Torn Labrum recovery

My son had his torn labrum repaired the 2nd week of April. He began intensive PT last week and has already regained a tremendous amount of motion. The PT said he's doing well, and thought he could progress beyond the protocol that was set forth by his Surgeon. However, he's going to wait until he visits the surgeon on Friday, and let the doctor determine whether he can accelerate the process or not.

My son has some pain while the PT is actually working on the shoulder, but it's apparently related to the scar tissue.

Hey guys,

just keep doing what the PT's tell you and it will all work out. If I remember correctly, the Lambrum works like a washer in the shoulder joint. Tore mine the first time, shredded it the second. Along with a few other muscles. Just make sure they do their prescribed rehab. They ended up taking mine out and I came back feeling fine. The tear was worse than when it was removed.

Good luck and tell your boys to remain focused on getting back and staying mentally positive. The mind is a powerful tool in the process.. imo..

Bizazz,

Your doc starts rehab a whole month earlier than ours. He says he won't release him for six months to throw "hard" again. He can start softly throwing in August. But till then, it's building up the strength in the shoulder.

I wonder if the rehab start is related to the severity of the tear and amount of work required to re-attach? My son didn't have any additional damage other than the labrum tear (e.g. rotator cuff, etc.). He also ended up going about 2 months between the last time he pitched and the actual surgery.

quote:

Originally posted by obrady:
Son went to first PT session yesterday, three months after surgery. He was put through the normal rotator cuff exercises and didn't experience any pain. Of course he didn't ask the therapist if that was normal, so I'm asking anyone of you who have been through it. Was the lack of any discomfort normal or is it a positive sign that he’s further along than expected?

Lack of pain/discomfurt is +
A number of questions remain
What was the RC regimen?
Wat reps, weights, banding?

Too earlyto tell, no pain = better than some.

Depending on the exercise, but very light, 1 lb for most, 5 lb for a shrug exercise.

quote:

Originally posted by obrady:
Depending on the exercise, but very light, 1 lb for most, 5 lb for a shrug exercise.

Supra/infraspinatus, teres and subscapularis
RCs that stabilize the shoulder
The head of the upper arm bone
In the shoulder joint

RC exercises are to help assure
That the humeral head
Stays in the socket
Where the labrum is cushioning the joint

By doing so, less humeral head movement
Means better labrum recovery
While your son does not play
And then when he does

His prognosis is subject to the positioning of the tear
The surgical success
Whether he is a position player or P

This cannot be rushed
Post rehab strength training should not be delayed

quote:

Originally posted by Bizazz:
I wonder if the rehab start is related to the severity of the tear and amount of work required to re-attach? My son didn't have any additional damage other than the labrum tear (e.g. rotator cuff, etc.). He also ended up going about 2 months between the last time he pitched and the actual surgery.

Rehab is a prescription
Like any prescription it is subject to Dr. personal judgement
Invasisveness of surgery
Knife or arthroscopic
Is a certain determiner


Area and severity of tear
Is as well

quote:

Originally posted by Bizazz:
My son had his torn labrum repaired the 2nd week of April. He began intensive PT last week and has already regained a tremendous amount of motion. The PT said he's doing well, and thought he could progress beyond the protocol that was set forth by his Surgeon. However, he's going to wait until he visits the surgeon on Friday, and let the doctor determine whether he can accelerate the process or not.

My son has some pain while the PT is actually working on the shoulder, but it's apparently related to the scar tissue.

Return of motion quickly is typical
The body refuses to allow
Full range under injured conditions

Unless the protocol was prescribed with high conservativeness
I cannot see the need to accelerate
When the downside is severe
if injury re-occurs

PT work-offs of scar tissue
Are always painful
NSAIDS would be helpful
Hopefully prescribed
For pain and swelling
Ask if not

My PT would not give any medication---he felt they would mask what was happening as he worked---you learn to endure the pain--after awhile it becomes part of the procedure---I was going three times a week immediately after surgery so he wanted to know what the story was as we worked

quote:

Originally posted by TRhit:
My PT would not give any medication---he felt they would mask what was happening as he worked---you learn to endure the pain--after awhile it becomes part of the procedure---I was going three times a week immediately after surgery so he wanted to know what the story was as we worked

Some PTs, once pain in range is determined, will opt for NSAIDS.
Others not.
If the range of motion required to break apart scar tissue but pain inhibits that range, a PT may look to NSAIDS for pain control.

My son had his surgery on April 18. He had very good pain control so he had almost no discomfort. He started PT 3 weeks after surgery although at the beginning it was basically just moving the shoulder. He is now 2 months post surgery and has no pain with his PT and goes 3 times per week. His range of motion is very good and he does not feel any tightness in his shoulder. We anticipate his being able to toss the ball in about a month but still a while away from pitching. Just hoping now that he doesn't do something stupid and put himself back to square one.

3boysmom,

Sames here. Tossing starts July 11.

College son has his 8 month post op with Dr. Andrews in the morning.
It's been a long process, but one thing that can't be emphasized enough is the PT and patience. Don't push it. Son was cleared at the 6 month appt to begin complete baseball workouts, but wasnt 100% comfortable with swinging the bat, so pulled back. A few weeks ago, started back up..and is now working out 2-4 hrs a day getting "baseball ready" and feeling great!

Even if you're cleared, you have to listen to your body and back down if necessary. I know mine does not want to go through this again. Just wanting to play ball... Be patient and let all those parts heal back properly.

My son had surgery June 20. He was found to have a small labral tear. Thirty minutes to repair, probably 12 months to recover. Today at post-op session, Dr. warned against being hasty with wants, and instead being realistic with needs. I've gone from initially reading that rehab would be 4-6 months, to being told by the surgeon that he should expect 8-12 months rehab, and along the way being told by his future college pitching coach that 12-16 months might be realistic.

My son had his labrum repaired 4/10. He's on a throwing protocol about 3 times/week. Started with 2 sets of 25 throws at 30 ft and is working his way up. He's been throwing at 90 ft for the past week with no pain (3 sets last time out). The PT said he could think about pitching when he's able to throw 50 times at 180 feet with no pain. The surgeon is onboard with the protocol, so I'm trusting these guys to know what they're doing.

A bigger problem is that he's throwing with his old man. I'm probably going to max out at 120 feet.

I spoke with son's PT about 10 days ago and he gave the green light for son to try fall baseball. He will be limited to batting and infield work but assuming proper progress between now and fall he feels it will be a nice transition for him. He is optimistic that he can start pitching late October or early November. Of course, this is all dependent on his progressing at the same level he has to this point. He will likely start tossing the ball on July 16. He only had pain prior to the surgery when pitching so I think he will be very confident until he gets back to full pitching. I am not sure how he will feel mentally when he gets there.

When you or your kid, were first giving permission to start "tossing" the ball; how long did it take to work through the intial pain?

Bizazz:

Once you feel you have "maxed out" on the distance get your son to throw to you out of a bucket of balls. You just catch...
I am another old guy with no arm anymore.

Every case is different, but I'm kind of surprised that a PT would be the one to tell the patient that it's OK to play fall ball. My son had TJ and every advancement was up to Dr. Andrews alone.

quote:

Originally posted by itsrosy:
Every case is different, but I'm kind of surprised that a PT would be the one to tell the patient that it's OK to play fall ball. My son had TJ and every advancement was up to Dr. Andrews alone.

Good point. My understanding is that the PT's only job is to do rehab which might include, upon doctors orders a throwing program. The final ok to play in actual games is by doctor only based upon examination and PT's notes on rehab.

Not playing yet. Just tossing in the backyard.

quote:

Originally posted by birdman14:
Bizazz:

Once you feel you have "maxed out" on the distance get your son to throw to you out of a bucket of balls. You just catch...
I am another old guy with no arm anymore.

Why didn't I think of that.

I'm getting it back to him at 120 with an occasional bounce or two. We're probably going to try a few at 150 tonight.

To answer those who were questioning the PT giving the okay for fall ball, I am certain that he has discussed this with my son's doctor. The PT sees him 3 times a week, the doc sees him every 6 weeks. The PT is also the top in the area specializing in baseball players. After we discussed it with the PT we did also get clearance from the doctor. We just didn't see him prior to needing to get the registration in for him to play. At any rate, son is still doing very well. He is on a throwing protocol and hitting off a tee. He will start throwing from a mound in 4-6 weeks(not pitching, just throwing) and can start working with his pitching coach again at that time. We are anxious to see how he progresses. His strength before was his arm strength and we have no idea yet if he will have that back.

Update - It turns out that my sons pain was being caused by tightness in his elbow. After all those months of limited arm movement, the PT says his joints all tightened up and need to be stretched out. After a couple of sessions it's already much better.

Mine had his labrum repaired May 29th. They had team physicals yesterday by my son's surgeon. Doc said his shoulder is fine and he can practice immediately. He starts throwing today. I hope it goes well.

Son had labrum surgery 7/29/08. Sling came off today. Surgeon likes his chances for full recovery. Was impressed with range of motion today, 1 month post op.

Will update progress.

Background...Two days before college opener, freshman sons shoulder get sore and "pops" on pitches. Scratched from opening day starter slot. Comes back 1 month later after diagnosis of tendonitis. Shoulder still hurts but tries to pitch through it in relief. Faces 5 batters doesn't record an out, is dropping arm slot to try and relieve pain.

MRI with dye one week later shows swollen burser sac, no labrum tear. Cortisone shrinks burser, begins pitching as closer again 2 weeks later. Throws 16 scoreless innings, starts out overpowering and dominant, but every outing velocity drops slightly, accuracy starts slipping. By seasons end, shoulder sore again, gives up 3 runs in an inning and looks poor doing it.

After a months rest and no relief from pain, next MRI shows tear. Surgery reveals 2 tears, both small. One repaired with only a stud, the other with 1 stud and 1 stitch.

CPLZ - Hope your son's recovery is coming along and progressing on schedule.

My son received the Army baseball media guide in the mail this past week....enjoyed reading your son's bio. Sounds like he has great velocity, I hope that he is good as new post recovery.

P.S. sounds like a decent bowler too.

Correction and update. Doc released him to resume batting practice, but he is still recieving pt. He threw two days last week. First day from 45 feet and second day at 60 feet. He said first three throws went straight into the ground. Arm lost all muscle memory. He has to work his way up to 120 feet and one more visit with the Doc. So far no pain. Swing feels good.

My son had his operation 04/07 and was cleared to throw and hit 08-07. His arm is 100% and has no problems (his was non throwing arm).

My only suggestion is to err on the cautious side. Take extra time if needed. A few additional weeks of therapy is better than another surgery and 4 months rehab.

Junior had his third post surgery evaluation this morning and doctors are extremely pleased (understatement) with the stability in his shoulder and his range of movement.

He is now 11.5 weeks post op and they have cleared him to start throwing in the next 4 weeks. We'll be following the ASMI ITP throwing program outlined in the book Preventative & Rehabilitative Exercises for the Shoulder & Elbow.

Doing the math, that would give him an earliest return to competition of around the second week of March, or 3 weeks into the college season.

I will keep everyone updated on progress.

Just ended 4 weeks into throwing program. Arm feels great, moving from 60 to 90 feet tomorrow. 270 degrees range of motion and slowly increasing. All signs are still thumbs up.

cplz, great news about your son's recovery. I checked out your link to ASMI and one of the books written by Kevin Wilk. As you know, Kevin is the #1 PT up in Doc Andrews rehab facility. When Drew Brees had his shoulder rebuilt by Andrews, I heard that he did basically his entire rehab in Birmingham, and worked out daily with Kevin Wilk. KW deserves as much credit as JA in this case. Heard that this was the worst looking shoulder injury Doc Andrews had seen.

Mine ended his fall practice a couple of weeks ago. He is up to 165 feet on a line, two sets of 25. Still doing rehab with the trainer, but Doc is very pleased. No pain and a little rest before spring season starts.

My son is about 6 weeks into his throwing rehab. So far, so good. He's out to about 150' 3 days a week. says his arm feels better now than it has for two years(he had some problems after his soph. yr. in HS). He has a very good pitching coach who has some experience with labrum tear recovery. He is also a student of good fundamental throwing, which I'm sure will be a benefit. He will however, redshirt this year as a precaution to trying to come back too soon. He's gained lots of flexibility, and added good lower body strength during fall workouts.

Junior just pitched his first inning of comptetitve baseball today and did fine. He feels great, although he has days when he feels better than others. Some days he feel tight, others he feels very loose.

I.e. a couple of weeks ago he had his worst long toss session of recovery, really didn't feel like he had it together and was very tight. A machine the trainer uses measured a huge muscle spasm in the back of his shoulder. Two days later he threw a 90% bullpen and felt awesome.

Although he pitched today, he's not all the way back yet, and that may not happen completely this season. They are planning on him being in the starting rotation in three weeks when conference play starts.

It was exactly 7 months and 8 days from surgery to the first day back of competition. There was one tendonitis setback that cost a week, but no other setbacks so far during recovery. Tendonitis was cured with rest and Naproxin orally.

Son 3 months into Rehab not doing well has limited range of motion doing rehab 3 days a week,is this the Norm?

That depends on the severity of the injury, the extent of the repair undertaken, and a host of other factors. There is no way to compare your son to any others. Every one's situation has some facets that make it unique or at least not comparable to yours. Please rely on your son's surgeon's and PT's input.

My son had surgery in January (torn labrum), reported to spring training, and is now back in college.

His bowling, tennis and golf are getting much better and he seems very interested in grades now. As I measure it, he had a good career.

My 11 year old son's tournament coach played to AAA and had the same surgery. As I measure it, he had a good career too.

If you are reading this post-op, listen to the professionals (PTs and Dr.s) and stay on the time line they suggest. It is critical and against an athletes competitive nature.

Anyone have any stats on recovery and additional years of service once this surgery is opted for?