UKC

I have recently been diagnosed as having a SLAP Tear/Lesion following MRI scan. The injury is a result of a trauma in January - bouldering indoors. Pain is mild at present and the specialist has advised surgery should it get any worse. It won't repair without surgery, but may not get any worse. The surgeon has ok'd climbing for the time being - but to avoid anything that irritates. Climbing seems to be fine - weights, campus etc are not. I'm planning on keeping an eye on it with a view to possible surgery in Sept/Oct.

I'm interested in any "others" who have had this specific injury and their experiences.

Cheers

Rich

In reply to richard kirby:

Sorry to hear

I am starting to suspect my SIS is something more sinister like a SLAP tear.

I don't have anything helpful to add (sorry), but have a few questions. My (private) physio has told me it takes ages to get an MRI scan done on the NHS but private scans cost the earth. This is compounded by the fact that he claims MRI scans are often unreliable at diagnosing SLAP tears. My other worry is that I don't have insurance and couldn't afford to have the surgery done privately. Are you going the NHS route (I can just imagine the waiting list) or private?

In reply to Jenn:

yep SLAP tears often don't show up in a standard isometric MRI, really need a dynamic MRI but the machines are rare in the UK (esp NHS).r last piece of gear

As far as prognosis,it's affects can be related to a very specific movement.. You may be fine climbing for months and then 10ft above your last piece of sketchy gear, have to make a specific move and then...... eugh

In reply to richard kirby:

Hi Rich, I'm in the same boat as you. I have to go see a shoulder specialist at the Wrightinton Institute and doc said it'll need surgery to repair. I've had mine for 2 years though and it gives me no end of troubles; climbing, karate, drawing, so I think mines at the stage where it needs sorting. It'll stop me climbing for about 6months but once it's done it's done...that's omething to look forward too.

Regards,

Mike.

In reply to richard kirby:

There's also an entire forum for people with SLAP tears: http://slaptear.com/component/option,com_fireboard/Itemid,23/

Good luck!

In reply to Jenn:
Mmm, cheers


I was lucky enough to go private (cover thro' work). Prior to the scan the Surgeon said they were 75% reliable/accurate. However, he was very confident on seeing the scan results that it was a SLAP. I guess it depends on the clarity of the imaging & whether you managed to remain motionless. I'm guessing here.....

The guy I'm seeing has a really helpful site- may be worth a look;

http://www.shoulderdoc.co.uk/article.asp?section=15

Good luck.

In reply to idiotproof:

My physio did mention something about a dynamic MRI. I believe there is a private one in London, but is cost prohibited for me.

In reply to richard kirby:

Thanks a lot for the info. I'm off to see my physio again tomorrow. Hopefully he'll have some more insight as to what I should do.

In reply to Jenn:

Get an MR arthrogram. 6 week wait in Manchester, once referred. Although you may need to see an orthopod before getting one requested.

In reply to richard kirby:

Keep talking people - I have an exam on shoulder injuries (in particular tears of the glenoid labrum) in a month. This way I can revise and be on UKC at the same time :0)

In reply to TeaGirl:

Good> So what do you know? - Be liberal with your knowledge.

Mine is a tear from 11o'clock - 2 o'clock.

Is it likely to get worse if I continue climbing?

What is the success rate in surgery?

Once repaired is it likely to tear again?

Keen to know as much as possible before I make any decisions.

In reply to richard kirby:

Eeek - I'm not a surgeon! But I'll tell you what I've learned for the exam... There isn't much research into SLAP lesions healing on their own - appropriate ROM, strengthening and proprioception exercises may reduce symptoms, however many patients often only find overhead activities uncomfortable as this aggravates the injured area so climbing is either best avoided or should be limited by pain, depending on how large the tear is. Do you know its severity? If it's a type I or III lesion it may be arthroscopically debrided. Type II and IV lesions often require the labrum to be surgically anchored back onto the glenoid - this requires protected healing time. Any procedure will require rest to allow the repaired tissue to heal without being placed under stress before careful rehab to gradually increase stress until full use is regained. So surgery would definitely stop you climbing for a while but may have a better long-term result.

In reply to TeaGirl:

Additionally if you have previously dislocated your shoulder or have generally lax ligaments surgical outcome is generally not as good and re-injury rate higher than if this is a one-off and caused only by the traumatic injury.

In reply to richard kirby:

What is a SLAP tear?

I've done something to my shoulder which means that i can't raise my arm above my shoulder without large amounts of pain and some strange contortions to allow movement.

not sure how i did it, but i can boulder fairly well, but can't lift pans and things. its getting very irritating as it niggles all the time.

In reply to canadiankate:

It's a tear of the glenoid labrum (rubber washer type thing which deepens the 'socket' part of your shoulder's ball and socket joint). It stands for Superior Labrum from Anterior to Posterior (ie it's at the top from front to back). Get your shoulder checked by someone who knows - there's a range of strength and range of movement tests that can identify the injured structures.

In reply to TeaGirl:

Off to see the surgeon for another chat in a week or two. He's on leave at present and rang me with the results. It's difficult to come up with all the Q's you want to ask when your on the phone. I currently know little else other than its fairly large and 11-2 O'clock. Your comments are useful if only to give me some ideas of more specific Q's I need to ask him

Thanks anyway and good luck with the exams.

In reply to TeaGirl:

I know i should, but its a total nightmare to get to see anyone and my GP is useless. its starting to move sans pain now, but i find after warming up loads and loads moving it the way that it really hurts helps. It hurts to begin with and then after a while the pain isn't so bad. I think its just very tight muscles or summat.

If it hurts in 6 months time, then i'll go.

In reply to richard kirby:

Thanks. Hope you have a speedy and full recovery whichever treatment route you go down and get back to climbing as soon as possible.

In reply to richard kirby:
Sorry to hear that Rich. I imagine you're sorted for medical advice but shoulderdoc seemed helpful when I had rotator cuff pain, except that it started improving with physio alone . Didn't Ewon have the same problem?

In reply to richard kirby: Ok - If it is a SLAP tear, it won't get better on its own and will require surgery. If your tear is anything like mine, you'll be getting limited pain pulling down but more pain doing anything 'palm up', like underclinging as often the tear occurs where the long head biceps tendon attaches to the labrum. If this is the case you should be careful not to pull hard in such a way as you could detach the LBT completely. Holding something at arms length where the hand is rotated sideways can often hurt too.

I went through a couple of months of physio (whilst in denial) and I am having surgery on mine at the end of May. I am informed that it is likely I will be in a sling for up to 4 weeks and rehabilitation will means 6 months out. However, the surgery has a 90% success rate and it his extremely likely you will return to full strength. I have received some very positive anecdotal evidence to this effect from a couple of the guys on UKB who've been through it already. I'm told that the projected recovery/rehab times qouted are more for an 'average joe' and it iss often much less for an active sports person. On the whole I am very confident and whilst its gonna be hard work, I'm looking forward to having a fully functioning shoulder after struggling with a niggly, painful one for over a year.

Also, if you do elect for surgery, there is much pre-habbing you can do to make your rehab easier-Mail me if you need more info. Good luck!

In reply to canadiankate:
Some stuff on 8a.nu-goto forums page click on dr8a....Possible injury inducing moves described moves to think about.I wish boulder prob setters would take this on board..you know dyno shouldery 1 arm finishes may look dramatic but they may cause injury as well-i guess thats another story though.

In reply to richard kirby:

Hi Rich,

I had (or still have) exactly the same injury, confirmed by MRI (in 2004). Again the risk with surgery was that it could make it worse so i didn't go that route either.

I had a cortisone injection into the shoulder (which was extremely painful) and then did the std exercises over the next 6 months and things started to improve.

However, I had quite a long lay off from climbing as it was simply too painful to climb. A quick look in the log book shows that I did it in June 04 and only climbed 2 routes between then an March 05 - 9 months)

Anyway, I can climb now but it still hurts a lot at times. If i was less lazy and actually did the exercise regularly then I'm sure even this would disappear.

Chris.

In reply to chris sm:

I had a SLAP lesion in '94. Shoulder anterior dislocated. Dislocated again a year later. Had surgery (Bankhart repair). 7 years in the Army no problem. Been climbing and active ever since. I was early 20's when I had it done. Prob about 6 months all in for rehab back to full strength.

Osteopath now so understand anatomy & treatment. My personal opinion is if you can afford surgery (time, money, inconvenience etc) then it's worth it in the long term. You will otherwise always have a weakness and when your shoulder is externaly rotated and flexed ie. climbing type positions it will be vulnerable. If you excellent rotator cuff and phasic muscles e.g. lats this will help but it only takes a slip and being caught off guard...

Continue research and try to get opinions from suitably qualified specialists. Good luck.

In reply to chris sm:

Hey Chris

You good?

....if it's a SLAP tear, from what I can tell no amount of exercises are gonna make it disappear? It needs re-attaching. Are you thinking that the muscles/tendons etc surrounding shoulder will be stronger and thus more stable.......

Anyway, touch wood -mine is pretty good and feels stable with soreness after burley stuff...so may leave it and consider surgery should it get any worse. It's not stopping me doing hard stuff - just can't really do risky training (campus etc). Wall training on routes seems fine and thats what I've always done up until this winter.

In reply to richard kirby:

Yeah, exactly, it's the symptoms that will disappear.

When I actually do the exercises regularly, the whole shoulder is more stable and the pain drops (to nothing). If i do lots of sport climbing (and bouldering) and no exercises then it becomes very painful, "clicky" and unstable.

.... unfortunaly, I'm in the latter phase at the moment! But nothing a summer of sedate trad climbing can't cure...


Very good thanks. Licking wounds after a brutal day on Northumberland Sandstone over the weekend......

See you around!

In reply to richard kirby:

I was diagnosed last year with a SLAP lesion, I saw a Mr Leonard Funk privately and was then referred onto the NHS, I had an MR arthrogram which did not show up the SLAP lesion. I ended up having the operation, upon waking up I was told that I had in fact torn my supaspinatus (rotator cuff) and they had pinned it back into place. I have since had a 99.9% recovery.


I was told by a number of specialists that a SLAP lesion (as well as rotator cuff tears) will not self heal. climbers tend to work through pain and find other ways of mobilising their shoulders.

Leonard Funk has a very good website www.shoulderdoc.co.uk, it explains in detail, injury issues and shows photos of gruesome looking operations.

If you have an operation you will have to take about 3 months off climbing - this might seem bad now but believe me it is better in the long run - I speak from experience of other injuries I have ignored

Good luck with your decision making.

Chris

In reply to Chris Gore:
So does this mean you're back climbing, or are you still king of the triathlons?
I believe Rich has already been to see Dr Funk (and presumably Sister Disco).
I'm sure if I went under the knife they'd find very little holding anything to anything else...
See you on the Lime?

Arran D.

In reply to Chris Gore:


Hi Chris

Yep..Len Funk, same guy I'm seeing. So, did Len Funk do the Op but on the NHS or was it someone else?

......and are you saying that len Funk initially diagnosed a SLAP lesion and following that the surgury actually revealed rotator cuff. I'm just wondering how reliable his diagnosis of me is - he's told me it is SLAP lesion. But following your comments I'm starting to doubt the accuracy of his diagnosis.

Mmmm, I guess its irrelevant as sooner or later I will need to have the Op which will reveal the true nature of whats going on.

How long after diagnosis did you have Op? Did you keep climbing following diagnosis

..and if so...what sort of standard were you climbing - trad/sport?

Cheers

R

In reply to richard kirby:

Off topic by a long way, but I was a student when Mr Funk was a registrar; we revered him for having the coolest name in the hospital. Glad to hear he's going strong!

In reply to richard kirby:

Rich,

It sounds like he has seen the SLAP lesion on the scan whereas nothing in my shoulder showed up on the various scans. It was just all the symptons I had, presented as a SLAP lesion. However all this meant was that I got one extra hole in my shoulder!

I did my shoulder, bouldering (repeatedly failing on the same move) but I was doing alot of swimming at the time which compounded the situation. The injury occurred in Easter and I had the operation in January the following year. It was carried out by Leonard Funk and also he followed it up after I came out of surgery to let me know how the operation had gone and a further consultation 3 weeks later, all on the NHS. To be honest I think they might have forgotten about me as there is only meant to be an 18 week wait from diagnosis!

I did keep climbing and it didn't really affect my standard except for specific moves which were too painful. At the time I was climbing about 7b nothing too hard or powerful. My body is very used to this grade so I don't think it was to much of a strain but if your pushing your limits it might be a bit more of a problem.

Hope that's of some help

Chris

In reply to Serpico:

Hi Arran

Yes I am climbing but only indoors so far this year, I might be agrophobic! besides someone told me climbing outside was dangerous.

No more triathlons, if you think you get injuries from climbing, triathlons are another world of pain

Hopefully see you out there

Chris

In reply to Chris Gore:

Great, thanks for posting Chris.

The whole deal looked pretty bleak to me a few weeks ago with the depressing thought of potentially not being able to continue climbing at my current level. I certainly feel a lot more positive about the likely outcome of surgery should it be necessary.

Cheers

Rich