Shoulder worries consuming my life - how to resume safely after SLAP tear

I’m 99% sure I have some sort of labrum lesion in my left shoulder, probably a SLAP tear, possibly in both shoulders. No extreme pain, only mild pain every now and then and a clear feeling of some instability (more than normal clicking with associated feeling of joint movement). When opening a door sideways i feel some dull pain right around the bottom of the lateral deltoid. Some clinical tests that I performed on myself are positive, specifically the clunk test and the active compression test. (the PT I went to did not perform any labrum tests as far as I know, despite me specifically stating what I was worried about). No/almost no pain during lifting, but some clicking which I can easily work around.

Main concern is not the symptoms itself, but what the future holds. I’m only 24 and and am extremely scared that during the coming years/decades my shoulder(s) might degenerate to the point where I will need a shoulder replacement (at a young age). I have not been able to think about anything else for the past weeks. I have had these symptoms for many years without really being concerned with them, but I feel like lately they have become slightly worse (or maybe I just notice them more because I focus on it all the time).

X-ray shows “mild clavicle elevation” on the left side. I will get in contact with an orthopedic surgeon and ask for an MRI. I am preparing for the worst and that I will require surgery.

What drives me crazy is that I do not know what caused my injury. Most likely it's "bad form", but I will never be able to prove this, so I might just re-tear the labrum if I keep doing what I'm doing.

I have been lifting for 10 years now. I started with squat, deadlift, bench, press, and chinups. I have done some varying silly accessory work but never that much, and always returned to the basic lifts quickly. My back starting aching and I developed some sciatic pain through squats and deadlifts, that despite countless form checks did not resolve, so I cut those lifts out (i know i risk getting banned for this) out of fear of injury, and have basically only been doing chins, presses, incline bench press, and some lunges for the past years. I have always had my elbows abducted (so not at 90 degrees), and for the past couple of years I have always focused hard on doing the shrug during the press. In my early years I may have done this less well, I do not remember. Maybe that caused a labrum tear? My press has never been above 130 lbs, and my bench press never above 175.

I am completely at a loss as to how I have to resume training if I have to get SLAP surgery done. I absolutely do not want to re-tear anything. I guess my main questions are this:

- How likely am I to (re)tear a labrum doing a press with a proper shrug?
- Is there any truth to the idea that the bottom part of bench press places risky stress on your labrum? If so, is there any safer chest exercise that can prevent my chest from looking completely silly?

I have given up on the idea of lifting very heavy weights. I know this attitude is not greatly appreciated here, but at this point all I want is to remain somewhat fit for the rest of my life (not completely atrophied) with healthy joints.

Thank you very much for reading this, I really am at a loss.

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Originally Posted by gadsie

I’m only 24 and and am extremely scared that during the coming years/decades my shoulder(s) might degenerate to the point where I will need a shoulder replacement (at a young age). I have not been able to think about anything else for the past weeks. I have had these symptoms for many years without really being concerned with them, but I feel like lately they have become slightly worse (or maybe I just notice them more because I focus on it all the time).

X-ray shows “mild clavicle elevation” on the left side. I will get in contact with an orthopedic surgeon and ask for an MRI. I am preparing for the worst and that I will require surgery.

What drives me crazy is that I do not know what caused my injury. Most likely it's "bad form", but I will never be able to prove this, so I might just re-tear the labrum if I keep doing what I'm doing.

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I think your shoulders are the least of your problems.

"No/almost no pain during lifting"

Then lift.

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Originally Posted by Mark Rippetoe

I think your shoulders are the least of your problems.

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Perhaps I should not have shown how much this is affecting me mentally because it is not helpful and this is not the right place for that, so i'm sorry about that.

But if I may ask, do you think it's possible to tear a labrum over time doing a proper press or bench press? And do you think there is a certain weight on the barbell where the risk of injury becomes higher than any beneficial effect on joint health?

It is always possible to get hurt. Correct technique reduces the probability. Courage!

OP, I have had rotator cuff tendinitis in my right shoulder for about 25 years. Doing Starting Strength has done more to make that tolerable than anything else, including physical therapy a few years before I discovered SS.

Last spring, I actually did injure my right labrum. Not sure how, precisely, although I suspect it was racking a clean. I have long forearms and have to take a pretty wide grip on the clean and it puts a lot of stress on that shoulder. Bench pressing also irritates it. I had a physical exam that indicated tendinitis in one of the RC tendons, either the infra or supraspinatus, I don't recall, and it doesn't matter, along with a non-SLAP labrum injury. The doctor recommended PT which I declined.

I worked with a SS Coach who's also a DPT to identify ways to continue to train the bench without further injuring it. I dropped the power clean entirely and replaced it with the power snatch. I did all my volume benching with a 2 inch block and had to focus carefully on elbow position, but 6 months later I managed to get my bench to 300lbs.

As far as weight on the bar and risk, I can tweak my shoulder with the empty bar if my elbows are too close to my torso, or if my grip is too narrow. If you're training the lift intelligently your risk of injury should be relatively low and not dependent on a magic number.

Whatever is wrong with your shoulders, I suspect that continuing to train the press and chins will do more for you than anything else. A consult with an SSC would probably give you some peace of mind with these movements as well as the bench press, both in terms of form and how to program them.

Nobody is going to cut into your shoulder until you've at least done some kind of physical therapy, and I believe that barbells are superior to resistance bands in that respect, considering that you're able to use them.

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Originally Posted by Matt James

OP, I have had rotator cuff tendinitis in my right shoulder for about 25 years. Doing Starting Strength has done more to make that tolerable than anything else, including physical therapy a few years before I discovered SS.

Last spring, I actually did injure my right labrum. Not sure how, precisely, although I suspect it was racking a clean. I have long forearms and have to take a pretty wide grip on the clean and it puts a lot of stress on that shoulder. Bench pressing also irritates it. I had a physical exam that indicated tendinitis in one of the RC tendons, either the infra or supraspinatus, I don't recall, and it doesn't matter, along with a non-SLAP labrum injury. The doctor recommended PT which I declined.

I worked with a SS Coach who's also a DPT to identify ways to continue to train the bench without further injuring it. I dropped the power clean entirely and replaced it with the power snatch. I did all my volume benching with a 2 inch block and had to focus carefully on elbow position, but 6 months later I managed to get my bench to 300lbs.

As far as weight on the bar and risk, I can tweak my shoulder with the empty bar if my elbows are too close to my torso, or if my grip is too narrow. If you're training the lift intelligently your risk of injury should be relatively low and not dependent on a magic number.

Whatever is wrong with your shoulders, I suspect that continuing to train the press and chins will do more for you than anything else. A consult with an SSC would probably give you some peace of mind with these movements as well as the bench press, both in terms of form and how to program them.

Nobody is going to cut into your shoulder until you've at least done some kind of physical therapy, and I believe that barbells are superior to resistance bands in that respect, considering that you're able to use them.

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Thank you for the input Matt.
Are you not scared that the labrum tear is going to get worse, and slowly degenerate the underlying hyaline cartilage? How was your slap tear diagnosed?

I paid a lot of money for a 3T MRI on January 4th, because I can’t handle the stress of waiting months for the healthcare insured one. This one is without a dye injection though.

I’m terrified of what they are going to find, that they are going to find much more than just a SLAP tear. Or that I wake up from the surgery and tell me all the damage they saw during arthroscopy and that I will be needing a bilateral shoulder replacement. Thank god there’s university break now because I can’t do anything productive.

I made a lot of mistakes as an ignorant teenager. I found starting strength, but just started working out without paying too much attention to form etc., even skipping warmups for years. I thought I was doing a good thing starting lifting early, but now all I wish is that I never touched a barbell. Will probably never forgive myself, but what’s done is done.

I have already decided that I will not be continuing barbell training, despite the fact that the injuries are probably my own fault, it is not worth the risk for me.
I will switch to light dumbell overhead pressing and keep the chins because I do believe that having some muscle mass is healthy for the joints.

Amazing.

got to be a troll.

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Originally Posted by Mark Rippetoe

Amazing.

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I tried.

OP, I think you should cancel the MRI and spend that money on a therapist. Not a physical therapist.