Labrum Rehab

[Honor&Glory]

As unfortunate luck would have it, my 16 year old daughter, a fast pitch catcher with several D2 schools that are all on the verge of offering her a scholarship, has been diagnosed with a labrum tear in her throwing shoulder.

Her shoulder specialist has said he wants to do everything possible to avoid surgery. The odds of her returning to form (1.8 pop time, 58-60 mph overhand throwing speed) are not great if he has to go in and repair or debride the injury.

We are 8 weeks into her rehab...the pain when she throws (which we have only done once this weekend as part of her throwing program that was prescribed for her) has subsided from a 10 to a 5...and her range of motion is getting better.

I wanted to ask if anyone here has or knows of a throwing athlete that was able to overcome this injury from rehab only?

The thing is that there is a divide in the sports ortho world between docs who want to do surgery and docs that do not. Truth is, if she wasn't a throwing athlete the rehab would be all she needs, I think. it only hurts when she throws, the MRI did not show any rotator cuff damage so it is not a quality of life thing.

Thought I'd ask if any throwers out there have had any experience. I'm a seriously worried dad at present time. Appreciate any stories anyone cares to share.

Thanks,

H&G

 

[Nutriaitch]

yes, but my age and situation is quite a bit different than your daughter's.
Make sure she stringently follows her therapist (or whoever prescribed the rehab) advice and doesn't overdo things. She's young enough and with minimal enough damage for her body to fix itself if done properly.

I'm 37 now and first messed mine up about 5 years ago. Because I'm stubborn and stupid, I continued playing beer league softball (summer and winter) until it got completely unbearable and no longer had the arm strength/endurance to throw to 1st from my normal position at 2B more than twice in a game.

had it checked out a few times during the last few years and am always told the same thing. Rehab will help some, but at my age it won't fix anything as the body just doesn't heal in your mid thirties like it does in your teens.

I inquired about surgery and was advised against it. I have damage to my labrum and bone spurs that would need to be removed.
I'd be looking at a very long, painful, and brutal rehab post op.

The nature of my job would not allow me to miss as much work as would be necessary following surgery, nor would I have the time to properly rehab it.

so my doc recommended to go as long as possible before having the surgery.
I'm limited in what types of overhead activities I can do and for how long.
on good days I can play catch with my sons, just can't pitch to them anymore. On bad days, changing a lightbulb is pushing my boundaries.

My most recent cortisone injection provided about 10 days of relief. So I'm now on tramadol in an "as needed" basis.
I'm not big on medication (other than whiskey), so I only take it when I'm miserable.

 

[ginn421]

Majority of recent research indicates non operative management of labrum tears is not associated with a good outcome, especially for throwing athletes.

Think of it this way, if a varsity athlete at OSU tore her labrum, they most likely would perform surgery ASAP to limit total amount of time off.

She most likely will have a better outcome re: throwing long term after surgery compared to rehab only. Anyone saying otherwise is either being overly optimistic, not up to date with the research, or both.

That being said, if she's only painful when she throws, it may be worthwhile to postpone until a college extends an offer and have them deal with it on campus, as long as she can still perform at her previous level.

Sorry for being a downer, just giving it to you straight like I do with my patients.

 

[ginn421]

Reading nutriaitch's post above mine, that sounds like a typical reaction of the shoulder if she would continue to throw and do rehab only. It may work out now, but eventually it will catch up to her and her prognosis after surgery will not be as good. If it's a clean, small tear only her rehab post op would be much easier.

 

[Honor&Glory]

Thank you both...
I do believe she is going to need surgery but if she has it now she will miss all of high school ball and a good portion of her summer season which scares me that coaches would not offer her given a shoulder injury. Moving to 1st base is not an option. she's a small girl (5-3). If she had a little more foot speed a move to 2nd would be possible but her strength is her intelligence from behind the plate. She calls her own pitches in both high school and summer teams and is the defacto pitching coach for her travel team..

I do think we are in a manage it until she gets an offer mode. signing day for her would be just over 12 months away. thank you, ginn for your response.

 

[NJ-Buckeye]

H&G keep doing your homework... and find the best doctor you can... many doctors have this 'specialty' but only a few are THE BEST of THE BEST

Labrum tears are generally baseball.. so I'd contact the Cinci Reds and talk to their medical staff head.. for a recommendation.. highly suspect he'll talk to you or worst case you could find him in the public sector... and email him...

It will sound crazy.. but I'd even consider the best on planet earth.. Dr Andrews
I believe he has periodic visits to the DC area...

My son is 32 and the routes we chose have not worked... he's had 2 surgeries and needs another... we've done the intense PT route numerous times... labrums are tough... and could lead to rotator cuff itself

 

[ginn421]

Glad to help out, hopefully she can manage until then.

Re: labrum healing on its own: the labrum is very much like the meniscus, in that it has a very poor blood supply. This means it cannot heal as effectively as a muscle or tendon can. The shoulder will be unstable for a longer period, and could lead to rotator cuff issues down the road, even if there's none now.

 

[ginn421]

H&G keep doing your homework... and find the best doctor you can... many doctors have this 'specialty' but only a few are THE BEST of THE BEST

Labrum tears are generally baseball.. so I'd contact the Cinci Reds and talk to their medical staff head.. for a recommendation.. highly suspect he'll talk to you or worst case you could find him in the public sector... and email him...

It will sound crazy.. but I'd even consider the best on planet earth.. Dr Andrews
I believe he has periodic visits to the DC area...

My son is 32 and the routes we chose have not worked... he's had 2 surgeries and needs another... we've done the intense PT route numerous times... labrums are tough... and could lead to rotator cuff itself

Not sure if you're near Columbus, but Drs. Julie Bishop or Grant Jones at OSU are phenomenal

 

[NJ-Buckeye]

Don't know who is outstanding in the state of Ohio or anywhere else for that matter...
but I know this is a decision that she will deal with for the rest of her life
and not the next 12 mths or even her college career

It's a really tough spot for a parent... been there

 

[Thump]

Labrum tears are generally baseball.. so I'd contact the Cinci Reds and talk to their medical staff head..

The Krem reaper?

 

[Honor&Glory]

H&G keep doing your homework... and find the best doctor you can... many doctors have this 'specialty' but only a few are THE BEST of THE BEST

Labrum tears are generally baseball.. so I'd contact the Cinci Reds and talk to their medical staff head.. for a recommendation.. highly suspect he'll talk to you or worst case you could find him in the public sector... and email him...

It will sound crazy.. but I'd even consider the best on planet earth.. Dr Andrews
I believe he has periodic visits to the DC area...

My son is 32 and the routes we chose have not worked... he's had 2 surgeries and needs another... we've done the intense PT route numerous times... labrums are tough... and could lead to rotator cuff itself

her shoulder doc is Dr. Roth with Beacon Orthopedic...Doc Kremcheck's office and her PT is the Reds shoulder therapist. But I have considered reaching out to Dr. Andrews and would travel to Alabama to his main office if necessary.

 

[Honor&Glory]

Don't know who is outstanding in the state of Ohio or anywhere else for that matter...
but I know this is a decision that she will deal with for the rest of her life
and not the next 12 mths or even her college career

It's a really tough spot for a parent... been there

you are 100% correct...I actually advised my daughter (30 ACT score, 3.5 gpa) that if rehab does not work to not have the surgery. if just modifying her life style by not throwing leaves her pain free, then her quality of life is way more important. She, however, is determined that if she needs surgery she will have it. she's not ready to give up her dream of being a college athlete.

 

[NJ-Buckeye]

Andrews also has a location in FL that could be easier to get to... and I thought he pops into the DC area a couple times a mth

 

[Nutriaitch]

you are 100% correct...I actually advised my daughter (30 ACT score, 3.5 gpa) that if rehab does not work to not have the surgery. if just modifying her life style by not throwing leaves her pain free, then her quality of life is way more important. She, however, is determined that if she needs surgery she will have it. she's not ready to give up her dream of being a college athlete.

it's not just the dream of playing college ball that's hard to give up. or at least wasn't for me.
for me the hardest part is not playing ball anymore. during the season, I don't take my normal route home from work because I don't want to see the lights at the complex where we play.

 

[Nutriaitch]

whatever you do, make sure you do your homework and choose wisely.

until you have a bum shoulder, you don't realize just how much movement relies on that joint. even when you think you're not moving the shoulder.

mine is now pretty much permanently fucked because I didn't handle it right until it was too late. even if I choose surgery, at best I'm looking at a 50/50 shot at getting back to about where I'm at now as far as strength and range of motion. anything more would be considered a bonus. the pain relief would be a crap shoot for me as well.

now a "pain free" day for me is about a 3 on a scale of 1-10. I truly don't remember the last time I had a day I could say I was completely without pain or discomfort (other than the first couple days after my cortisone injection).