# Shoulder Recovery and Surgery Advise



## davec113 (May 31, 2006)

I damaged my shoulder ~18 months ago fairly badly, most muscles were torn, labrum torn, bicep tendon subluxed, but no surgery. A couple months ago reinjured it with a small SLAP tear, type 2. This is a tear of the labrum where the bicep tendon meets it. 

I think it was inevitible as the bicep tendon was subluxed, or moved from it's groove, and hence would become inflamed. 

PT was going well, then I decided to take some time off weights and let my body adjust and bicep tendon calm down, I did more yoga, and when I went back to the weights I thought I eased back in and unfortunately it looks like this is what caused the tear. 

It's been 8-9 weeks and inflammation has just went down in the last week or 2, now I have a surgical consult coming up. The issue is now that inflammation is down should I give my body time to heal or get surgery to repair my labrum and put the bicep back in tendon back in place?

MRI impression off the area was "Interval development of moderate long head biceps tendinopathy with interstitial tearing.". "Small Type II SLAP tear, new since prior MRI.". "Interval partial healing/scarring of prior high grade teres minor tearing. No new rotator cuff tear. Mild infraspinatus and moderate teres minor muscular atrophy."

I can also say my bicep and deltoid atrophied but are now seeming to recover. Bicep stays sore all the time but may be improving and recovering to some extent. 

If anyone has any advise or anything to add please do!


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## pedromayall (Jun 12, 2013)

Well, since I first dislocated my left shoulder it never fully recovered. It only got worse, for everytime I crashed hard it dislocated again and the tendons and the rotator cuff were in the end ruined. I had a surgery back in may, fully reconstructed the ligaments and the shoulder is fully healthy now. I´m riding again since last october. I could havebeen spared a lot of suffering if I had the surgery sooner. Not saying you should operate your shoulder as soon as you can, but if your doctor says you should, I think you would do well to comply. Good luck!


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## Jp716 (Aug 19, 2016)

(Disclaimer: I'm not a healthcare professional, but am recovering from a similar injury (grade 2 tear, 16 weeks since surgery).)

Unfortunately, labrum tears will not heal without surgery to reattach the labrum. Depending on the severity of the injury, your shoulder can still function w/o surgery, but it's not going to be as strong or stable as prior. 

My doc recommend surgery based on my age and lifestyle, even though I was able to ride and workout after inflammation from the initial injury subsided. The recovery isn't exactly quick or pleasant, but I'd like to think I'll be better off in the long run. I was able to start riding gravel/fire roads at about 16 weeks, though it will be close to 6 months before I can ride singletrack.

I'd recommend following through with the consult, and maybe getting a second opinion as well. If you have any questions on my experience, feel free to ask, and good luck!


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## davec113 (May 31, 2006)

Thanks for the replies. 

I have the surgical consult on Monday... 

Things have gone really well in the last week or so, my muscles are recovering very quickly and don't feel as sore... and what's interesting is the inflammation of the bicep tendon hasn't returned, even after doing PT. I'm not trying to max out on curls or anything of course but doing a regular workout combined with lighter band exercises for injured parts seems to be fine. 

Another thing that happened, twice, is an overexertion of the bicep that felt like it was injuring it but ended up helping it improve... one was on my bike avoiding a crash and the other lifting weights. Both caused soreness and bruising, in fact the bruising is just going away now, but after a couple days there ended up being a large net gain. 

Also, I have been taking low-ish doses of ibuprofin and using topical solutions that contain cannabinoids. Mary's Medicinals CBC transdermal compound and Elite CBD Muscle Freeze. One side effect is a cyst on my arm on the bone right below my deltoid has shrunk to about half it's size. It's been there for many years and after a week of topicals it shrank. It hasn't gone away but I'm hopeful it will. 

It'll be interesting to see what the surgeon has to say. It seems they are moving more towards avoiding surgery at this clinic, which is Steadman Hawkins in Denver, they have an excellent rep so I'll probably just go with their recs. If surgery ends up being the right way to go hopefully I can wait until fall.


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## davec113 (May 31, 2006)

Diagnosis was "Elway Arm". Turns out my long head bicep tendon had completely ruptured, which is why it wasn't inflamed anymore. 

This leaves me with "popeye" arm, and a bicep with only one top attachment point, but is what the surgeon would have recommended for my case anyhow. He said they don't repair this anymore unless you're under 25 y/o. 

Surgeon said my strength and range of motion were excellent, so we will look at how it's doing in a few months and potentially clean out any scar tissue or whatever. I do have a small catch in my arm so there may be some trimming needed but other than that I guess I'm good to go.


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## pedromayall (Jun 12, 2013)

davec113 said:


> Diagnosis was "Elway Arm". Turns out my long head bicep tendon had completely ruptured, which is why it wasn't inflamed anymore.
> 
> This leaves me with "popeye" arm, and a bicep with only one top attachment point, but is what the surgeon would have recommended for my case anyhow. He said they don't repair this anymore unless you're under 25 y/o.
> 
> Surgeon said my strength and range of motion were excellent, so we will look at how it's doing in a few months and potentially clean out any scar tissue or whatever. I do have a small catch in my arm so there may be some trimming needed but other than that I guess I'm good to go.


Great, man! It seems you will be slaying trails soon.


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## davec113 (May 31, 2006)

pedromayall said:


> Great, man! It seems you will be slaying trails soon.


Just got back from a ride... 

After the SLAP tear didn't get better I rested it for a bit but that only seemed to make the atrophy worse, so I started doing light exercises. After it fully ruptured it was feeling better within a few days so no downtime at all. I'm still not as strong as I could be but it's been less than a month since my muscles were atrophied, strength is coming back surprisingly quickly.


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## pnwskiandbike (May 10, 2019)

Looking at how people handled their injuries. Lots of good info / opinions. I got a particularly difficult decision, as I have both clavicle fracture (end is crushed in many pieces), and fully separated AC (grade 3/4). 

Surgeon says "if it will heal", in discussing both surgical and non surgical options. He is 50/50 on doing surgery and says my best bet may be to go non surgery and let it heal as a 'ball' out of place. He says he has about 4mm to get a screw into on the top portion, and it may not take. Let alone get through the remaining fragments. He says he may just out the fragments and leave me with a short collar bone, while surgically reconnecting AC. His concern is the fragments not healing in either surgical or non surgical option. 

Wondering if anyone else had both clavicle fracture and AC separation. 
Of if there is any input to make this a easier decision. Thanks !


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## davec113 (May 31, 2006)

I'd consider getting a 2nd opinion. 

Sorry I don't have anything else to offer, but good luck! ...and after going through a few injuries I'd say that persistence in doing rehab/pt/working out and being active in general is very important.


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## davec113 (May 31, 2006)

davec113 said:


> Just got back from a ride...
> 
> After the SLAP tear didn't get better I rested it for a bit but that only seemed to make the atrophy worse, so I started doing light exercises. After it fully ruptured it was feeling better within a few days so no downtime at all. I'm still not as strong as I could be but it's been less than a month since my muscles were atrophied, strength is coming back surprisingly quickly.


To update the thread, which I forgot about... 

I had an MRI done about 2 months ago, so about a year after the tendon rupture, and there were some interesting findings:

- My near-fully-torn rotator cuff muscles (Superspinatus and Teres Minor) are now near fully recovered and the MRI no longer shows a tear, just slight atrophy. I can feel these muscles still healing and getting stronger and I think it's been external rotations horizontally and vertically, using bands for resistance about 2-3x week or so that have achieved this. The surgeon did not think this would be possible and the muscles would not recover, but other back muscles would make up for it... he was very surprised to see the MRI results.

- The long-head bicep tendon that ruptured did not fully rupture and there is still some pulling at times, it's not painful but it may let go at pretty much any time. The tendon on the top side is somehow back in it's normal groove and the bottom where it attaches to the muscle is where it tore, but it's still kinda attached. No pain, but obviously not totally ideal. If it does go all the way it should just be sore for a day or two so there's really no point in doing surgery to cut it the rest of the way.

- There's still a small catch/pop when arm is straight out to the side and overhead, then moved down with elbow locked. Just slightly flexing the elbow avoids this, so it seems 100% avoidable in daily life. Again, surgery to fix something I never really notice seems like a bad idea.

- Slightly restricted ROM vs right side, but very slight.

- A minor "cleanup" surgery is recommended for the best possible long-term outcome with short recovery, but I can wait until next winter no problem... this would also likely fix the catch/pop.


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## Radium (Jan 11, 2019)

Davec, that's very encouraging news to someone who is in a similar boat.


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