with the pain, stuggle to sleep, avoid surgery now and in 20 years your shoulder has more arthritis/osteophytes because it lost the stability the labrum helps provide and wore out earlier than it should have.

Did I say summarize....sorry this got a little long. Good Luck!

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I have 2 bad shoulders.

Chiropractic adjustments help for about an hour, and then the pain is worse then before.

PT helps to a degree for temporary relief, but the pain progressively gets worse over time.

I get daily deep tissue massages, that helps for short term (1-2 hours) as well.

I take Flexeril when the stiffness and immobility gets unbearable, but makes mush out of the rest of me and helps only minimally.

Vicodin ES and Oxycodone for the worst of worst times, but still only makes things bearable.

I have associated headaches with the shoulder pain.

I have been to the Mayo Clinic, pain clinics, several MRI's, yadda yadda.

Good luck with your situation, I hope it goes well and the discomfort can be minimized.

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First off, the Labrum is cartilage and doesn't attach anything. It is a cartilagenous cup that deepens the shoulder socket for the end of your upper arm bone (humerous) to fit it. As it is, the shoulder is one of the most unstable/shallow joints in the body, and the Labrum helps stabilize it. The type of cartilage the Labrum is made of WILL NOT heal itself. You either live with the pain, or have the tear repaired surgically. Some people have minimal to no pain with a labral tear, thus requiring no treatment. If the pain is so bad that it effects your way of living, or what you do, as it did me (professional baseball), get it fixed. If it's not that bad, let it be.

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I am on my third as a result of a rear dislocation. The last time was a torn labrum before reconstruction. The best advice I can give is know your body and your pain tolerance. This will help in the recovery process. The recovery period can be minimal if you stretch and rehab correctly. I believe I was golfing and throwing a softball within a month. If you can get the nerve block instead of the anesthesia I would recommend it Good luck.

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Let me paraphrase....Your milage may very depending on driving habits... I believe there are 2 keys to Arthroscopy. (I've had Arthroscopy w/ reduction of the capsule) The first and foremost is the procedurist. Look long and hard..it is a very technical procedure. 2nd is PT..It should become your new "religion" follow it consistently and faithfully. I will give my 2c about anesthesia if the capsule is shrunk the only way I've heard to test the joint is to sub-lux or hyper extend the shoulder. I don't think you want to be awake for that...Versed is your ally and Fentanyl is your friend.

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