Labral Tears

[Paul Sousa]

Anyone have any history with these, or know about them?

I have had chronic shoulder pain/discomfort for years and have pretty much just ignored it. It's getting annoying now though and I am trying to figure out what it may be. I'll try and list some of the stuff going on with it:

- Constant muscle knots between my spine and scapula
- Pain/tenderness in my trap (also some clicking)
- Pain/tenderness in the front of the shoulder
- Pain/tenderness at the top of the bicep where it meets the armpit
- Pain where the tricep meets the inside of the elbow
- Radiating pain through the forearm and wrist

It's usually tolerable, but noticeable. It gets real bad after any time I throw (usually football), bad enough to wake me up from sleep. Massage of the knot in my upper back helps alleviate some of the issues for a bit, but it comes back.

Does this sound like a possible tear? I'd like to go into the doctors with an idea of what it could be, because usually they just say it's a muscle strain and send me on my way. I have had this for years, sometimes better sometimes worse, and I am confident there is more going on.

[Ian Kovtunovich]

Anyone have any history with these, or know about them?

I have had chronic shoulder pain/discomfort for years and have pretty much just ignored it. It's getting annoying now though and I am trying to figure out what it may be. I'll try and list some of the stuff going on with it:

- Constant muscle knots between my spine and scapula
- Pain/tenderness in my trap (also some clicking)
- Pain/tenderness in the front of the shoulder
- Pain/tenderness at the top of the bicep where it meets the armpit
- Pain where the tricep meets the inside of the elbow
- Radiating pain through the forearm and wrist

It's usually tolerable, but noticeable. It gets real bad after any time I throw (usually football), bad enough to wake me up from sleep. Massage of the knot in my upper back helps alleviate some of the issues for a bit, but it comes back.

Does this sound like a possible tear? I'd like to go into the doctors with an idea of what it could be, because usually they just say it's a muscle strain and send me on my way. I have had this for years, sometimes better sometimes worse, and I am confident there is more going on.

I had a SLAP tear (superior labrum, anterior-to-posterior) about 8 years ago. Initial diagnosis was some kind of rotator cuff issue, and they sent me to PT for 3 months, but it didn't get any better. I made them gimme an MRI at that point, and from that, they were able to tell quite easily that it was the SLAP tear, and scheduled me for surgery.

Trying to self-diagnose and then go to the doctor and tell them what is wrong is probably not going to be very helpful. Many of those symptoms are probably not related and would thus be red herrings as far as diagnosis goes (it sounds to me like you have several issues going on--pain at your elbow is probably just some tendonitis, pain in your forearm and wrist might be carpal tunnel-y stuff or something else, musclular crap between spine and scapula=who knows?, but the pain at the top of the bicep/front of shoulder + the clicking sounds like your money symptoms for some kind of shoulder injury). The things you think might be symptoms of something might be nothing, or might be indicative of some condition you've never heard of, and the doctor is going to ask you whatever questions they're going to ask you regardless of what your hypothesis is, because they can't make a diagnosis based on your diagnosis, they have to go through their process to figure it out. Which doesn't mean they will necessarily get it right (as happened to me), or give you a treatment plan you like, so you may want to go with second and third opinions, and be pushy about getting an MRI, and maybe be prepared to pay a lot, since insurance sometimes dictates your course of treatment. I.e. insurance doesn't want to shell out a couple $K for an MRI without seeing if PT and NSAIDS will take care of it.

The shoulder is a real clusterfuck of muscles and ligaments and tight space all trying to swing your arm around like a fucking helicopter and pick up a million pounds off the floor (you are DL-ing 1M lbs, right?), and it might also be stemming from your tight upper back--as you said, working some of that out alleviates the symptoms somewhat. Maybe you should dig up some stretches for your shoulder, wrist, and forearm (there are great wrist and forearm stretches on WebMD under the carpal tunnel and tennis/golfer's elbow sections; they probably have shoulder stretches too), and do them religiously a couple times a day for a week or two and see if you have any improvement. I thought I was going to need surgery for a torn meniscus a while back, but the knee doc said that, yeah, I probably had a small tear, but it was in any case not worth operating on, so why don't I try some hamstring stretches and NSAIDS and just ease off it for a couple weeks and see how it goes. Stretching turned out to be totally money, and any time it acts up, I lay on the stretching and it chills out.

Good luck with your shoulder, in any case. After my ordeal, shoulder issues scare hell out of me.

[Paul Sousa]

Thanks Ian, I appreciate the response. I have tried some conservative approaches in the past based on doctor's advice and it continues to return. Normally it is just annoying/uncomfortable, but if I do anything like throwing a football around all of the areas I mentioned as symptoms start to hurt a lot. I am wondering if I have a tear causing some instability in the shoulder, and then throw, if that puts extra strain on the tendons in my arm, and the muscles in my upper back.

So you'd suggest only mentioning symptoms directly related to the shoulder if I see a doctor?

[Ian Kovtunovich]

So you'd suggest only mentioning symptoms directly related to the shoulder if I see a doctor?

Oh, not necessarily that. I just meant, I wouldn't overdo it trying to diagnose it yourself and expect to show up at the doc's office and say, "hey, I think I've got X going on, now what're we going to do about it?" and have the doctor just roll with that, or even put much stock in your assessment. By all means, I would lay out all the symptoms you're having, but don't get too attached to any ideas you may have about what the actual problem is. Maybe since you've already gone through some conservative treatment and not had much success, you'll have better ammo for getting an MRI.

[Paul Sousa]

What if I slapped him and then gave my diagnosis? I mean, doesn't he realize I spent about 15 minutes googling labral tears?

[Ian Kovtunovich]

What if I slapped him and then gave my diagnosis? I mean, doesn't he realize I spent about 15 minutes googling labral tears?

HAHAHA! Yeah, I think you've got a good game plan.

"Bitch, I said it's a labral tear! Now schedule a goddamn OR before I smack you a second time!"