Torn Labrum - Recovery without Surgery?

My doctor thinks I have a labral tear. It may not be torn too badly since apparently it wasn't obvious on the MRI. I took three months off of swimming before seeing the doctor - I figured it would get better on its own, but it didn't. I've done about 4 weeks of physical therapy and will do another two before seeing the doctor again. My range of motion and rotator cuff muscle strength have definitely improved, but the impingement pain and shoulder clicking during freestyle recovery motion is still there. My doctor suggested that after 6 weeks of physical therapy he'd have a better idea if surgery would be necessary. Two weeks to go... In searching this and other forums, it seems that physical therapy doesn't do the trick for most swimmers with labral tears, and they end up in surgery. Or maybe those that choose surgery just like to post more about it? If you've recovered from a labral tear without surgery, let me know! I'm willing to do many more months of physical therapy if I think I can avoid surgery! Brian I had a SLAP tear and didn't have surgery. (Natalie Coughlin also tore her laburm and I think rotator cuff and didn't have surgery) LOTS AND LOTS AND LOTS of core work. You can definitely do it - I would suggest taking time off of swimming and just kick while you are rehabbing at least for the first 4-6 weeks. I found that through rehab and tinkering with my stroke to make it more from the core that I was able to come back pain free. You might want to find a knowledgeable coach or PT that knows swimming and have them review your stroke and see what changes can be made to take the pressure off of your shoulder.

Define "core" work please. I am also suffering from a "slap tear" and had to quit swimming. John Smith Core - your abs, back, and legs basically. Lots of pilates type stuff. There's a ton of stuff you can do with the swiss balls/those big workout balls - ab work, planks on your elbows if you shoulder hurts to do them on your hands - or knees and elbows. Strengthening your legs especially your quads and hammys. Working on things like posture. I know my tear was small and it took a few months out of the water (even kicking hurt - even with my arms at my side) and three sessions a week with a shoulder guru before it was better. I had a PT that's a swimmer look at all 4 strokes and tweak them to take the stress off of my shoulder. Building core strength will help a ton. If you have more questions I'm sure others (or I) can clarify/help.

I had labral tearing and a SLAP lesion diagnosed with an arthrogram. As I've said in other threads, before the diagnosis, I used ART (www.activerelease.com) and PT to keep it under control, but the pain always flaired back up. What worked best for me was getting four PRP treatments (plasma regeneration therapy, see www.treatingpain.com). Now, I'm pretty pain free IF I baby my shoulder, do my RC exercises, lift weights, and don't get overly stupid with 100 fly sets (which I did recently, idiot that I am). Lifting seems to have helped a lot; my ART doc says my shoulder muscles are not sheer mush anymore. However, insurance companies won't always cover PRP, as it's a relatively new treatment and quite expensive. You have to be a pain in the ass to get it covered. GoodSmith, don't quit. Get treated!

- it does not heal on it's own - ever ! Without surgery, you are basically trying to build all the muscles around that area to help you not feel the tear or to use your muscles in a way that the tear does not affect you. The tissue itself is closer to a ligament - so it does not heal on it's own. I didn't have any luck with PT either. But PRP involves actual regeneration of the injured tissue and ligaments using your own blood platelets, which are injected directly into the effected areas. Many professional athletes use it.

I had a SLAP tear and didn't have surgery. (Natalie Coughlin also tore her laburm and I think rotator cuff and didn't have surgery) LOTS AND LOTS AND LOTS of core work. You can definitely do it - I would suggest taking time off of swimming and just kick while you are rehabbing at least for the first 4-6 weeks. I found that through rehab and tinkering with my stroke to make it more from the core that I was able to come back pain free. You might want to find a knowledgeable coach or PT that knows swimming and have them review your stroke and see what changes can be made to take the pressure off of your shoulder. Define "core" work please. I am also suffering from a "slap tear" and had to quit swimming. John Smith

A few years ago I thought I had a labral tear, but the MRI was negative. However, without an arthrogram a small tear could have been missed. Anyway, my orthopedist recommended six months of PT before considering surgery. After about six months of daily RC exercises my shoulder began feeling better. I did not take any time off from swimming. No pain or clicking now.

I also had a SLAP tear in my shoulder and I did have the surgery - I did a lot of research on this and have talked to quite a few people about this -- here is what I came away with - - this stuff is very difficult to diagnose - even with good MRIs (contrast) - they told me I had a labrum tear and a tear in the long head of my biceps tendon (that is a death sentence for competitive swimming) - when they went in, the biceps was fine - it does not heal on it's own - ever ! Without surgery, you are basically trying to build all the muscles around that area to help you not feel the tear or to use your muscles in a way that the tear does not affect you. The tissue itself is closer to a ligament - so it does not heal on it's own. - recovery with or without surgery is totally different from case to case -- I have talked to people that never got full range of motion back with the surgery and I have seen people swim meets 4 months after surgery (Nick Brunelli last year). Some people get help with PT only amd some people (like myself) feel no difference at all. If you do the surgery - - the rehab people are as important (or more) than the surgeon. Find somebody that understands swimmers and the range of motion our shoulder needs. Personally - my rehab after surgery was long and almost hopeless at some point :badday:. I finally got better when I let the shoulder be on it's own for 6 months - but now I am swimming faster than before :D

I'm not in the market for this (yet) but will keep an eye on it. It reminds me of a treatment a guy I work with got for his knee. I forget the specifics but it involved tissue or cell harvesting/culturing of some kind to replace some of his knee cartilage, possibly using non-embryonic stem cells (I forget the exact details), and was a less invasive and better outcome option than conventional surgeries. I didn't have any luck with PT either. But PRP involves actual regeneration of the injured tissue and ligaments using your own blood platelets, which are injected directly into the effected areas. Many professional athletes use it.

I had (still have) a SLAP tear and did not have surgery. Shoulder surgery is a nightmare and there is no guarantee that you get back to a 100%. The thing about PT on a shoulder is that it TAKES LOTS OF TIME to get better. Give your PT several months before making a decision. At least six months. It only takes a couple sessions with a therapist to learn the exercises; once you do, do them every day. You also need to focus on posture, core, sitting position, sleeping position, all those little things make a huge difference. And when you get back to swimming, take it easy at first and learn to swim with your back muscles rather than your rotator. Again, give your shoulder and PT a lot of time before making a decision. I seriously thought about surgery, but am really glad I waited.

I had labral tearing and a SLAP lesion diagnosed with an arthrogram. As I've said in other threads, before the diagnosis, I used ART (www.activerelease.com) and PT to keep it under control, but the pain always flaired back up. What worked best for me was getting four PRP treatments (plasma regeneration therapy, see www.treatingpain.com). Now, I'm pretty pain free IF I baby my shoulder, do my RC exercises, lift weights, and don't get overly stupid with 100 fly sets (which I did recently, idiot that I am). Lifting seems to have helped a lot; my ART doc says my shoulder muscles are not sheer mush anymore. However, insurance companies won't always cover PRP, as it's a relatively new treatment and quite expensive. You have to be a pain in the ass to get it covered. GoodSmith, don't quit. Get treated! I have been seeing an ART specialist once a week, but the pain and range of motion has leveled off and is not getting better. This is a really frustrating injury. I am about ready to follow ehoch's and other's advice and just get surgery. It doesn't sound like I have much to lose at this point. I am already unable to swim. John Smith