surgery confirmed obvious type 2 Slap repair on 12/8, 6 anchors placed with large bone spur removal. During surgery bicep tendon was “obviously displaced” but not relocated. Severe arthritis found as well. Started PT 4 days post op. In sling for 6 weeks. After 6 week mark increased PT from 2 days per week to 3. Since that time ROM is still really bad, weakness…Is still really bad. And, by bicep connection point at shoulder is really brutal. Any experience with this? Fear is a revision surgery to move bicep connection point.
It sounds like your shoulder joint is not Stable. Or the bones aren’t coming together correctly around your shoulder. Or your humerus isn’t Centrated in the joint.
And because your joint isn’t stable, it moves around funny during your PT exercises and things are feeling worse.
So you first need to relearn how to get your shoulder properly “aligned” and “tight” and in place before you can get much out of internal/ external rotation drills.
Does this sound like crazy talk, or (hopefully) something reasonable?
Thank you for your reply. No, that doesn’t sound crazy. My shoulder does feel really unstable. I’m not sure if that is weakness related or something structure wise. PT assures me that it isn’t, and that feeling is normal post op. I have a follow up app. with the surgeon tomorrow. So, we’ll see…
It could Easily be weakness in shoulder internal rotator and scapula depressing muscles. Like your shoulder is “shrugged up” and you need to “pull it down.”
Or it could be that your bicep tendon moves out of the groove, so your arm bone moves incorrectly. Then it goes back in so things are slightly better for a short time. Then it goes back out and things hurt again. So you need to learn to get the tendon back in the groove yourself.
3rd possibility could be a little douchey arm/shoulder muscle like the coracobrachialis is super tight and pulling your arm bone out of position.
If any of these are your issue, all the surgery and internal/external rotations in the world wont help much.
Start with rubbing my shoulder pretty hard. Including incision sites(which I understand) then passive ROM to almost full range. (Horrible) feels like shoulder is going to dislocate.
“finger ladder,” 10 to the front, 10 to the side x1
arm bike. Slow for 4 min frontwards, then 4 min backwards. (Backwards hurts bicep)
wall slides x10 front, 10 side
Seated pulley front x20 side x20
Draw abc’s on the wall (about head high) with a small ball.
O, have also done cupping. Once at around 4 weeks post op (I think) then again about 8 weeks. I think those time frames are correct. But hard to remember.
Heres a dude putting his bicep back in place. Notice how his arm is kinda away from his body, then he makes a motion somewhere between sticking his hand into his pocket and doing a dip, while internal rotating his hand. This motion, pressing your shoulder and arm down while rotating it in gets your upper arm centered in the shoulder joint.
This is the coracobrachialis, a small muscle in the front of your arm/shoulder that can get tight and cause your shoulder to move shitty and be painful.
And this is a stretch to loosen up that tiny muscle. Notice it’s the same, shoulder depressing, reaching into your pocket while internally rotating your arm motion as resetting your bicep tendon.
This is a band resisted motion to strengthen and center your arm and shoulder. Notice its the same reaching into your pocket, bringing your arm in and down motion.
This is the sort of basic, underlying motion you need to get down. Then you need to learn to keep the joint “tight” as you internally/externally rotate. After that you can get into all the reaching and raising stuff.
If you look at yourself in the mirror, is 1 shoulder higher or lower than the other? Does the bottom of your rib cage Flair or stick out on one side? Or is 1 side turned forward, or rotated slightly ahead of the other side?
If your ribs are funny, your arm is always gonna hang funny.
Any idea of the odds/frequency that I could have re torn the labrum in PT. Only thing that makes me think that is I’m two months out now (which I know isn’t long) with the same symptoms as prior to surgery. When they stretch my shoulder. By this I mean I’m laying supine on table and they (Pt) bring my arm up over my head(flexion?) to almost full ROM. Super painful.
You need to figure out how to get your shoulder level and your rib pulled in First. Then figure out how to centrate and stabilize your shoulder joint with. And move your arm around below shoulder level. Getting your arm up over your head is like step 4.
Agree. Concerned at this point if it’s re torn. Had a follow-up this morning with the surgeon. He wasn’t too excited by my progress at the 2 month mark. He dropped pt to twice a week instead of three. And moving me to a different pt company. I have the same symptoms as prior to surgery. Just a lot weaker now….
I am currently rehabing a shoulder injury. Not the same but. The PT makes a big difference" Mine is specialized in sport injuries.
At 8 weeks post op, I had only limited passive ROM, at 12 weeks I had some active ROM.
Now getting close to 16 weeks I have near full active ROM and full passive but we just started to work in strength a few weeks back.
Do you have a home rehab program or just PT session.
We can’t compare but I had some passive ROM stuff to do at home 2 to 4x per day.
Mostly front raise and lateral raise using a broom stick, done laying down or standing reaching discomfort not pain.
After week 10 some active ROM was added but that was not much at first.
