Shoulder Surgery Rehab

If your son is telling you that at each step of his progressive throwing rehab he is feeling discomfort that improves/alleviates before he moves to the next step in his rehab, that would not be unexpected.
If he continues to have pain while throwing from distance A, and then it increases some when he moves back to distance B, and that repeats back to distance C, that would not be expected.
The location of the pain, whether on the back of the shoulder with follow through vs top of the shoulder overhead could also be relevent.
Remember, he has at least some scar tissue/adhesions from the surgery. What was described as "fraying" of the labrum came from some source that seems not to have been addressed in the surgery, from what you have provided.
The pain with sprints isn't a symptom I have heard reported with shoulder/labrum repair since there isn't any overhead/above shoulder action with the arm/shoulder. I can conceive a scar tissue formation/adhesion producing some pain with active arm motion of sprints but it isn't something that would be common from my reading.

What does your doctor and PT guy have to say?

they are the ones who are "hands on"

TR, you would hope that would be the case.
But it isn't always. Sometimes your son, and you as a parent, need to be a very informed patient in this medical system.
I say hello everyday to a player who was religiously following a medically supervised, daily throwing program for a period of nearly 5 months. Turns out the doctor and trainer were both incorrect in what was happening.

infielddad is correct, it is not unusual to feel discomfort (not pain) as you progess.

My son is going through this right now, rehabbing from tendinitous, each time he throws more pitches per outing he feels some discomfort, but not pain. They have told him that this is normal.

TR brings up a good point, if he has concerns he should speak to his doctor or trainer.

That is a sad commentary---if you cannot trust your doctor and PT guy here who do you trust ?

quote:

Originally posted by TRhit:
That is a sad commentary---if you cannot trust your doctor and PT guy here who do you trust ?

The docter went in for a labrum tear and found something else. Strike 1

Doctors are not Gods and are wrong sometimes. I agree with infield dad, you absolutly must be an informed patient. To trust a doctor blindly is a scary proposition.
That being said, you should discuss the situation with your doctor, ask questions, get answers, stay informed. If you are uncomfortable with how things are going, get another opinion.

Tripledad

I do not consider that to be a strike---many times not all the damage is not seen until they get in there---been there done that

TR. you might be right, I don't know a lot about that injury. But I would be sceptical, and would get informed. I would wonder, how common is a torn labrum misdiagnosed by a doctor? Did he misdiagnose a tear from an MRI and do surgery, or did he speculate a tear, and tell the patient we have to do surgery to determine the extent of the damage?

I'm just responding to your "trust" comment. When a doctor tells me something, I hold doc to it, I ask questions, I nail them down to specifics, And find out if they have a clue WTF their talking about.

You can tell from my post, I'm extremely sceptical of the medical profession and have good reason to be. I will leave it at that.

quote:

Originally posted by TRhit:
Tripledad

I do not consider that to be a strike---many times not all the damage is not seen until they get in there---been there done that

I think it is very important to remember that the use of current generation MRI scanners, combined with contrast dye, a top quality orthopedist and a good radiologist to interpret the scans should minimize, or eliminate, some of the explanations that we couldn't see it until "we got in there."
Turns out you cannot always rely on the doctor or others, which is unfortunate. That cannot be underestimated or understated but it is often unrecognized. It was for me.

My son is on a supervised throwing program that the team Orthopedist instructed him to follow. His throwing program consist of throwing at a specified distance for two days - resting the third day and then moving back 10 feet the following day if no pain was present at the previous distance. He has been following this program for approximately three weeks. He is at approximately 130 - 140 feet now.

Concerning the surgery, I did a good bit of research on the topic and found it not uncommon for MRI's to give false readings on the labrum. In many cases, they find more damage than originally thought after they go in. In my son's case, the damage was less - just a little fraying.

The report from the doctor has been positive but I am concerned about the differentiation between pain and discomfort. Discomfort could easily be pain if I know my son. As was suggested above, I was wondering if scar tissue might be the culprit of the discomfort when sprinting.

Thanks for all the feedback.

Infielddad -

For the player that followed the throwing program for 5 months to only find his problem was misdiagnosed, what was the original diagnosis and what was the final one?

quote:

Originally posted by infielddad:

quote:

Originally posted by TRhit:
Tripledad

I do not consider that to be a strike---many times not all the damage is not seen until they get in there---been there done that

I think it is very important to remember that the use of current generation MRI scanners, combined with contrast dye, a top quality orthopedist and a good radiologist to interpret the scans should minimize, or eliminate, some of the explanations that we couldn't see it until "we got in there."
Turns out you cannot always rely on the doctor or others, which is unfortunate. That cannot be underestimated or understated but it is often unrecognized. It was for me.

My son had the MRA (with the dye) done and the team physician, team trainer and team radiologist couldn't agree on what they were seeing. Flew him up to Baltimore where the Head Team Physician and Director of the Division of Sports Medicine and Shoulder Surgery and Associate Professor of Sports Medicine and Shoulder Surgery at Johns Hopkins wasn't even positive as to the extent of what Josh's injury was, but knew he needed surgery. Turns out his labrum was torn a quarter of the way through which required stitches and 3 screws.

The shoulder is much more intricate than the elbow which is why TJ has such a high rate of success and guys like Rob Nen never recover from torn labrums. We're praying for a full recovery and hopefully he will be good to go by next spring training.

I have to trust the physician in this case.

I've seen similar results for my son who is just recovering from a layoff due to an elbow injury and nothing as serious as what your son went through. He tends to get discomfort the day after going up in distance. That started at about 195'. Sometimes it lasts a day, sometimes a couple days. His discomfort is usually around the deltoid and felt during deceleration. He's gone through this before and it just took time and resting it when he felt pain or significant soreness.

One thing I would ask is if he is throwing on an arc as he goes up in distance? If he's throwing on a "line" then you really have no idea how hard he's throwing from session to session and he may not be increasing the intensity as gradually as he should. If he's throwing on an arc and only throwing hard enough to reach the prescribed distance then you know that he's only going up in intensity quite gradually.

I'm a bit surprised that he's throwing 2 days on, 1 day off, rather than every other day when he's only out to 130 or 140'. Is he getting the soreness only after the second day? Most of the throwing rehab programs I've seen say that if there's soreness during throwing then they should take a day or two off and then go back to the previous distance and if there's soreness after throwing then they should take a day off and have at least two days of throwing without soreness before going up in distance.

He normally feels discomfort when he moves to the next level but it is really day to day - some days it feels pretty good and some days it feels not so good. I have heard that shoulders are very tricky and in fact the doctor told us that shoulders seem to have a mind of their own. His fall workouts will be finished in another 3-4 more weeks and I am hoping that a couple of weeks with limited throwing might get him over the hump - we still have a long way to go before we get to 22 February.