Hello, I'm new here. I've recently found out from my MRI report that I have a 'tear in the superior aspect of the cartilaginous glenoid labrum anteriorly, the glenohumarl joint is otherwise normal' and also, 'a small partial thickness tear is seen in the superior aspect of the supraspinatus tendon at the musculotendinous junction'.

I hurt my shoulder playing in goal in February - I fell on an out-streched arm resulting in this injury. Due to commitments to my team I didn't really do anything about it until I fell on it again in March. Went to the physio a couple of times and she told me to stop playing (which I didn't want to do cos we were at the silverware stage of the season) so I waited until the end of May to get it seen to properly. I've been very diligent with my physio exercises since then and the physio is happy with the improvement in strength and range of motion but doesn't think my shoulder should still be sore. Physio reckons he can't do much more cos the cartilidge is causing the problem.

I went to the GP who prescribed me with oral steroids as I had pain in my AC joint and rotator cuff but they don't seem to have helped much.

So here come my questions, I'm due to see an ortho consultant in a couple of weeks and I'd like to know what to expect... is surgery really the only way to solve this problem? Or will a cortisone shot be suggested? Is surgery inevitable and should I just get it over with as physio hasn't been effective enough?

At the moment, my shoulder has a dull ache most of the time but not really sore enough that I'd take painkillers (I hate them) and then I get sudden pain when I feel the catching. I also get pain when I put my arm above my head. The most annoying thing about it all is that I love road cycling but after maybe 15-20 mins I get pain down the side of my arm. It's really getting me down as I'm not much of a jogger/runner and love cycling and want to get back to it but can't. Also, I worried that once the field hockey season starts again that if I dive on that side it'll just hurt even more. FYI, I'm 27 and reasonably active.

I suppose what I'm hoping to hear here is whether or not surgery would be beneficial here and how long I should expect this whole thing to drag out... any help would be much appreciated. I've already learned loads from reading around the forum.

You are describing pretty much exactly what I was feeling, except my MRI came back negative. I tried PT - it made it worse, I tried cortisone shot - it did nothing. Your SLAP tear won;t heal itself but you can strengthen the muscles in your shoulder to try to compensate. Honestly, I'm more pissed with myself that I didnt see my doctor sooner and he is sorry that he did not go in sooner, as I had all of the classic signs of a tear except a positive MRI. I ended up having a pretty significant labral tear that required 3 anchors to repair, but because it was due to acute trauma, it was sitting really tightly against my glenoid and only visible when he went in with his probes and poked around.

If I were you, I'd get the surgery if it is offered. Pain on a daily basis, even dull pain is not worth it.

Thanks for your reply - are you still recovering from your surgery - how long will the overall recovery take? I'm anxious that I'm gonna miss a whole hockey season

I suppose the thing is, is that I've strengthened my shoulder to a point that the physio is very happy with it (other than the pain aspect) so I just don't want to be told to go off and do another couple of months physio just to be in the same situation. Although I'd be nervous about getting the surgery, if it's what is ultimately needed, I'd prefer to have it sooner rather than later so I can get back to hockey/cycling.

What is the usual treatment of this sort of injury once physio has been tried? Is it usually surgery or just more PT and then cortisone injections?

Hey martha - people can relate their own personal experiences, but no one can tell you how it will turn out for you. Every situation is unique, everyone's anatomy and injuries are unique and everyone's recovery timetable is unique.

A slaptear is a structural failure of the shoulder. I worked out and did lots of PT but would always reach a limit that I couldn't push through. My doc was very realistic about the situation. He said "I can do PT, followed by cortisone and then surgery or we just go straight to surgery."

Usual treatment is surgery. Some people on here have done okay without, but if you are planning to actively play hockey again... you're probably looking at surgery...

Andy is absolutely right, but be mindful of cortisone - 3 injections max over a longer period of time then it becomes counterproductive and can actually harm the tendons. Plus the placement of the needle needs to be accurate, which isn't real often in a doctor's office without imaging.

I had extensive email exchanges with my first surgeon (wonderful OS who moved away after my first 2 surgeries) - this is an excerpt from an email from him about injections after surgery. He never offered to do it after all:

Question 1 - steroids are not a benign intervention and generally should
be avoided except when necessary as they block the natural healing and
remodelling response that is part of the normal post-operative recovery
and last well past 3 months. Since there are other aspects of your
recovery process (physical therapy) which may solve the problem without
interfering with healing, it is best to pursue those first. That being
said, if we are not starting to make good headway with an optimized PT
program soon then it would be time to give an injection