Thread: Circumfrential Labral Tear

I have a near complete tear of my labrum and I am having surgery in a few months to repair it. Can anyone shed some light on what recovery is like for something like this? I know the first month is no movement at all, and the next 3 are basically no lifting anything after which I can resume normal activity. Is it going to be a year before I could expect to do even a push up? I was also told to expect some loss in range of motion due to the extent of my injury, anyone have any experience with this?

I had a labrum tear and under went a very invasive procedure to repair it (Bankart repair). The doc basically filleted my pectoral muscle (~4" wide) and dug into the pocket and fixed me up. Not sure if yours will be that extensive, but it took about 6-months before I could really work it.

If it sounds similar I can share more. I was dislocating my shoulder a few times a week with lots of pain, so the repair albeit painful for the first couple of weeks of recovery, was really worth it in the long run.

Im seeing supposedly one of the best shoulder specialists in Boston and he will be repairing the tear arthroscopically, so I am assuming my recovery wont be as bad seeing as the procedure is less invasive as yours was. Sounds rough though, how did you tear it?

Long thread on shoulder injuries and recovery here:

http://tetongravity.com/forums/showthread.php?t=29192

I tore my labrum in 2003 and had arthroscopic surgery. I forget the specifics, but the term "Bankart repair" did come up. Maybe that's one of the things that I had done, or maybe it was the "this is what you will get if this don't work" option.

Rough timeline of injury/recovery

September 03 - Dislocation = ouchie....

October 03 - Knife time
- Sleeping sitting up
- Percoset for the first few days, then nothing

November 03 - Sling comes off, arm feels very very fragile. PT starts

Nov 03 - April 04 - Sitting on my ass, playing computer games, going to PT. PT sucks, but is very necessary. I go skiing once in March and ski very conservatively. My PT guru is worried, but approves the trip.

Late April 04 - May 04 - Start climbing again. I can no longer do a single pull-up. I work my way back to that goal.

Late Summer/Fall 04 - Almost back to normal re: shoulder function

Winter/spring 04/05 - Feel back to normal re: shoulder function

So yeah... it takes about a year. It sucks. I'm sorry. Develop a video-game habit, read more books, and learn to love the life of a couch-potato.

Watch your self though - Ligments and other stuff take time to heal, it's a process that can't be pushed that hard. A friend of mine tore the crap out of his shoulder tumbling down a couloir in France. He gets it repaired, is the star student of his PT guru, and all is well. He's back climbing well before anyone expected and is doing great. Then one day he goes up for a dyno or something and tears it all out again.

Thanks for the insight - I think as long as I have some expectations set I can handle it. I also bought an Xbox 360 and Call of Duty 4 last month in preparation for this.
Its funny but everyone seems to mention a dislocation or specific catastrophic event, but I cant seem to pin point it to one catastrophic event, but rather a series of events that lead to my current condition...

Feb 2000 - Hard fall skiing with outstretched arm on vacation - pretty painful, couldnt raise my arm above my head but I skiied the rest of the week and pain subsided after a few weeks. Never saw a doctor. I think this was the initial injury, but It didnt seem like a dislocation to me, not as catastrophic.

Summer 2004 - Start getting into weight training heavily, notice that I tend to have some overhead stability issues when doing dumbell shoulder press - my shoulder seems to just give out on me from time to time, and my lifting partner decides its a good idea to wear steel toed shoes to the gym as long as I keep it up. I decide its just a strength issue and work on building up muscle around the joint in other ways, I eventually work through it. I also live with some clicking/popping in the joint from time to time.

Summer 2005 - Things have progressed well with weight trainging and I am really starting to move some heavy weight (for me) and Ive put on a lot of lean mass in the past year. I take a week off after some behind the neck presses resulted in severe pain in my shoulder, I decide to stop doing those altogether in the future. Heavy decline and flat bench are starting to result in lingering pain. I finally start getting long lingering pain post work out. I wake up in pain at night when I roll over onto the bad shoulder. My PCP says its just tendonitis and to take some time off. I dont do any presses for about 3 months.

Winter 2006 - Start back up and continue to lift without real incident. I stop doing wider gripped presses ( I have long arms) and start learning how to lift correctly for my body type with a narrower grip. I attempt to do some decline presses but it always results in instability and pain, so I cut these from my workout permanently. In retrospect Im assuming by this point I have a pretty significant posterior tear, and thats the reason for this. I never have a problem doing incline presses. I still cant do Dips and behind the back triceps presses like I used to, but I am regaining some strength.

Summer 2007 - By this point I am back to a normal spot. I still dont do decline, and I only to flat bench with a narrower than normal grip. I avoid dumbell presses because of stability concerns. I can do dips and triceps presses again. No real issues in the gym and I have learned to live with my stability issues and lift correctly for my body type. I dont do exercises that irritate or exacerbate my condition. Out of nowhere a day long canoe trip results in severe shoulder pain that lasts weeks and is not releived by normal pain meds. Somehow that paddling motion has awoken some demons. Im finally convinced this isnt just "tendonitis" and I make an appt to see a sports medicine dr. He works me up for an MR arthrogram which shows the circumfrential tear and a massive paralabral cyst that is likely impinging a nerve and causing some atrophy of my rotator cuff.

Since then I have had to stop most of my workouts, and Ive noticed as I lose strength and muscle mass, the joint is more and more susceptable/fragile. I think those years of weight training simultaneously worsened and masked my problem. In retrospect I wish I had learned about how to lift for my body type and that whats good for my stalky buddy isnt always good for me (i.e. heavy flat / decline presses, behind the neck anything ever). I would also have spent far more time building up the posterior deltoid and rotator cuff to strengthen the joint more prior to attempting those heavier presses that likely caused the posterior tear. Now when im in the gym I see other guys making the same mistakes, walking around holding their shoulders and it makes me cringe.

You have a labial tear? Sounds like you have worse problems than that shoulder, son.

I"ll chime in. I have open L labral repair surgery 9-6-06. It took 8 months for the beast to get back to 85-90%, rehab was a bitch...

I had similar experience, fall on outstretched arm skiing, then the crusher was a body surfing accident in Manhatten beach, then numerous dislocations.

I had the ortho in 95.

Here is my advice. the shoulder is a bitch to get right, the surgeon is super important, find THE best and one you are comfortable with. Knees are slightly less dependent and way more popular.

Consider an open procedure STRONGLY. Research shows that scoping on this type of injury is far less effective long term that open. It may take you 3 more months to rehab, but chances are you wont need it ever again.

Buy an Xbox, get gears of war for anger, tiger for concentration and tony hawk for drug stupors...

I beg to differ. The open Bankart repairs for anterior instability, which you (Fred had) can be moved immediately. My patients return to sports in three months.

My arthroscopic ones do not do as well as fast. Since the repair is not as stout, the patients has to sit in a shoulder immobilizer for six weeks. That stiffness needs at least five more months to be worked out.


The reported results from the proponents of of arthroscopic stabilizatons (meaning the redislocation rate) are just short of the tradional open approach. Metaanalyisis- the process of combining several scientific studies together has indicated that open surgery is superior to arthroscopic for this problem. My clinical experience, as well as what I have learned monitering these types of websites, indicates that the redislocation rate in surgeries done by the average private practice sports doc is many times greater than that. In short, the arthroscopic Bankart repair is sexy, everyone wants to do one, and have one. Its just that the Emperor is Wearing No Clothes.

Wait a second, this post is called "circumferential labral tear. If the entire 360 degrees is torn off, (something that I have only seen inside a book) an arthroscopic approach works best.

Originally Posted by drmark

Wait a second, this post is called "circumferential labral tear. If the entire 360 degrees is torn off, (something that I have only seen inside a book) an arthroscopic approach works best.

From the mr arthrogram report...

Glenoid labrum shows circumferential tear with mild displacement
of posterior labrum off glenoid rim, with associated capsular
thickening and mild stripping. This finding may be associated
with posterior glenohumeral stability. Articular cartilage of
posterior glenoid fossa shows degenerative change and surface
defects. Large paralabral cyst extends from the posterosuperior
aspect of the glenoid rim posteriorly into the spinoglenoid notch,
and measures approximately 3.5 cm in greatest dimension. Smaller
paralabral cysts involve the posterior labrum and extend
inferiorly. The anteroinferior component of the labral tear is
partial thickness and nondisplaced from the glenoid rim.

Thats alot of labral tear.
I would do an arthroscopy. If only a posterior or anterior repair was necessary, I would do it through an open appproach. The posterior approach needs immobilization following for six weeks.

If repair needed to be done on both sides, I would do it arthroscopically. Immobization for six weeks will also be necessary.

And that ^^^^ is why TGR is so cool.

Originally Posted by drmark

If repair needed to be done on both sides, I would do it arthroscopically. Immobization for six weeks will also be necessary.

Thanks for the feedback, its reassuring. The shoulder specialist is telling me four weeks immobilization, but I guess well find out when its all said and done. Sounds like I am case study material.

I should note I had a back issue as well that severely lengthened my rehab time, so my rehab time is not representative of normal healthy rehab times for open surgery.

I would tend to agree with Dr. Mark on the shoulder and arthroscopy in that there are plenty of Docs willing to operate but fewer with extensive experience and high functional outcomes. So get the GUY in your greater area shown for shoulders and his technique...I got on a plane to have my revision done

I initially went right to MGH Sports Medicine because my goal is to have this repaired so as to be functional again. I saw one of the team physicians for the patriots, red sox, and bruins, and after the initial workup he referred me to this shoulder specialist who has a background in repairing swimmers shoulders. I hope at this point I'm in the right hands.

They did mine arthroscopically and it was repaired to be able to continue to play baseball.

After immobilization the rehab started with holding a rod that they would pull on to get my range of motion back. Slow progress at first but youll be back at it before you even know it. I would say that 8 months after surgery is very possible to be back at it. DO YOUR EXCERCISES AND REHAB!!!! without doing it and more, you will be screwing yourself.

It even makes wiping yourself fun.

Originally Posted by Adam132601

It even makes wiping yourself fun.

This is the same type mentality that inspired me to take up tele skiing this year.

Hey there. I wish I'd found this board last year - as I have been struggling with sports-related shoulder injuries since last May and it's been quite a trial.

I am 2 months post-op from a 360-deg (full) labral tear following a water polo injury (5-25-07, L side full disloc) and then skiing injury (12-30-07, both sides full disloc). (<--- Yes there is a story here) I had 7 anchors reattaching my labrum on my left side, and will likely have to have surgery on my right ... someday.

When I asked if I might as well get them both done at once, my shoulder surgeon here in NYC said, no way. How are you going to wipe yourself? PLEASE, DON'T EVEN THINK ABOUT DOING THEM AT THE SAME TIME!

I have to say that the last 2 months has been pretty sucky getting around, doing stuff, and trying to work. I had my surgery on 1-17-08, the Thursday before MLK weekend, and went back to work (and stopped Percocet) 1-22-08. It was ROUGH. I can't even imagine having both arms immobilized. It was hard enough with 1 post-op surgery and one post-dislocation arm having to do everything. In addition to wiping yourself, think about dressing and eating. The recovery with 1/2 a working arm these last two months has been far more disabling than my initial recovery with 1 good arm last May. If I had to do it again I would have taken more time before going back to work.

FYI, I was supposed to start PT a month ago but due to work craziness, including travel that my dr. advised against (as he did the skiing), did not start until last week. It really sucks. So glad to find this board and hear about other people's recoveries. Right now, PT = physical torture. (Yes, I have forgotten how much it hurt post-op.)

SkiBumNH, when are you having your surgery? My dr. did it arthroscopically but he warned me that there was a chance he'd have to open it up. Luckily he didn't.

I am so thankful to find this board because no one I know here in person seems to know what I'm going through... including my orthopedic surgeon husband.

Originally Posted by kboo

SkiBumNH, when are you having your surgery? My dr. did it arthroscopically but he warned me that there was a chance he'd have to open it up. Luckily he didn't.

The countdown is on, April 10th. I've never had any sort of surgery before and Im starting to get nervous about it already. My surgeon has told me it will be done arthroscopically with no mention of open work. I've done all the research, and in my region, I am seeing "the guy" for shoulders. I am a traveling consultant so my employers and I have worked out a deal for me to be down for 4 weeks post-op during which Ill be working from home, and occasionally going out to clients when my girlfriend gets sick of seeing me and drives me to work (tough/illegal to drive a stick in a sling). Based on your feedback and others I'm planning on taking 5 days to bounce back from the initial surgery which would have me off any meds no later than tax day. I was told to expect a loss of a few degrees of motion given the size of the tear. Im not too bent out of shape seeing as my flexibility blows as is due to the injury, and my golf game couldnt possibly get any worse . Im big into weight lifting (part of my problem) so I hope to attack the PT with the same mentality, celebrating the small gains and improvements, and staying heavily committed to it. Everyone has told me that being religious about PT is the key to a quick and successful recovery. I feel that I've set some reasonable goals and expectations for myself (hoping to do a push up by december). I've been trying to think of ways that I can remain active during the recovery process - I was thinking recumbent bike at the gym may be a good way to get the heart rate up. If you've got any ideas please pass them along.

This was my first surgery as well, and I didn't really get too nervous until they were running through all the patient questionnaires and giving me the gowns to wear. Then it was too late!

I didn't drive - even an automatic - until about a month post-op. Also did not travel until about 5-6 weeks post-op. If you are traveling for business, very minor things, like - putting carryon into overhead compartment, getting dressed in clothes that aren't totally loose and stretchy, carrying/pulling luggage or a briefcase - are all very difficult. I wouldn't push it. On all my recent trips I either checked my baggage or only carried on when traveling with my (business) partner who gladly carried my bags for me and put them in the overhead. Then again, it sounds like you have 1 good arm, right?

That being said, it was the little things like being able to tuck my shirt in, and washing my hair on the side of the head that had the operation, and putting on deodorant and washing my pits, that had me really frustrated.

I came back to work - desk job, working on computer only - 5 days post-op. In retrospect I would have taken a little more or only worked partial days that first week. It's a lot to come off the percocet (I was too stoned to work while on them) and try to function at work and not get distracted by the pain. I found I was inefficient and that was frustrating to me too.

hey skibumnh, im having an open repair of a torn labrum the same day.
good luck!

Just a quick 1 handed update: 7 hours post op... nerve block still effective - no pain yet but i have started on the meds to stay ahead of the pain.
Surgery was a success, Ive got 5 anchors now and im looking at 4-6 weeks immobilization and a total 4-6 month recovery. More to come...

Best on ya - good vibes sent. I get my MRI read tomorrow at 2pm.

Glad to hear it went well

+++vibes+++ for the rehab - do the exercises even when it hurts, and be patient

So the findings are....

"There are no rotator cuff tears or underlying tendinopathy. The AC joing appears normal without degenerative changes. There is no evidence of a subacromial spur or os acromiale. The tendon of the long head of the biceps appears normal. There is no evidence of a SLAP tear. However, there is a minimally displaced tear of the posterior labrum which involves almost the entire posterior labrum but does not extend up to the posterior superior labrum. The bone marrow signal is physiologic. There is well developed muscularity [my favorite part of the report] without fatty atrophy or abnormal signal."

So day 2 was much worse... The nerve block wore off at around midnight last night and things got progressively worse pretty quickly. This was some of the worst pain ive ever experienced, totally unrelenting and unaffected by pain meds in the dosage I was prescribed. I found it impossible to achieve a seating position that provided any relief. I called my NP and she upped my dosage to help with the break through pain. This worked for me but resulted in nausea and vomiting - insult to injury. things are finally starting to get better now and im hoping that im getting through the worst of it. This blows, i don't know what i would have done without the block last night.