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  1. #1
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    SLAP tear aka effed-up shoulder...

    so, the GP says the 10 weeks of pain I have been enduring when using my left arm to do almost anything is likely a labral tear.

    says I can try cortisone injection / PT just to see if there's any significant improvement, but he thinks it's likely I'll need arthroscopic surgery plus 6+ months of rehab.

    the course of 'no action' is also available...said the tear would eventually scar up, pain would lessen somewhat, but I'd probably lose some degree of mobility.

    anyone just toughed this out...? what were the results?
    eff all y'all...

  2. #2
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    I had surgery, the pain was too sharp. Wrecked again about 3 months post op. still have pain, not as bad this time. Probably live with it for now.
    Recovery was a little more painful than I thought. Try to be real conservative during recovery and it should be in a lot less pain after.

  3. #3
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    Quote Originally Posted by Oxtox View Post
    so, the GP says the 10 weeks of pain I have been enduring when using my left arm to do almost anything is likely a labral tear.

    says I can try cortisone injection / PT just to see if there's any significant improvement, but he thinks it's likely I'll need arthroscopic surgery plus 6+ months of rehab.

    the course of 'no action' is also available...said the tear would eventually scar up, pain would lessen somewhat, but I'd probably lose some degree of mobility.

    anyone just toughed this out...? what were the results?
    You went to a GP.

    General. Practitioner.


    Why not go to a sports medicine doc, or an ortho doc, or a PT for a second opinion ?

  4. #4
    We have met the enemy...
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    Quote Originally Posted by cda 455 View Post
    You went to a GP.

    General. Practitioner.


    Why not go to a sports medicine doc, or an ortho doc, or a PT for a second opinion ?
    I would do this. Mine (right shoulder) has been f'd up beginning with a massive crash when I was still racing, and another good hit a couple of years ago--both times partially dislocated. Not torn AFAIK, or it had healed if it was.

    After the second one (and a lot of hard work on the reno) I was starting to lose mobility and was in constant pain.

    Went to an ortho who is also a sports medicine dude--he laughed at the shoulder the first time I took off my shirt, saying I'd really clobbered that one.

    He did send me for physio to see what they could do--after a few weeks I started getting mobility back, and when he saw me the second time he agreed--no surgery for now, and keep working at the physio exercises. Still have some pain, but I can get work done and have the strength back in my right arm--very important for house construction.

    IMO--and in his--surgery is the last resort.

    I'd get a second opinion at least.
    "When the spirits are low, when the day appears dark, when work becomes monotonous, when hope hardly seems worth having, just mount a bicycle and go out for a spin down the road, without thought on anything but the ride you are taking."

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  5. #5
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    Quote Originally Posted by paredown View Post
    IMO--and in his--surgery is the last resort.
    my opinion as well.

    got the cortisone injection from the GP and a Rx for PT. not noticing any particular effect from the steroids....bummer.

    the GP's opinion was that PT wouldn't hurt anything and might make any future surgical rehab less arduous.

    the Rx was for 10 sessions, will see what that produces.
    eff all y'all...

  6. #6
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    Quote Originally Posted by Oxtox View Post
    anyone just toughed this out...? what were the results?
    Yes. And not good.
    I didn't realize mine was torn. Went several months with pain waiting for it to get better. It would get a little better, then get worse after I'd go and use my arm and irritate it again.
    Finally went to an ortho. Got a cortizone shot. Within a few days I was 60% better. Within a week I was 80-90% better.
    Moving your arm helps prevent scar tissue, but the joint is inflamed, so movement hurts like a SOB and prevents healing. It's a viscious cycle. The cortizone shot reduces the inflamation and pain.
    Get the shot. Thank me later.

  7. #7
    tlg
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    Quote Originally Posted by Oxtox View Post
    got the cortisone injection from the GP and a Rx for PT. not noticing any particular effect from the steroids....bummer.
    Give it a few days. Mine actually felt worse the day after the injection.

    As far as noticing effects... keep an eye out... Steroid and Testicles Shrinkage by MunFitnessBlog.com


    the GP's opinion was that PT wouldn't hurt anything and might make any future surgical rehab less arduous.
    I went to a few sessions of PT. Didn't really notice it helping much and just did some exercises at home on my own.

  8. #8
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    What kind of studies have been done to diagnose your problem? X-ray, CT, MRI, anything other than a physical exam? In this case there is no way, absolutely no way, I would embark on a course of treatment without a thorough exam, including appropriate studies, from a specialist. GP's are great but this type of problem dictates you see a specialist, especially since you're 10 weeks out and still experiencing significant pain. My experience is it's unlikely to get better by itself.
    "Those who can make you believe absurdities can make you commit atrocities." Voltaire

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  9. #9
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    Quote Originally Posted by Oxtox View Post
    anyone just toughed this out...? what were the results?
    Been down the labral tear path 3 times now..... Still recovering from round 3 surgery. Surgery sucks, definitely last resort.

    As others have said - Go see ortho/sports medicine doc. Get an MRI to figure out the extent of the tear. Get a good PT. Cortisone should help with the pain, and enable you to more easily do the PT, but if the tear is bad enough no amount of PT is going to fix it.

    For me it's always come down to how unstable the shoulder was due to the tear, I rode one out for 10 years before giving up and having surgery. I wish I'd done it much sooner.

    Good luck.
    AKA - Go Dot

  10. #10
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    Quote Originally Posted by Oxtox View Post
    so, the GP says the 10 weeks of pain I have been enduring when using my left arm to do almost anything is likely a labral tear.

    says I can try cortisone injection / PT just to see if there's any significant improvement, but he thinks it's likely I'll need arthroscopic surgery plus 6+ months of rehab.

    the course of 'no action' is also available...said the tear would eventually scar up, pain would lessen somewhat, but I'd probably lose some degree of mobility.

    anyone just toughed this out...? what were the results?
    I've had one shoulder mostly reconstructed and another scoped. Neither of them required anything close to 6 months of rehab. It will take upwards of a year until you trust the joint and "feel right" if that makes sense, but it isn't that bad of a rehab. Still, like everyone else said, surgery should be a last resort. Best of luck to you.

  11. #11
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    Thought I'd share my $.02 as well...

    I used to be a full on DH guy....until the hits finally started to pile up. Now I just ride the road. Anyway, I completely blew out my left shoulder on a bad crash a few years ago. Level 4-5 separation, labrum tear, rotator cuff tear and something supraspinatus tear. I was initially taking the PT route to try and avoid surgery, but since I wasn't making any range of motion improvements, still suffering from insane amounts of pain as well as my collar bone about to poke through my skin, it was obvious surgery was the only way to really get better.

    Let me just say this, of all the surgeries I've had, that one was the most painful. However, with that said, I wouldn't hesitate to have the work done again should the need arise. (Big caveat to that is to find a GREAT surgeon!) As others have pointed out, there's no way I'd go into something like that without being examined by specialist. All in all, I'd say I have ~90-95% of both range of motion and strength back, and it didn't take a year. Probably closer to 4-6 months before I was able to go back to the usual routines. (ie., riding DH again)

    I'm not a doctor and I didn't stay at a Holiday Inn, so take my anecdote as you wish...

  12. #12
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    From an xray tech point of view, do the shoulder xrays which will rule out a fracture and then get a MRI. After that, Its really up to you. I've had a couple friends who bypassed surgery and one who had it and the one who had it almost has full range of motion back. The other two guys are still having trouble brushing their teeth.

    The bad part about the shoulder is there are so many muscles that hold it together. Once you have surgery its getting those muscles moving again that is the most painful.

  13. #13
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    Gonna have to follow this. My youngest son has a tear, just been waiting for tennis season to end.
    Tis the season for all of us not hard enough to play to belittle those not hard enough to win. We are a funny lot. - dave @ November Bicycles

  14. #14
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    I followed the route of letting it heal on it's own. There is minor discomfort through part of the range of motion but good enough that I don't see any reason to consider surgery.

    There was pain and limited range of motion for about 6 months which felt like forever after about a year range of motion was back to normal with a little tenderness.

  15. #15
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    Quote Originally Posted by BikeGeek View Post
    I followed the route of letting it heal on it's own. There is minor discomfort through part of the range of motion but good enough that I don't see any reason to consider surgery.

    There was pain and limited range of motion for about 6 months which felt like forever after about a year range of motion was back to normal with a little tenderness.
    I happened to join up with a guy on my ride this evening...while chatting, my shoulder condition came up and he said he'd done the 'no action' option for a similar injury....his results exactly mirrored what you describe.

    48 hrs after the cortisone injection, I'm noticing some minor improvements in ROM and pain levels...won't start PT until the 15th, but am doing exercises I found on the web in the meanwhile.

    thankfully, riding doesn't seem to aggravate the problem very much.
    eff all y'all...

  16. #16
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    Ach!!! I'm learning from all of the your responses. After a number of life-long slaps, they have caught up to me, with the same tear(s). It has been years now. The pain has subsided, but it never goes completely away. And it so disconcerting to be lifting a hammer or chainsaw -especially reaching up, and have the weakness just takeover. Just trying to hold something up and watch the arm drop despite willing it otherwise. The muscles spaz and often the pains come from all over. When all becomes quiet, I can press right around the tuberosities (both shoulders) and find a very acute spots... pain.

    I keep saying I will get the surgery, then put it off. I can cycle, road and mtb, and/but I have sights set on longer tours/races. Especially when offroad I must worry I can't brace the bar truly well enough, that I won't help myself when I really need to keep matters in control. I don't know if some cortisone shots will help me this far into a history and overall damage. But everybody here is helping with experiences. Thanks.
    It's strange to consider that Civil War vets and atomic bombs
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  17. #17
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    Quote Originally Posted by Oxtox View Post
    so, the GP says the 10 weeks of pain I have been enduring when using my left arm to do almost anything is likely a labral tear.

    says I can try cortisone injection / PT just to see if there's any significant improvement, but he thinks it's likely I'll need arthroscopic surgery plus 6+ months of rehab.

    the course of 'no action' is also available...said the tear would eventually scar up, pain would lessen somewhat, but I'd probably lose some degree of mobility.

    anyone just toughed this out...? what were the results?
    Have to make an appointment this week to have my left shoulder looked at. I was doing well for a while, doing the exercises the physical terrorist gave me when I had a problem with the right shoulder, but I think I pushed it just a bit too hard. I've got pain doing even the lightest movement in certain directions, mostly pushing or lifting movements.

    I was assuming it was just the same deal only with the left, I hope it's not more serious.
    Whenever the legislators endeavour to take away and destroy the property of the people, or to reduce them to slavery under arbitrary power, they put themselves into a state of war with the people who are thereupon absolved from any further obedience, and are left to the common refuge which God hath provided for all men against force and violence - John Locke

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  18. #18
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    Quote Originally Posted by Oxtox View Post
    I happened to join up with a guy on my ride this evening...while chatting, my shoulder condition came up and he said he'd done the 'no action' option for a similar injury....his results exactly mirrored what you describe.

    48 hrs after the cortisone injection, I'm noticing some minor improvements in ROM and pain levels...won't start PT until the 15th, but am doing exercises I found on the web in the meanwhile.

    thankfully, riding doesn't seem to aggravate the problem very much.
    May I ask how old you are?


    I've by far beaten myself up much greater during my younger MTB days and pretty much never had any down time. The only thing I dealt with was picking gravel out of my skin from the countless many times I 'ate it'.

    Fast forward me turning 40 back in 2005 and now everything seems to hurt ! Looking back on some of my crashes back in my late teens and twenty's; there's no way I could replicate those crashes without serious injuries now.

    Everything heals slower now than when I was a 20 year old fearless MTB'er screaming down the fire roads of San Diego County. Yes; I'm being Mr. Obvious, but it's when you're living that reality that it seems like a new concept.


    Heal fast my fellow velo friend !

  19. #19
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    As a Board Certified Family Medicine physician (oh no . . . a really smart GENERAL PRACTITIONER) who is a cyclist and has a labrum tear myself I feel I can give you a little advice.

    It all depends on how much it is bothering you. If it is affecting your day to day life, what you can and can't do, and causing significant pain then you need to be more aggressive in diagnosis and treatment.

    Unlike everyone that bemoans the fact you saw some GENERAL PRACTITIONER it may shock you to know many of us know what we are doing.

    When is an orthopedist and their expertise going to be needed . . . . not until your shoulder needs an operation. As a GENERAL PRACTITIONER I can fully and completely examine your shoulder. I can inject if indicated, I can send you to physical therapy, and yes I can even order you an MRI when none of this more conservative therapy helps you. This is NO DIFFERENT THAN WHAT AN ORTHOPEDIST IS GOING TO DO. How do I know that? I spent months working with them as a resident and discuss diagnosis and treatment issues with them all the time. The ones I refer to regularly love my patients as when they get them all the work is done, all they need to do is schedule the surgery to fix the problem.

    Essentially, if you aren't improving with injections, physical therapy, anti infilammatories, etc, and having significant issues after weeks of this treatment then you need an MRI. If the MRI confirms a bad labrum tear then it's time to see the ortho doc and politely ask him to fix this screwed up shoulder in the operating room.

    Mines been torn for 10 years. Doesn't bother me on day to day activities. However, if I try and throw in an overhand motion for more than 5 minutes then I have terrible pain/swelling, and decreased use of the arm for a few days. Therefore I gave up playing softball and only throw the football around at a tailgate for maybe a few throws at most. If I have to change more then 4 light bulbs in the house at a time. . . I'm screwed. Other than that mine doesn't cause issues. Once my two young sons begin to play baseball I'm going to have to make the tough decision to get mine fixed as I will not be happy if I can't throw with them.

    Hope that helps and hopes the fact it comes from a lowly GENERAL PRACTITIONER doesn't bother you too much.

  20. #20
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    Quote Originally Posted by MCG DAWG View Post
    As a Board Certified Family Medicine physician (oh no . . . a really smart GENERAL PRACTITIONER) who is a cyclist and has a labrum tear myself I feel I can give you a little advice.
    thanks for your input, I really appreciate hearing from you.

    as for those ragging on seeing a GP, there's a sequence to things. my insurance requires an exam by my PCP (a GP) prior to a referral to a specialist. so, obviously, his diagnosis was the first step...

    his (and your) advice seems quite logical to me. try the cortisone and PT, see what they produce. if that fails and I can't tolerate the discomfort, get the MRI and consult with a sawbones. seems like a no-brainer...

    fwiw, I'll be 61 in a couple of weeks. so, yeah, the rate and degree to which things heal are noticeably less than they were a couple of decades ago. but, I'm in much better better physical condition than 95% of my peers...thanks to cycling, swimming, yoga, good diet. hopefully, even if I do consent to surgery, I can bounce back fairly quickly.
    eff all y'all...

  21. #21
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    My step father-in-law is 67 and he had the surgery done for his SLAP tear after dealing with it for 8 months (and fighting workman's comp).

    He tried and tried to not have the surgery. However, he couldnt even open his truck door and that was the last straw for him. It didnt hurt too much unless he put weight and barely lifted his arm. After having the surgery, its almost 100%. He cant lift his arm over his head yet but he literally has no pain about 6 months after the surgery.

  22. #22
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    Your mention of shoulder injuries is interesting to me, to say the least. There is plenty of info on the Nat'l Institute of Health website on these ortho problems and surgical alternatives.

    I was clotheslined by a car door in 6/2008 and MRIs showed a 1/2 inch SLAP tear and partly sheared biceps tendon on LH shoulder. Got several opinions and glad I did not have arthroscopic surgery because it has a low success rate for folks with cartilage loss due to arthritis. Like I have. Cedars-Sinai ortho in LA does titanium acromial head replacement with supposedly high success rate, but it isn't cheap and I don't have any insurance coverage.

    If anyone needs advice on self-healing the answer at least in may case is a definite no, five years on its hard to do any lifting above shoulder level, or even hang or do any kind of lat pulldowns. Easy to reinjure, hurts like fury at the strangest times (crossing arms while riding on a bus, straphanging) even though lifting while bending down is possible.

    Along came another car door accident in 7/2010, caused similar injury to RH shoulder, also tore meniscus in RH knee. Of course there was and still is plenty of aggravation of earlier injuries, pain, little commitment to PT at free clinic, incompetent attorneys, shark auto insurance opposition and no insurance coverage of my own. So this has thrown me back on SSA, who says I am not disabled and still several years away from Medicare benefits plunks me in a hole. County medical system will not provide elective ortho surgery, period.

    Prior to my 2008 accident I made the most of my time between contract work and rode both mtb and road about 200 miles a week. No one is hiring partly disabled folks over 45 no matter how well-qualified. I ride only between bus stops and do short local commutes now on a beater.

    If anyone is injured in this way, and assuming they're in a position to do so, get the best, most well-qualified surgeon you can find - who has actually done lots of these surgeries, get testimonials and try to get healed the soonest you can.

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