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I had my shoulder scoped out last week 19 months after a slap repair and a bicep tenodesis. Besides mild fraying of the rotator cuff and the posterior labrum everything looked in tact. However, the doc said I have excess laxity of my glenohumeral joint, specifically anterior instability. 

I was not able to throw after the first surgery, despite a year of strenuous pt and upping my weight. So I am going to pursue another surgery where the doc is going to do a thermal capsular shrinkage, also known as a capsular shift. 

Does anyone have experience with this? 

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Please read this article, especially the last paragraph, where TCS is no longer recommended.

 

https://www.verywell.com/shoul...e-tightening-2549887

 

Keep in mind TCS and surgery for a capsular shift are two VERY different things. TCS was very popular in the 90s and early 2000s, but it is no longer recommended. Successful results are usually not long term and in many cases aren't successful at all.

 

If you're still not convinced, I will offer this: I had TCS in 2004 (at age 38...long after my "prime"). I also had a sizable bone spur shaved from the top of my humerus (thanks to years of abusing my arm). I was able to return to "old man" sports after about 6 months without pain, but to this day I don't have the ROM I had before surgery and I was never able to make the throws--velo wise--that I did prior.

 

There are two surgeries recommended on the site I listed for you. If you opt for surgery, please check those out. I would not recommend TCS.

 

This is just my perspective, based on my experience. Best of luck to you, whatever you decide.

GHHS-2016LHP posted:

Please read this article, especially the last paragraph, where TCS is no longer recommended.

 

https://www.verywell.com/shoul...e-tightening-2549887

 

Keep in mind TCS and surgery for a capsular shift are two VERY different things. TCS was very popular in the 90s and early 2000s, but it is no longer recommended. Successful results are usually not long term and in many cases aren't successful at all.

 

If you're still not convinced, I will offer this: I had TCS in 2004 (at age 38...long after my "prime"). I also had a sizable bone spur shaved from the top of my humerus (thanks to years of abusing my arm). I was able to return to "old man" sports after about 6 months without pain, but to this day I don't have the ROM I had before surgery and I was never able to make the throws--velo wise--that I did prior.

 

There are two surgeries recommended on the site I listed for you. If you opt for surgery, please check those out. I would not recommend TCS.

 

This is just my perspective, based on my experience. Best of luck to you, whatever you decide.

wow, thanks. i pm'd you

 

 

kt333 posted:

I had my shoulder scoped out last week 19 months after a slap repair and a bicep tenodesis. Besides mild fraying of the rotator cuff and the posterior labrum everything looked in tact. However, the doc said I have excess laxity of my glenohumeral joint, specifically anterior instability. 

I was not able to throw after the first surgery, despite a year of strenuous pt and upping my weight. So I am going to pursue another surgery where the doc is going to do a thermal capsular shrinkage, also known as a capsular shift. 

Does anyone have experience with this? 

Your doctor should be recommending excercises to tighten the capsule, which is the preferred treatment before any surgery. However, the surgeon may see a willing and able patient. I know of one player who had this surgery,  then had a second surgery to loosen the capsule.

Proceed with caution.

I have always lurked on the boards never responded until this post.  Had this procedure completed nine years ago with the promise that rehab would be much quicker. I was trying to rush for my final year of eligibility. I have since switched ortho because of different health care provider.  Went to new doc for other shoulder and when I informed him that I had had the procedure on my "good" shoulder, he responded " I would not consider that your good shoulder.  He ordered an MRI for both shoulders so we could start a treatment plan for the problems that he insisted will surface.  For me it was worth it because without that procedure I wouldn't have been able to play that final year of college.  But for anyone that has any possibility of a longer career I would steer clear.

interestedinball posted:

I have always lurked on the boards never responded until this post.  Had this procedure completed nine years ago with the promise that rehab would be much quicker. I was trying to rush for my final year of eligibility. I have since switched ortho because of different health care provider.  Went to new doc for other shoulder and when I informed him that I had had the procedure on my "good" shoulder, he responded " I would not consider that your good shoulder.  He ordered an MRI for both shoulders so we could start a treatment plan for the problems that he insisted will surface.  For me it was worth it because without that procedure I wouldn't have been able to play that final year of college.  But for anyone that has any possibility of a longer career I would steer clear.

Very good advice to this young man who, I do believe, is now in his 6th year of eligibility and has had his shoulder operated on twice already all in a pursuit of a professional career. 

 

interestedinball posted:

I have always lurked on the boards never responded until this post.  Had this procedure completed nine years ago with the promise that rehab would be much quicker. I was trying to rush for my final year of eligibility. I have since switched ortho because of different health care provider.  Went to new doc for other shoulder and when I informed him that I had had the procedure on my "good" shoulder, he responded " I would not consider that your good shoulder.  He ordered an MRI for both shoulders so we could start a treatment plan for the problems that he insisted will surface.  For me it was worth it because without that procedure I wouldn't have been able to play that final year of college.  But for anyone that has any possibility of a longer career I would steer clear.

Sounds like you were in much better shape than me considering you played your final year. 

I was able to throw 300 ft before my slap repair/bicep tenodesis and now can't throw over a 100 ft without my shoulder subluxing. 

I also found this article regarding anterior instability and the role of the subscapularis: https://www.ncbi.nlm.nih.gov/pubmed/17346865

What stood out to me from the study was the following line: "Exercises alone are unlikely to be adequate for all patients with anterior instability symptoms."

charliebball posted:

TCS really has no place in current shoulder treatment, for several reasons.  Also the fact that they just scoped your shoulder without a treatment plan, and then are recommending yet another procedure makes absolutely no sense.  Not sure where you live but we need to get you to a good shoulder specialist.  Feel free to PM me 

No we had a plan. And he was of 1 of 5 doctors I inquired with. I told him to be as conservative as possible, and to also remove my sutures and any scar tissue. MRI's weren't showing any tears despite ongoing symptoms, so scoping it out to what was going on was ideal.

He did find that I have internal impingement while he had me in external rotation... Which could be do to the anterior laxity of the joint.

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