I received my invitation to join the greater SLAP tear community courtesy of my enjoyment of volleyball over the past 17 years. I coach and play for the University of Chicago club team and last year didn't take my usual summer break. Instead, I headed out to North Avenue as soon as the weather got nice and played at least 2 days a week. Sometime in late July or August, I noticed some pain in my shoulder on certain attacks. This pain intensified a bit as fall arrived and I found myself playing 4 times a week. If only I had known then what I know now...

Like many people, I don't have the greatest health insurance, so it took a while to get an appointment with the sports medicine doc through the student clinic on campus. I finally was able to see her in mid October and although I explained I had been taking ibuprofen and icing, was told to continue doing so and given some shoulder strengthening exercises (sound familiar?). She thought it could be any number of things and wanted to proceed conservatively, especially since MRIs are so expensive. When I returned from winter break, my first practice felt great and I thought I had taken care of the problem...until my second practice. Nothing had changed.

Back to the doc and she gave me the option of having an MRI done. She emphasized the cost again, which was worrying me, but when she outlined some of the things that might be wrong and the consequences of letting them go untreated, I decided I would rather go into debt to know for sure. She also recommended that I have an arthrogram MRI because "some tears often don't show up on regular MRIs". It's about another $1,000 to have the arthrogram. If you've never had an MRI, the difference is that $1,000 buys an injection of contrast fluid into your joint, which makes tears show up better on the actual MRI. This takes place immediately before your MRI and isn't too uncomfortable. The radiologists numb you up a little and x-ray your joint to get a bead on your joint space. They then insert a needle and fill your joint with fluid. The best way I can think to describe the sensation is when you are sitting in an airplane, waiting to take off as the baggage handlers finish loading luggage on the plane. It's the same sort of dull thudding/bumping sensation.

When my results came back and I went to meet the doc, she showed me images of our friend, SLAP tear (II). Luckily, while our insurance sucks, we do have fabulous doctors here. She referred me to Michael Terry, who was/is the doc for the U.S. National Ski and Volleyball teams and the Chicago Blackhawks. As you can imagine, I had a lot of confidence in his recs. Even without the resume, he demonstrated an uncanny ability to do something no other doc could do. The first doc I saw could make me feel uncomfortable, but couldn't cause the accute pain I would feel when playing. Same thing with Terry's resident. And at a tournament I went to in April that also featured doctors looking for subjects to take part in a shoulder study, two different doctors could only cause some minor twinges. I worried they thought maybe I was imagining my symptoms. As soon as I saw Terry, he ran through the same basic positions the others had done, with similar results, then said "now with volleyball..." and proceeded to move my arm in three new ways that resulted in my saying "ow" with ever greater intensity. That was the best evidence of his competence I could have received.

I had my surgery May 22, and while the pre-op/nerve block was fun (see elsewhere, in my reply to bmorgac) the post-op wakeup was not. I had my tonsils out in March and felt like a million bucks for the 12 hours after my surgery. With the SLAP surgery, I felt like a can of worms. Just down, tired, and pissed off. I assume they used some different mix of drugs durin gmy surgery and it may have also been the result of the longer length of surgery (a little over 2 hours). Sleeping was definitely strange (and it still is) because I'm usually a stomach/side sleeper and between the sling and the icepack contraption they ordered me to stay rigged in, I had to try to sleep on my back. I didn't need to move to a chair and eventually the worn out feeling each day brings lets me zonk out. But I am looking forward to the day I can stomach sleep again!

My pain wasn't too bad. The block worked well for about 16 hours, and the ice and antiinflammatories were adequate from there. After a few days, I was able to remove my dressing, which was disgusting (alcohol will take off the yellow goo pretty easily). My range of motion was nonexistent and the depressing effect of becoming a temporary invalid is pretty powerful. Still, I did notice that my arm could move incrementally a little more each day, and you really need to pay attention to those little markers of progress. At the same time, I was/am petrified of screwing up the fragile repair so I didn't push my movement too much. I did have a few scares though, when I woke up with my arm elevated out to the side at an angle I was told not to do and when I unthinkingly tried to grab a TV remote that had fallen. You have to work to break a lot of habits.

I'm 4 weeks out now (I got to take off my sling at the end of the third week) and the therapy is slow going. I go twice a week (down from three times during the first week) and until the 5th week, my doc's protocol calls for gentle joint maintanence exercises. In other words, I do some pendulums, some shoulder blade pinches, and ice a lot. In therapy, I get stretched some and do some modified bicep curls with a 4 pound weight while laying down. I'm not allowed to do this at home. Apparently, week 5 will start a phase of pushing harder to restore my range of motion. To put my current range (at the end of 4 weeks) in functional terms:

I can't use my arm to comb/style my hair.

I cannot quite reach across my chest to apply deoderant as normal (I can reach if I lean my good arm upward and toward my injured one).

When driving, I cannot reach out and put the key in the ignition without leaning forward to shorten the distance. I can't comfortably turn the key and so reach over the wheel to do so with my good hand. Same thing with shifting from Park to Reverse of Drive.

I can type for short periods of time and scratch itches on my face.

Compared to how I felt after the surgery, it's still been amazing progress. You need to keep that in mind, because there are many moments that are incredibly depressing. I live in an urban environment and I find it changes how I perceive my space. I feel much more vulnerable when I am out, especially at night, since I know that I'm a wounded duck. And although I don't need my sling anymore, it helps to wear it in social situations just as a marker of your injury. I was at a crowded bar recently without my sling and since I look normal, people tried to squeeze by and stumbled into me, and it was difficult to protect my shoulder. And of course, I get initial odd looks when I shake hands with my left. The sling is definitely a useful marker in such situations. In general, while you won't want to, it's healthy and useful to have some friends around who can help you.

Finally, try to educate yourself as much as possible at the outset of the process. I learned about SLAP tears, but I didn't really ask a lot of questions about what other things my doctors might do once they got inside my joint with the scope. As it turned out, they also did impingement surgery which has had a big impact on my recovery. In the end, I have to trust their expertise. But I didn't feel impinged in the past and I would have liked to know such a procedure was an option so I could have raised questions about it.