Labral Tear (SLAP)
 

I've had a persistent pain/discomfort in my right shoulder for years. My right shoulder is noticeably weaker than my left and often gives out quicker when doing press exercises.

The pain has been a huge obstacle in working chest (bench press mostly).

I've recently gotten it checked out and was told I had a Labral Tear. Now keep in mind this occurred years ago but I only recently got it diagnosed.

Has anyone here had similar injury? Were you successful in working through it...If so what did you do?

I suffered a fairly serious shoulder injury in august, a type 3 ac joint seperation. I tore the ligaments that hold the collar bone to the shoulder. Its not really like a Labral Tear, but it is in the region.

I am unsure how Labral Tears are treated, so its hard to equate the injuries without knowing more, but I am rehabing by building the muscles in the shoulder to compensate for the missing tendons. This is prob not an option with a slap tear, but I have no idea really.

What have they suggested thus far? Surgery? Rehab?

The doc said
 

The doc said to "lay off of it." Stay away from whatever makes it hurt.

Almost as though he was bothered by my question. Honestly, "staying away isn't really an option." To be honest, your shoulder injury sounds worse than mine. Knowing that your slowly building it up gives me hope.

Yeah i've gotten that a few times, you say to the doctor, it hurts when I do this, and his/her response is "dont do that". Its bullshit, you want to live normally, not be restricted by your injury. I would seak a second opinion, perhaps see an orthopedic or something. I dont know much about Labral Tears, but it doesnt seem like something that you would need surgery to recover from. But with the little knowledge I have, that doesnt mean much.

My recovery has actually been fairly quick considering how much damage i did. my collar bone protrudes from my trap now, and moves around a lot. Its hard to keep it stable at times. But if you work hard, you can come back from just about anything.

Well I'll tell you what...
 

i definetly appreciate the reply...thanks for the advise..

I had to read up on exactly what a Slap Tear is and found some basic info here: http://orthopedics.about.com/cs/gene...der/a/slap.htm

Now it seems that you were able to work your way through this since you got diagnosed long after you sustained the injury but the pain has finally become too much. My advice is to schedule a meeting with a sports therapist and see what their input is. A good sports therapist deals with professional athletes and highly active people such as bodybuilders so they are able to give you a better idea of what you can and cannot do.

Also I think it would be worth it just to see them and get some exercises to help relieve the stress/pain in the area. I had to do this with my shoulder impingement and it really helped my shoulder heal faster and the preworkout exercises I got from them helped tremendously. They may have you layoff the activites that impact the injury the most for a while as you rebuild the area and your strength in the shoulder, but I believe you would come out much stronger.

Btw flat bench causes alot of stress on shoulder injuries so even though it sucks not to do it for a while, you would be better off switching to something else while you rehab the area.

Thanks Sleazy
 

Yea, it flares up mostly with flat bench. I do dumbells virtually pain free so i guess it'll be dumbells vs. flat.

Ultimatley, I'm hopeing to fiind routines that I can do to strengthen the area. I was hoping the doc would say something to that affect but instead I left disappointed by his answer.

I've been able to work past quite a bit but in the last year it's just played a bigger role in my gains. It also varies tremdously. I can go from benching 275 one week to barely getting 225 up 2 weeks later...It's just something so sporatic that I was hoping there was some specialized activity that would simply strenthen the area.

Perhaps, I simply need to do what hardgain stated. Perhaps, I need a second opinion.

OK, you definitely need to see a specialist like Sleazy said.

I, like the others, know exactly what you are talking about with the doctor. They are just generally going to react to the problem with that sort of attitude. And even a regular everday "physical therapist" is likely to look at your desire to bench press or any number of things with that same attitude.

A little background that may help.

Whether you have a labral tear now does not mean you've had a tear for years. That injury is more likely a result of a generalized problem you've had for years, upon which wear and tear may have lead finally to a labral tear. It may also lead to other things.

It's the whole idea of "working past it" that probably got you in the fix of it all coming to a head. You can rarely ever really work past things are around them for long. Eventually everything gets out of balance and you have just a bigger problem then you had in the first place. Especially with shoulders because there is such a sensitive balance of stabibility, or lack of it really. One structure just can't take up the slack of others for long before becoming overloaded and boom, a little problem is a big one.

Since you're talking about flat bench and "working chest" I would suspect that you've had an anterior instability or the GH joint. Some type of recurrent anterior subluxation. The humeral head coming partially forward could definitely cause pain and apprehension, maybe a popping sensation, etc. Probably the gh ligament (there is not one discrete ligament it is more like a sheet of ligament) is lax and overstretched. If it's been going on for years than some scapular disfunction may be present also (what they call scapular diskynesis)...look for some scapular winging...and maybe there was bicep tendonitis for a good while.

To make a long story short, you do not usually just suddenly get a labral tear one day working chest and then just sort of ride it out. The instability is the real underlying problem. The tear is more likely the symptom. Keep in mind I'm saying "most likely". I don't know of course. You will read people saying "I got if from dong bench" but probably none of them will be able to pinpoint when they "got it".

If a SLAP lesion was more sudden then probably something more traumatic happened like falling on an outstretched hand or lifting a weight much too heavy with really bad mechanics. Basically something that wanted to suddenly dislocate the shoulder so that the biceps tendon contracted very suddenly and the end result was the tear.

The reason I want to point all that out is because when you look this stuff up besides traumatic events like falling or the kind of problems pitchers get when it comes to weights it'll just say "lifiting heavy weight". That is vague enough to be worthless. There is obviously more to it than "lifting a heavy weight" or we would all be in pain all the time. If you lift properly and with steady progression then it should take more than lifting something heavy. If you remeber something sudden and traumatic that would be very important info. But if not then consider other underying problems. Could even be in the mechanical structure of your shoulder.

Most of the patients studied are are simply not involved in weight lifting activities so we are at a disadvantage.

You may want to consider your form on bench. Are you lifting in a way that severly challenges shoudler stabibility? Maybe you flare your elbows out?

One thing we all need to do in general is give our joints time to recover. The ligaments, etc. cannot recover at the rate the muscles can. If you ignore discomfort, never take time off, or adopt the moronic attitude of "whatever doesn't kill you makes you stronger" then everybody will eventually get chronic problems. How bout, "whatever doesn't kill you will put you in a wheelchair for life"....for those who don't live in fairyland.

Anyway, none of this will likely help you solve the problem, but hopefully it will give you some background of what to expect and look for when you see a specialist. Sorry it was so long. I suppose it is entirely possible that one day you had bad luck and it lead to a SLAP lesion but you must consider these other things.

BTW, it's all assuming you got the correct diagnoses, which I wouldn't count on. The first second opinion you need is what it actually is, let alone how to deal with it.

Thanks for the reply Eric,
 

Going back to when the pain first started it was definetly poor form, I can't deny that. I was a novice and had no clue what I was doing. I stayed out of the gym for years because of it and returned roughly 3 years ago.

Now, you do bring up an interesting point. I don't believe I'm flaring out my elbows but perhaps I am. If there's one thing i'm not it's closed to suggestions and opinions. I'm going to make a point of having someone critique my form the next time I go at it.

What you write also gives me hope, believe it or not, if the issue is form then perhaps the role of the tear may be less significant.

Once again, I do appreciate all of your replies.

That's great advice...

I started lifting weights because of problems a doctor diagnosed with my left shoulder 4 years ago. It was sugested that I start lifting light weights to increase the strength in my left shoulder & bicep but never to lift the weights higher than equal to my shoulder. I followed that for a while but felt the need to move forward.

I have no problems now with a flat bench press but an incline press (or lifting any weights above my head or shoulders) makes both of what might be going on in my shoulders grind and pop...usually feeling like they are missing a few gears. The back left shoulder blade also seems to pop in and out of place.

With no answers coming from the doctors, I've continued on with what I am not supposed to do with considerable increases in strengh and size but have been just waiting for the house of cards to fall.

In the meantime, my shoulder discomfort has been much less painful since lifting weights and I even find that the pain increases if I am away from the gym for any extended period.

I've got an appointment with my doctor for a check-up in January. I'll be sure to ask for a sports specific specialist.

Thanks

Good luck to both of you. Pauly, besides form it may be useful to post what kind of training you've done over the last few years. Basically a sort of overview of you typcial routine. I mean, there could be some obvious problems. For instance a whole lot of benching a little else :D

ZXNV it sounds like you need a shoulder overhaul (I mean a "repair" program not the assinine big shoulder Thib routine by the same name). Especially given what you said about the scapula. I would suggest that you limit overhead pressing and just drop the inclines altogether. If you do OHP then use dumbells and do it in the "scapular plane". Basically that is what people mean when they say "to the front" So if pressing with your elbows extended out to the sides is zero degress, basically you press with the dumbells about 30 degrees in from there, toward the midline of your body. Trying light weights you may find doing it that way gives you less popping and grinding.

Thanks 3237,

I noticed today that you even took the care to go back and fine tune your reply.

Much appreciated.

You know what?
 

Eric,I read in a previous post that you are opposed to Wide Grip. Interestingly, enough that's what I've been doing. Wide Grip for about 2 years.

So as you say, I don't believe my form has been all that perfect.

You made an interesting point. Powerlifter doing wide grip for 1 rep vs Non-Powerlifter for more reps. Come to think of it a power lifter is who recommended I do the Wide Grip. I figured if it works for him....

Thanks, for the info I'm going to a more neutral grip at once.

I kind of thought there may be obvious things that could change. It's kind of unusual to get such bad problems in such a relatively short time of training, other than traumatic injury like I said before. Best of luck on that. If you need further tips on form go ahead and post away or even start another thread since that could be useful for many.

You know powerlifters do what they have to do to get the job done so creating a shorter distance for the bar to travel, etc.

But you really have to consider the "box" that someone is coming from. You can't take all advice blindly and there are things that you may not know about the advice giver, such as their chronic shoulder problems :) You have to consider what works for you and the risk versus reward involved. Plus you have to consider the difference between what goes on in comps and what is a sustainable way of training.

When I see someone say "you should only use a partial range of motions on bench press" or, in other words, only bring the elbows down to torso level, the first thing I consider is they probably have their elbows flared out and are using a somewhat wide grip. So to them, anything other than partial range is uncomfortable or painful. Yet the advice seems to come from some right way wrong way thinking rather than what it really is: an intrinsic limitation of the way they bench press.

Likewise, you'll get someone saying never use a partial range of motion. This person may do everything "right". Neutral grip, shoulders tucked at not more than 30 degrees or so. Shoulders down and scapula retracted. But even given all that, thoughout years of bench pressing and working to get your numbers up, your shoulders take a beating. A partial range of motion may be just the thing to take a little bit of stress off the shoulders sometimes. Not to mention the obvious use of board presses, etc. to work the sticking point.

Anyway, it's great if you switch to a neutral grip. Try not to let you elbows flare out too much from you sides (find the position that feels best to you), keep your shoudlers down and scapula retracted, chest up, all that stuff. But nothing is fool-proof so I guess what I am saying is you can never just just "leave well enough alone". You always have to be thinking, adjusting, and learning. There can be a little value in all sorts of places and the trick is to know how to figure it out.