Tore my shoulder labrum in a fall. Surgeon mentioned biceps tendonesis surgery is an option, and much easier recovery, but that he recommends SLAP repair. Any medical experts on this or slowtwitchers with experience/thoughts? If the tendonesis surgery really does get you back to normal, even if it changes your anatomy, I’m having trouble buying into doing the full SLAP repair that requires such a longer recovery/rehab process. But, if there really is a long term benefit to going with the full SLAP repair, then I would do it and wouldn’t want to do the “easier†tendonesis surgery option just for short term benefit/ease. Thanks in advance.
If your labrum is torn, how will bicep tenodesis fix it? There are a few SLAP threads on ST, I’ve posted in most of them. I’m on my 3rd of 4 shoulder surgeries (first two were SLAP’s, 3 and 4 are more intense). There’s no such thing as an “easy” shoulder surgery.
Edit: A quick google suggests 4-6 month for full recovery. That was/is my SLAP experience. YRMV, but like I said…shoulders are no easy fix.
Thank you for posting, your comment is very helpful.
Re biceps tendonesis, my surgeon was explaining that some people choose just to have the biceps tendon cut off from the rest, so it’s not longer attached to the labrum, and can’t pull on it. Apparently, some football players and other athletes choose this option, for quicker return to play. He said the caveats are that you can end up with a slight cosmetic-only bulge in your biceps area, and some people end up with pain when turning a door knob. But, he also still advised against this option as the fix. To me, those two caveats are easily worth it if it means 2-3 months recovery vs 6-9 months recovery. However, not if there could be long-term problems as a result of not having the full SLAP repair. Here is an article discussing the two surgeries: https://www.ncbi.nlm.nih.gov/m/pubmed/30723678/
If your labrum is torn, how will bicep tenodesis fix it? There are a few SLAP threads on ST, I’ve posted in most of them. I’m on my 3rd of 4 shoulder surgeries (first two were SLAP’s, 3 and 4 are more intense). There’s no such thing as an “easy” shoulder surgery.
Edit: A quick google suggests 4-6 month for full recovery. That was/is my SLAP experience. YRMV, but like I said…shoulders are no easy fix.
I’m glad that I’m not alone. Two slap’s and a 360 with 8 anchors and the bicep.
What in the world did you do to yours?
I’ve given up. Both torn but not slipping so I just try to keep them strong.
Interesting article. For me, tenodesis was never an option. I had/have a torn labrum, bicep tendon, hills-sachs lesion and a lot of scar tissue from multiple (7-10 in my estimation) dislocations and countless subluxations.
I guess you need to find out which surgery is better for your long term health.
Thanks for the love…well, it’s a long story as someone like yourself might expect, but the short version…
2012 May, surgery on RT. 4 anchors I think, sling for 4 weeks. Still trying to swim my senior year in college. 2014, April, surgery on LT. 3-5 anchors I think, sling 4 weeks, you know the drill.
2016, December. Dislocated my LT - fell backward on my arm while Nordic skiing. I was going downhill and didn’t know how the skis really worked. Totally my fault. Later that winter, I also dislocated my RT. Since then, it’s been like field day on trying to keep my shoulders healthy and strong. I went on a kick of gaining about 40lbs after weighing in around 127 (5’7†barefoot) and got up to almost 165 at some point (I’m back down to 155, but I’m about 10 weeks post-op, so weight loss was expected). Strong like brick shit house. However that didn’t really seem to help. In fact, it may have made it worse, but I can’t really be sure - just a hunch.
The last straw was when I feel badly off of my MTB and dislocated my left. I had a really hard time resetting it on the trail, and two nights later, I awoke at 0300 and it was somehow dislocated. I don’t remember dislocations ever happening that quickly one after another, let alone in my sleep, so it was a F’CKING bear to get that bastard back in. In fact I was a moment away from calling EMS. Oh, by the way, I never went to the doctor for any of these subluxations or dislocations, I just jacked it back in and dealt with the pain. I had surgery in my left in mid August, and I get my right one done in about 2 weeks.
My surgeon (Dr. Cooper in Salt Lake, highly recommend, he’s even had shoulder surgery himself) said I could blame genetics on this. I’m going to because it makes me feel better, but I know my lifestyle didn’t help when I already had super unstable shoulders (I thought it was a great idea to start mountaineering, and that was responsible for one additional dislocation). It’s at least made me absolutely stone cold dead serious about shoulder stability work once I’m all healed up. No exceptions, 3 days a week in the gym, 15-30 mins will be spent working in that either before or after lifting (I’d like to gain that muscle back).
Sorry if you’re not American and are unfamiliar with the units, I just didn’t feel like converting them. My brain is dead tonight.
Feel free to ask and learn from my mistakes. Oh, by the way I’m only 28, so I really want these surgeries to work.
Had surgery on both shoulders for torn labrum on both, rotor cuff damage and impingement on both also. The right one they did not clip the bicep tendon and the recovery was longer due to the anchors but the left one they did clip the bicep tendon and recovery was shorter. The recovery was about a year for the left one and and a year and a half for the right one. I have some residual stiffness and lack of flexibility in the right one when doing heavy lifting but I knew that going into this that was a possibility. I’m glad I did it because the day to day pain was over and I didn’t have much of a choice anyhow since the labrum was pretty destroyed from the MTB accident. Now I am post surgery by about 4 years and shoulders are strong and swimming is not a problem and I would say I am about 95% of where I was pre injury.
I tore my labrum during an Ironman Race in October 2018. I did not know that it was torn until after the race when I started swimming again the following week. There was so much pain I could not complete a lap. I had the MRI in November and decided to have the surgery.
I had Slap surgery (10-2 tear in left shoulder) during the first week of December 2018. Bicep Tendinosis was a possibility prior the surgery but was not needed. I started aggressive PT two weeks after surgery. I went to the PT four times a week and did the proscribed exercises two times a day. Three weeks post surgery I was able to ride the bike on the trainer and walk on the treadmill as long as I did not put any stress on the shoulder. I would ride the bike and walk on the treadmill with the sling on.
I was cleared for full workouts by Mid February 2019 (10-11 weeks post surgery). I participated in my group’s annual Tucson Bike Camp during the first week of March 2019. My first post surgery half Ironman was June 2019. My first full Ironman post surgery was July 2019.
The biggest issue is getting full range of motion in the shoulder. Strength came back quickly but the flexibility took about a full year. The joint will be very stiff for a long time. The PT designed exercises for me that would mimic the swimming motion so that I could get stronger faster.
In the end it probably depends solely on the individual. Everyone’s experiences will be different. I do recommend buying or renting the Polar Ice Shoulder Therapy Machine. I did not take it off my shoulder for two weeks. It helped with the pain and inflammation.
Thank you for posting, this is very helpful. Your recovery time for the SLAP repair seems less than so many of the stories that I’ve heard. Do you know how many anchors you had? My surgeon said that my only option based on my MRI was surgery (this was back at the end of June/early July). I figured I would wait until Fall to do it, so long as the pain wasn’t that bad most of the time, as I’d just started a new job. My biggest concern was waiting that long if it was still going to hurt even running, which it did when I injured it.
Fast forward to now, however, and I have very few limitations. I’ve been swimming 18-22k/wk (4-5k per wkout), which was my normal before. I have no problems with free or back, and I’ve been doing fly now, too; although, I’m very cautious about the pull of breaststroke, so still uneasy about doing that (I could try). I’m swimming close to my prior times in swimming, and I do pull sets with zero hesitation; although the top-end speed is definitely not there right now, but I also haven’t been training it, as I wanted to be careful about pushing it. I can’t even remember when I last had pain running or biking (and I climb at lot here in Nor Cal). Three weeks ago, I tried some Vinyasa power yoga with push-ups, and was weak, and hesitant on the -up portion of the push-ups; however, have done it twice since this past week, and doing full push-ups now with no problems…minus some obvious loss of strength since I didn’t do any strength training/vinyasa for ~5 months. Just this past week, I noticed myself reaching for a cup in the high cupboard and also putting my backpack on, both with my right (injured) arm, with no problems, which was something I hadn’t done since pre-injury.
My MRI report reads: “the superior labrum is torn and detached (image 9 of the coronal T1 FS sequence), the anterior and anteroinferior labrum are torn and detached (image 14-15 of the axial T1 sequence), and there is a complex tear of the substance of the posterior labrum (image 13 of the axial T1 sequence). The appear to be two MGHLs (image 12 of the sagittal T1 FS sequence), and anatomic variant. The biceps tendon and biceps anchor are intact. Mild supraspinatus tendinosis. No evidence of full-thickness rotator cuff tear. Trace amount of fluid in the subacromial/subdeltoid bursa. 6 mm cartilage signal body posterior to the glenohumeral articulation. No clear donor site is identified.”
I think maybe I should get a second opinion on the MRI. My concern is that I already feel like I’m 95% of what I was pre-injury, and what if the surgery makes it worse?
Thank you for posting, this is very helpful. Your recovery time for the SLAP repair seems less than so many of the stories that I’ve heard. Do you know how many anchors you had? My surgeon said that my only option based on my MRI was surgery (this was back at the end of June/early July). I figured I would wait until Fall to do it, so long as the pain wasn’t that bad most of the time, as I’d just started a new job. My biggest concern was waiting that long if it was still going to hurt even running, which it did when I injured it.
Fast forward to now, however, and I have very few limitations. I’ve been swimming 18-22k/wk (4-5k per wkout), which was my normal before. I have no problems with free or back, and I’ve been doing fly now, too; although, I’m very cautious about the pull of breaststroke, so still uneasy about doing that (I could try). I’m swimming close to my prior times in swimming, and I do pull sets with zero hesitation; although the top-end speed is definitely not there right now, but I also haven’t been training it, as I wanted to be careful about pushing it. I can’t even remember when I last had pain running or biking (and I climb at lot here in Nor Cal). Three weeks ago, I tried some Vinyasa power yoga with push-ups, and was weak, and hesitant on the -up portion of the push-ups; however, have done it twice since this past week, and doing full push-ups now with no problems…minus some obvious loss of strength since I didn’t do any strength training/vinyasa for ~5 months. Just this past week, I noticed myself reaching for a cup in the high cupboard and also putting my backpack on, both with my right (injured) arm, with no problems, which was something I hadn’t done since pre-injury.
My MRI report reads: “the superior labrum is torn and detached (image 9 of the coronal T1 FS sequence), the anterior and anteroinferior labrum are torn and detached (image 14-15 of the axial T1 sequence), and there is a complex tear of the substance of the posterior labrum (image 13 of the axial T1 sequence). The appear to be two MGHLs (image 12 of the sagittal T1 FS sequence), and anatomic variant. The biceps tendon and biceps anchor are intact. Mild supraspinatus tendinosis. No evidence of full-thickness rotator cuff tear. Trace amount of fluid in the subacromial/subdeltoid bursa. 6 mm cartilage signal body posterior to the glenohumeral articulation. No clear donor site is identified.”
I think maybe I should get a second opinion on the MRI. My concern is that I already feel like I’m 95% of what I was pre-injury, and what if the surgery makes it worse?
I would advise you not to rush into surgery. I had a similar story, however my shoulder labral tear was from crossfit/power lifting and ironically is one of the reasons I am doing tris today.
When I first met with the surgeon he aggressively pushed me to surgery - I went the conservative route and like you can do 95% of what I was able to do prior, with a few days every few months that are worse than others. But generally with PT and some time I’ve been able to get my shoulder back to almost normal use. I’d suggest getting a second opinion and meeting with a few PT’s who can maybe help you get closer to 100%. If you’re not satisfied then you should absolutely pursue the surgical route. Just don’t let a surgeon who is incentivized to do more surgeries push you in any direction.
Thank you. Good advice.
I’ve contacted a former classmate from b-school that happens to be the head of ortho at Cedar Sinai, so he’s going to take a look at the images this week. And, I’m working on scheduling with a PT that has experience with athletes and shoulders. 
Thank you. Good advice.
I’ve contacted a former classmate from b-school that happens to be the head of ortho at Cedar Sinai, so he’s going to take a look at the images this week. And, I’m working on scheduling with a PT that has experience with athletes and shoulders.
Curious—how is this going for you now?
My MRI reads slightly better than yours, but I am 6 weeks post injury (car hitting me while cycling) and really have very little right arm usage with pain, hence am leaning towards surgery…