Hi, everyone. I am a 32-year old female who sustained an inexplicable labral SLAP tear this month, a year ago. I am not old, an athlete, didn't have a fall or accident... perhaps it was a yoga or self defense class move I did that my shoulders weren't strong enough to handle or perhaps shoveling snow, hard to say. The worse part has been that it's a DOUBLE shoulder injury - whatever I did happened to both! As I am right-handed, my right shoulder is slightly worse then the left, solely because I use it more.

The first four months, I didn't get any treatments or do anything - I expected the pain would just go away and didn't realize how bad the injury was. Once I got an MRI, I opted for conservative treatments. I am too young to do cortisone shots and don't want to do surgery unless it's a last resort, especially since it's both of my shoulders. I used to be a side sleeper so I had to learn how to sleep all over again - on my back and propped up. I find I tend to slide down at night and my shoulders end up sore in the morning anyway, there doesn't seem to be a perfect position. Initially, the pain was pretty intense, and I was doing ice/heat combos 4-5 times a day. I also used pain pills, I think I had some tendonitis and bursitis so there was a lot of inflammation. I did physical therapy, conservative exercises, electrical stimulation, and ultrasound, between all these things (I work my arms out slowly every day and try to do some strength training like three times a week), I no longer use any pain pills and inflammation is down considerably. The main time I get it is in the morning, for the first half hour after I wake up - it tends to go away after that. There was a time a few months ago when I was waking up some mornings without pain and others with pain but it seemed like it was going away, then I foolishly went swimming overestimating my recovery (I tried to use my core to swim so I didn't think I'd used my arms all that much) but appeared to have undone any progress I did and haven't awakened without that 30 minute morning inflammation since.

This month marks my one year anniversary, I'm wondering if any of you have tried the conservative route as long as I have and what your experiences were, how long it took you to heal, etc. It seems every doctor or person I go to has a different opinion - some say it will heal and can take 1-3 years, others say it won't. In any event, weighing the risks, I want to wait it out. The pain really isn't that disruptive and I still have great range of motion and shoulder strength is still decent, so I assume these are good signs. I don't see it improving necessarily the past few months but I don't see it getting worse either.

I am just wondering if any of you have had a similar experience, can share what you did, can offer suggestions as to what I can do, etc. I really want this to go away, I am pretty young to be dealing with this type of injury and am not a very active person so I wish this thing would just heal already, especially since it's both arms. It's a great time in my life, I want to stay focused on all the positive things happening. Not to mention I really don't have time for major surgery and recovery, And, I have giant college loans to pay off, so I'm not in the position to afford any of that now. I am just starting a new career and have some really unique offers and opportunities and won't have "down time" for a long time. I have a portable electrical stim tens unit and a portable ultrasound I am going to start using a little more often. Anyone have any additional exercises, sleeping position solutions (as I think the inflammation comes from being in the same position so long - is there anything I can do about this?!), or things you did that worked for you?

I also want to know why I am still getting this inflammation in the morning, I assume it's the same position for hours and that's it, but I keep waiting for the day when I'll wake up without the inflammation again and it hasn't happened in several months. I could take an anti-inflammatory before bedtime but I don't want to get into the habit of that as I have a sensitive stomach. Is the morning inflammation a good thing or not? I know in some cases, inflammation is necessary for healing, in others, it's a hindrance. At this stage, is it a good thing? Should I try anti-inflammatories, ice, heat, etc or just let it be as it is naturally doing what it's supposed to in order to get through this? Is there anything I can mix into a smoothie or any supplements I can take to encourage healing? Advice is GREATLY appreciated.

Thanks!

Lastly, what's the difference in feeling between a partial tear and a complete tear? I imagine if it was completely torn you would be limited in range of motion in some way. Is this accurate? How would you be able to tell this, besides another MRI?

I'm doing what I can to get better and I'm willing to do whatever it takes (conservatively). Is there still hope?

it took me almost a year exactly to get in for first surgery, only cause i got lucky and called the day before the doctor was approved for an extra boking. in my consult he said if i wanted i didnt need surgery only if i could live with the discomfort. lots of people get these surgeries done its just a big waiting game.

I beleive it is worth a shot at rehab to avoid surgery, but as you found out performing overhead sports is really a no
go. I do think your sleeping is a problem, if you could get the inflammation to diminish it would make this more of a possibility. I have rehabed a few out of getting surgery, but told them overhead sports would most likely not be possible. One of them was a teenager and she is fine, the other a dancer and appears to be doing fine.
In terms of sleeping getting a tempurpedic type 3" overlay is something I would purchase and put on top of your existing mattress. I believe Costco has one. Also a postion that may work involves having a pillow on each side and sleeping in a stomach/side postion using the pillow under the body supporting the arm and chest. It is very comfortable usually as long as the pillow is tucked under your chest for support. You can then turn on the other side and grab the other pillow when you need to switch positions. I am not sure I can adequatelly describe this position, but it generally does work.

hi Zoem!
I've been injured now since early october 2010, so around 1 1/2 years. The problem with me is that i still haven't had a succesfull diagnosis. Still, my mri's have showed subcoracoid bursitis and other types of inflamatory process. The docs i've been attending are almost sure i suffer some sort of SLAP tear or bicep groove condition, but it's never showed up on neither mri's or arthrogram. My pain is quite moderate, ranging from that to just a disconfort and feeling of instability (at its best). I'm heading now towards a diagnostic/therapetic arthroscopy hopefully sometime late march. In my case (after trying EVERYTHING from accupuncture to nsaid's, PT, steroids,etc...) i've found that it does improve over the time to the point where the pain is minimal and the worst feeling is just disconfort and the feeling of instability. But still, it depends on ur needs and expectations. In my case, i could perfectly live with it and cope with my everyday life if it werent for me not accepting not being able to lift weights (i'm a very, or was a very thorough and disciplined bodybuilder) and `practice overhead or contact sports, something which im not willing to give up. It rapidly degenerates whenever i get back into the gym for a couple weeks, even with the lightest weights possible... So really, it depends on your goals and expectations in terms of physical activity. If you wouldnt mind changing your approach to sports and physical activity, and could bare living with just the disconfort and instability feeling in the shoulder, then consider the conservative approach, if not, get under the knife cause at least for what i've experienced, it wont heal completly on its own...
Cheers from across the puddle,
KRaM.

if it is a labral tear then you should get it repaired if you want to stay active in sports.get a good surgeon and you will be fine in 3 months.labral tear occur in young athletes more frequently.if it is completly torn then the joint wil be unstable.if yours is not then please get it repaired at this stage from a good surgeon so that you recover quickly.

Hi, everyone. Thanks for chiming in, please keep the discussion going! I am not an athlete, so playing sports isn't a priority. I am also not a very active person in general, which makes my injury surprising. Does anyone know what differentiates a partial and complete tear, aside form what shows up on MRI or arthogram? For example, I would imagine if you had a complete tear, your movement would somehow be restricted in some way. Is this accurate? I definitely think it's a partial tear but am wondering how you would be able to tell, if at all, if it was a complete tear. I love hearing your experiences and advice, thanks for sharing - keep it coming