Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I'm a West Point cadet in training. We're required to be in at least one sport so I play soccer. After making a really good dive for a goal, I injured my shoulder and had surgery to repair a labral tear. I wanted to get back into training as soon as possible so I cut short wearing the sling and started PT two weeks early. The whole thing fell apart. Now I have to have a second operation. What happened? Isn't an aggressive approach a good thing in rehab?

Answer:

Injuries to the labrum, the cartilage rim around the shoulder, are complex and difficult to treat. Improper treatment or rehab can result in an unstable shoulder. Often there are other soft tissue injuries that occur at the same time causing even more complications.

Most labral tears are sports-related injuries. Athletes (and military recruits) often have a purpose-driven approach to activity and exercise. Usually this attitude is in their best interest. After surgery, a different set of values is more helpful.

For example following the surgeon's directions and being compliant with treatment is crucial to the success (or failure) of treatment. Soft tissue healing can't be rushed. In normal, healthy adults, it takes six to eight weeks for the tissues to knit back together.

That's a minimum, not a maximum time frame. If the surgeon used bioabsorbable sutures to make the repair it takes time for the body to repair the damage and absorb or dissolve the anchors holding everything in place.

Going back to PT (physical training), especially if it involved any push-ups, pull-ups, or weight lifting before the tensile strength of the ligaments and tendons are ready is a common way to cause failure of the fixation.

The best thing you can do for yourself after this revision surgery is to follow the doctor's orders. Consider what he or she says and tells you to do no different than your drill sergeant’s commands. You'll be on a medical profile so there's no shame in wearing the sling and avoiding activities you've been told to avoid until the right time.

When in doubt, ask! Don't ask your fellow cadets or drill sergeant. Ask your doctor and only your doctor what you can and can't do, and when you can and can't do it.

David B. Cohen, MD, et al. Outcomes of Isolated Type II SLAP Lesions Treated With Arthroscopic Fixation Using a Bioabsorbable Tack. In The Journal of Arthroscopy and Related Research. February 2006. Vol. 22. No. 2. Pp. 136-142.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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