PT for possible shoulder labrum tear

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08-26-2019, 06:12 PM
DaveT

PT for possible shoulder labrum tear

After about three months of numb and sometimes sharp pain in and out of the gym I went to an ortho, got an x-ray (which didn't reveal much) and was recommended a few sessions of PT to see if that helps before getting an MRI. I asked what the MRI might reveal if the PT doesn't work and they speculated a torn labrum might be the culprit (which was torn and I had repaired about 20 years ago and has since been pretty much fine until recently). So my question is can PT help a torn labrum, or should I not even bother and just get the MRI and go from there. I am still pressing and benching, although with more caution, and have backed off about 10% after some more intense pain cut a couple of bench sessions short. Thank you in advance for any insight.
08-26-2019, 08:24 PM
Will Morris

Here is a more important question: can a torn labrum cause numbness in the upper extremity? Also, if you had a significant debridement in your labrum, you will ALWAYS have physical exam findings that would suggest labral pathology.
08-27-2019, 03:09 PM
DaveT

I can pinpoint the sharper pain to the joint itself but I can feel the numbing pain all the way down my arm. Not sure if that means anything.
08-27-2019, 05:12 PM
Will Morris

Quote:

Originally Posted by DaveT

I can pinpoint the sharper pain to the joint itself but I can feel the numbing pain all the way down my arm. Not sure if that means anything.

Is the labrum connected to the neurological structures coming down into the arm? If not, does the labrum come within close proximity to the neurological structures?

How are you able to pinpoint the pain to the joint?
08-28-2019, 08:09 PM
DaveT

Quote:

Originally Posted by Will Morris

Is the labrum connected to the neurological structures coming down into the arm? If not, does the labrum come within close proximity to the neurological structures?

How are you able to pinpoint the pain to the joint?

I'm guessing it does not, although the numb/dull pain seems to follow the sharp pain so I thought the two were related. Should I be looking at something other than the labrum?

Rereading chapter 5 of the blue book to see if there's something I'm doing wrong. I have brought the elbows in closer in an attempt the protect the shoulder but now I'm wondering if that's creating a longer MA and making it worse.
08-29-2019, 02:15 PM
Will Morris

Quote:

Originally Posted by DaveT

I'm guessing it does not, although the numb/dull pain seems to follow the sharp pain so I thought the two were related. Should I be looking at something other than the labrum?

Rereading chapter 5 of the blue book to see if there's something I'm doing wrong. I have brought the elbows in closer in an attempt the protect the shoulder but now I'm wondering if that's creating a longer MA and making it worse.

The labrum, itself, will not cause neurological symptoms. For this, you would normally start by clearing the cervical spine, then move down to the shoulder looking for physical exam findings to suggest impingement of a nerve. You are ALWAYS going to have physical exam findings of labral pathology if your surgeon debrided a large amount of labral tissue. PTs tend to forget this, or, you did not inform them that you had a labral repair / labral debridement. If you were a patient in my clinic, I'd be more interested in finding an answer for the neurological symptoms and move from there. It appears your providers think differently.

PT can certainly help with GH joint pain. But, so can a competent strength coach. If I were dealing with pain, I'd hedge my bet with a good coach before I went to a PT.....and that is coming from a PT.