/ Shoulder injury "Avulsion posteroinferior labrum"

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steve-grigg - on 11 Jan 2017
Hi All,

Have just got the results of an MRI scan for a shoulder injury, the report back was "avulsion posteroinferior labrum right glenohumeral joint", basically a tear to the bottom and rear of the labrum.

It's looking likely the surgery will be needed. Does anyone have any experience of this particular injury? All can find online is the common types (SLAP etc.) however according to the orthopaedic surgeon it's a more annoying place to access, so i would assume longer recovery time/less likelihood of success.

Current plan is to continue with light climbing and physio for the next few months till i have an appointment with a specialist to assess if surgery is the best option at this time.

Rock to Fakey - on 11 Jan 2017
In reply to steve-grigg:
Did you have a private hospital MRI?... If so how much did it cost you?
steve-grigg - on 12 Jan 2017
In reply to Rock to Fakey:

No it was from the NHS.
stp - on 14 Jan 2017
In reply to steve-grigg:

You might find some info on Training Beta. The host, Neeley Quin, had a labrum tear and discusses it a fair bit particularly when talking with physios.
Rock to Fakey - on 24 Jan 2017
Rock to Fakey - on 24 Jan 2017
In reply to steve-grigg:
How's it going?

How long did you wait?.. . Give us as much info as possible please, updates would be handy too.

I'm not sure if many consider the nhs route so it would be great to see how it differs from going private.
I suppose waiting times will vary from one region to another, but bearing in mind you could be taking time off climbing for a fair while, perhaps it might not matter to some, especially as you'd probably realise you can now actually try catch up on lots of other stuff again!

I would recommend reading the link,... The bit about just anchoring a torn labrum compared to bicep tenodesis seems important.

There's about 300m of comments to downclimb too....

"Ok, so if you have a torn labrum, it’s often caused by your biceps tendon. Your labrum is like a golf tee for your shoulder. It’s a bunch of cartilage that gently cups your shoulder to keep it all in place. The labrum is connected to the biceps tendon, and since we use that tendon a lot as climbers, it gets pulled and inflamed and can tear holes in the labrum – or tear it right in half.

So some doctors will go in and just tack the hole back together with anchors and hope it doesn’t tear again. My doctor (and according to my doctor, all good shoulder surgeons) will at least consider biceps tenodesis, which is removing your biceps tendon from your labrum altogether and attaching it to your arm bone.

That’s what mine did.

Tenodesis removes the possibility that you’ll ever have impingement (of your biceps tendon going under your shoulder) again, or that your biceps tendon will tear your labrum further. So they drilled a hole in my arm bone, threaded my newly cut tendon through the hole, and anchored it with some sort of rod on the back side of my bone and a plastic plug inside the bone (I think).


But I don’t have to wait for anchors to affix themselves to my labrum, and I didn’t have to be in a sling for 5 weeks, and I’ll be climbing 6 weeks after my surgery, and I feel incredibly fortunate.

Now, if my labrum had been more severely torn, he would’ve put anchors in it – not sure if he would’ve also done the tenodesis. "
Post edited at 09:22
Rock to Fakey - on 26 Jan 2017
In reply to steve-grigg:

Regarding my post above on Neely's blog + the comments below it,
dec 14, 2014, Chandler and Neely discuss how tenodesis is sometimes not the best option.
Mike Highbury - on 26 Jan 2017
In reply to Rock to Fakey:
> dec 14, 2014, Chandler and Neely discuss how tenodesis is sometimes not the best option.

But you do end up with a bulging bicep, which is cool.
Rock to Fakey - on 26 Jan 2017
In reply to Mike Highbury:

Or a floppy one...
Rock to Fakey - on 26 Jan 2017
In reply to steve-grigg:
This is 1 year after surgery for Neely....


Some of the post surgery therapies sound absolutely fab...

"He’s a chiropractor, which comes in handy sometimes because he can adjust me like nobody else I’ve seen. But mostly he just puts me on his table and tortures me in a loving sort of way. He digs into the places that hurt the most with his hands, and just keeps digging until they don’t hurt as much.

And then it hurts less and I climb better. It’s excruciating, and I cry and scream a lot, but it’s completely worth it." 

Dry needling...

".. stick needles into the places that hurt most, move them around in the most painful way possible, then put an electric current into them so they hurt even more. And then there’s less pain. It is also excruciating and tear-inducing.
No pain no gain"

Can't wait... !
Post edited at 11:19
steve-grigg - on 27 Jan 2017
Hi Everyone,

Thank you for all the advice and recommendations, sorry for the delay in reply, I'm a bit naff at checking them.

I have had a look at the article, and intend to read down through all the comments when i have a chance, it seems that most people have the SLAP tear and even that has a huge range of recovery times. it would be great to head about the recovery times of posteroinferior labrum but looking more and more likely that only the surgeon will be able to advice, let alone a climber.

In reply to the NHS, i have found it really good, in terms of timeline, the injury occurred on the 22/10/16, i went to A&E soon after (unfortunately no walk in centre near me) where i was in and out within 2 hours having had an X-Ray, the following week i saw a specialist who booked me in for an MRI and physio. First physio was the 25/11/16, where she tested my strengths and weaknesses and gave me exercises (no physical manipulation). I had an MRI on the 20/12/16, and more physio on the 21/12/16. On 09/01/17 i got the results and the unfortunate diagnosis. All and all i feel this is very good, it has probably been accelerated as the shoulder is a long term issue, so they saw little need dragging it out any longer.

Since then i have seen the NHS physio again, where she seemed a little "we'll wait and see" for my liking, so i booked in with a physio in Bristol called Danny brown(https://dannybrownclimbing.com/), a climber and physio who i had heard very good things about. He analysed weaknesses (had me wincing in pain by pushing my arm in the right way) so to understand what was wrong, did some physical therapy, then spent about half an hour giving me very specific, and more full on, exercises. He effectively said that what the NHS had given me was all good, but not very specific and all a bit safe, also that i should do everything i can before resorting to surgery.

I now have a date for the follow up with the shoulder specialist (late march) so will keep at the exercises till then. I experience more pain in day to day life then when climbing/exercising. So that potentially will be the deciding factor, if I'm still having those issues in two months time.

Any more advice would be appreciated, and ill happily answer any questions (hopefully a bit more rapidly) as well as putting up an update when anything changes.

Rock to Fakey - on 30 Jan 2017
In reply to steve-grigg:

Thought i'd heard the name before, DB, when i was making enquiries, one place I contacted was the Medical, Dan works with them, but unfortunately i found the reception team to be very salesy, as in they seemed slightly pushy trying to give me an appointment, so feeling hassled i decided not to use them.
Dan may be a great physio though.
steve-grigg - on 31 Jan 2017
In reply to Rock to Fakey:

That's a shame, Dan himself wasn't at all pushy, I didn't book a followup, was more of an open "if you want more exercises you can come back, but they will be a bit like this, so you can probably work it out"

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