pt or surgery Labrum tear (rot cuff 's fine)

**Quester** · 09-29-2016, 03:31 PM

Labrum in left shoulder is completely torn. The tear is on top from the front to the back, that's what the doc said. The rotator cuff is fine. He prescribed two months of physical therapy at their pt facility. Here's the thing: I know the labrum is connective tissue. Connective tissue cannot be improved through physical therapy because it doesn't grow as a result of use the way that muscle does. The goal of pt is to improve the rotator cuff in order to help stabilize the shoulder in the absence of a function labrum. But, I don't think it will grow back on its own and I already have strong, functional, rotator cuffs. I'm happy to do pt after an op. I guess this is turning into a journal instead of a question but I'm just frustrated. Anybody got any thoughts?

**Quester** · 09-29-2016, 03:32 PM

Also, I've got a copy of the MRI on disk but I think they use some type of unique medical software to view it.

**NACH3** · 09-30-2016, 08:30 AM

Originally Posted by Quester

Labrum in left shoulder is completely torn. The tear is on top from the front to the back, that's what the doc said. The rotator cuff is fine. He prescribed two months of physical therapy at their pt facility. Here's the thing: I know the labrum is connective tissue. Connective tissue cannot be improved through physical therapy because it doesn't grow as a result of use the way that muscle does. The goal of pt is to improve the rotator cuff in order to help stabilize the shoulder in the absence of a function labrum. But, I don't think it will grow back on its own and I already have strong, functional, rotator cuffs. I'm happy to do pt after an op. I guess this is turning into a journal instead of a question but I'm just frustrated. Anybody got any thoughts?

Try the PT first but if it's like your saying(structural) your going to more than likely need to get it repaired... I've had mine repaired 2x and now need a total rev joint replacement... I always say work with the best - shoulders are our most freely moving joint in our bodies - and try everything b4 surgery - but your case sounds more severe than most - a long tear like that - stem cell research in which another country will be involved(but you can harvest the cells here I believe of vice versa) or GH which is what I'm hoping will help

You won't have the ROM you did but how much have you lost already? Where's the pain in the anterior or posterior of the shoulder?

**Chauffeur** · 09-30-2016, 05:43 PM

It sounds like you kinda already know the answer to your question. If the extent of the damage to your labrum is severe, surgery is really the only option if you want to enjoy an active lifestyle at some point.

People with smaller tears sometimes respond well to PT, but it doesn't sound like you're dealing with a mild injury. Sounds like you've got a pretty extensive SLAP tear?

Im going to also assume that you've got some significant pain and loss of ROM. That's unlikely to get a whole lot better without surgery. It'll probably get worse with weight lifting as time goes by as well. Sucks, but that's how these injuries typically progress.

Surgery/recovery is no cake walk and only you know much this is affecting your life/daily routine, so the decision is ultimately up to you, but I wouldn't hold your breath for a miraculous recovery through PT alone.

Not gonna lie man, the recovery sucks...big time. But if you're struggling with daily tasks due to the injury, it's probably worth it.

**Proximal** · 10-01-2016, 05:19 PM

As Nach said - try the PT. If anything it will get your muscles prepped for surgery - which is VERY probable.

Is the biceps involved, did they give put a number on the tear 1--> 4?

Be happy your RC is not involved - that is exceptional news to be overjoyed about.

**Quester** · 10-04-2016, 07:53 PM

The MRI report says
"...
Findings:
rot cuf tendons intact...
biceps tendon ...(ok)
Labrum and capsular structures: There is a tear of the superior labrum, extending anterior to posterior. Capsular structures are intact.
Glenohumeral Joint: ...no acute fracture. There is an incomplete cartilage delamination within the ateroinferior glenoid, just posterior to the labrum, with the triangular cartilaginous flap. Normal morphology of the humeral head and glenoid. There are two sub centimeter T1 and T2 intermediate signal focci within the subscapularis reces, which may represent chondral loose bodies.
AC joint: ...type 2 acromion. ...The deltoid muscle is fucking awesome!
Impression:
1. SLAP tear.
2. Incomplete cartlilage delamination anteroinferior glenoid. (my glenoid is NOT inferior!)
3. 2 subcentimeter ...(same shit he said above)... loose bodies (I'm hard-headed, hard-nosed, hard-assed, and I'm a hard bodied mf!)
4. Intact rot cuff

**Quester** · 10-04-2016, 07:56 PM

I think I got it using the military press bench. The one where your back is against it and the rack is way behind you so you got to get help or ....suffffffffer!

**Quester** · 10-07-2016, 01:28 PM

Pain is when reaching behind to my back pocket, overhead like a football throw and just general ache.

**Quester** · 10-07-2016, 01:31 PM

Originally Posted by NACH3

Try the PT first but if it's like your saying(structural) your going to more than likely need to get it repaired... I've had mine repaired 2x and now need a total rev joint replacement... I always say work with the best - shoulders are our most freely moving joint in our bodies - and try everything b4 surgery - but your case sounds more severe than most - a long tear like that - stem cell research in which another country will be involved(but you can harvest the cells here I believe of vice versa) or GH which is what I'm hoping will help

You won't have the ROM you did but how much have you lost already? Where's the pain in the anterior or posterior of the shoulder?

I've heard GH is best for healing an injury like this (after surgery) but I've heard that its impossible to find reliable shit. One of my docs offers stem cell treatment but that costs roughly $2000 and insurance (of course) wont cover it. Any idea how much stem cell treatment is overseas?