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SLAP Tear of the Labrum - Surgery or Physical Therapy?


Original Post
Ryan Hill · · Oakland, CA · Joined Dec 2009 · Points: 30

About three months ago I suffered what has now been diagnosed as a SLAP Tear of my left labrum (specifically a Type II tear).  I've gone through an MRI and a discussion with my doctor, but interested in hearing what experiences other climbers have had.  Right now I have two options, 1) surgery and 2) physical therapy.  Currently I am taking option 2 with the ability to decide on surgery later down the line.  After 3 months of recovery I am climbing a few letter grades below my pre-injury level.  Strength is down, but I have most of my mobility recovered.  Some daily chores and movements are uncomfortable, but overall I have all my occupational ability from before the injury.

What I'd like to know is if you've chosen to have surgery or abstain from it and what type of experience you've had since then.  Also, if you've had surgery or PT in the San Francisco area and have someone you'd suggest I'll happily take suggestions.  

Finally, the prognosis for recovery post-surgery is good (my rotator cuff and all surrounding muscles/tendons are in good shape), but it seems like recovery will take about 4 months with no climbing and heavy focus on PT.  Is that a typical amount of time for recovery?  Is it possible to have a more aggressive recovery schedule?

Thanks for any insight...and yes, I'm gunna die!  

Jason Halladay · · Los Alamos, NM · Joined Oct 2005 · Points: 11,788

I incurred a SLAP tear in my left shoulder in 2009 doing a very shouldery move climbing. I opted to go with PT and strengthening and so far it's still holding up well (I'm climbing as hard or harder as I did before the injury.) It was quite weak for a couple of months post-injury and occasionally it annoys me and feels like something "is out of place" in there but relaxing and/or laying on the bed face down with my arm hanging off the edge for a bit gets me set again. In short, I wouldn't jump to the surgical option and would try PT/strength work for a bit. 

Re: surgical recovery time, 4 months sounds quite fast for a SLAP tear surgery from what I've read but I have no direct experience with it. I tend to think 6 to 9 months, maybe a year, for recovery for it. 

Ryan Hill · · Oakland, CA · Joined Dec 2009 · Points: 30
Jason Halladay wrote:

I incurred a SLAP tear in my left shoulder in 2009 doing a very shouldery move climbing. I opted to go with PT and strengthening and so far it's still holding up well (I'm climbing as hard or harder as I did before the injury.) It was quite weak for a couple of months post-injury and occasionally it annoys me and feels like something "is out of place" in there but relaxing and/or laying on the bed face down with my arm hanging off the edge for a bit gets me set again. In short, I wouldn't jump to the surgical option and would try PT/strength work for a bit. 

Re: surgical recovery time, 4 months sounds quite fast for a SLAP tear surgery from what I've read but I have no direct experience with it. I tend to think 6 to 9 months, maybe a year, for recovery for it. 

Thanks Jason.  That is more or less where I am right now.  Glad to hear that forgoing surgery is a viable option, at least for now.

I'll look around for recovery times, but have no reason to distrust the number I got from my doctor.  We started talking climbing and it sounds like he has a good amount of experience performing this procedure on athletes and active people in general.  

Logan Anderson · · Central ND · Joined Aug 2015 · Points: 155

I suffered a tear of the right shoulder labrum playing football in high school, I underwent intensive PT for two months and had good strength and capability but less range of stable motion and my shoulder was unstable under load and had a tenedency to disloacate easily plus it was sore after moderate movement . I chose to undergo surgery and after 3 months had most of my range of motion back and my strength was better than pre injury levels with no pain and most of my full range of motion. It all really depends on your personal feelings of how good your shoulder is with only PT.

Also try exercises that strengthen the small stablizer muscles of the shoulder, they help awesomely.

Mark Verosky · · Columbus, Ohio · Joined Feb 2017 · Points: 20

Suffered a SLAP tear during high school baseball. I went down the PT path for about 8 months and continued to pitch until it became so excruciatingly painful that I decided to go down the path of surgery. What I can comment from this expierence only relates to overhand throwing because I was not climbing at that point in my life. Although, in my opinion, pitching is more strenuous on the labrum and shoulder joint than climbing.

The recovery was long and painful. It took me about 4 months post op to start throwing a baseball again (light tosses) and 8 months for full speed throwing. After 1 year I would say I had about 85% of my strength back but that was dedication to some pretty stringent training. Took about 18 months to feel like "nothing ever happened"

The biggest downside of getting surgery (in my opinion) is that you seriously baby your arm. You are afraid to use it, it takes a little while to get yourself out of that mindset. For me it took18 months because every time I threw a baseball I felt like I was going to blow out my arm again since that was how I hurt it.

Looking back, surgery was right for me. It allowed me to get stronger after the fact and I have no pain at all in that shoulder anymore. I am well beyond the strength I had pre op and if it wasn't for the scars I would honestly forget I had surgery. But is surgery right for you is honestly up to you and your end goals in climbing. If you're just trying to have fun with climbing and your shoulder doesn't hurt all that much aside from pushing your grade. I'd say maybe decide against surgery. That's a decision you'll have to make after a few months of PT. But if you're dying to train and get your grade up and your shoulder is killing you, surgery may be the only path.

Hope this helps a little!

Lena chita · · Cleveland, OH · Joined Mar 2011 · Points: 250

PT should be the first-line response pretty much always... even if you end up doing surgery later, the stronger/more balanced your shoulder is before surgery, the better the recovery would be.

SLAP tear is one of those things that could go either way. Plenty of people walk around with a SLAP tear, and don't even know it. Plenty of climbers have it, and see only occasional twinge, or maybe need to baby the shoulder a bit, and stay on PT regimen long-term.

I did PT for about 6 months after I was informally diagnosed with SLAP tear (didn't get a formal diagnosis until 3 months after the injury, because that is the reality of MRI, etc). I was able to climb with SLAP tear, and even climb pretty well, as long as I avoided certain shouldery moves. But decided that the constant recurring pain was not worth it, and opted for surgery.

It was a good decision for me. Going in for surgery,  I was told no climbing for about 5-6 months post surgery, but at 3.5 months checkup the Dr said I could try climbing ,as long as I started out slowly and carefully. The recovery curve was pretty steep, once I started climbing again, and I was pretty much back to normal/recovered to pre-surgery level of climbing at 7 months. I was doing intensive PT for that entire time.

Guideline #1: Don't be a jerk.

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