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  1. #1
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    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possible?

    Well on June 5th I had my first serious crash, went over the bars, and landed hard on my left shoulder. The MRI results showed that I severely tore the labrum in my shoulder from the 11 o'clock to the 3 o'clock position but the rotator cuff is not torn. The orthopedic specialist explained that the labrum is cartridge material that has no blood supply and will never heal on its own. The procedure is to drill anchors into the shoulder and attach the torn labrum to the anchors, and shave off all the jagged pieces to make is smooth like it should be. Minimum of 4 weeks of the shoulder/arm completely immobile in a sling, then 4-6 months of physical therapy. I asked him if I would have any chance of a full recovery without surgery by just building it up doing physical therapy. He said I could try it and if I don't see any improvements in 6-8 weeks that I can decide to go with the surgery then. I'm wondering if any of you have been down this road and could give me some insight on whether I'm wasting my time trying to prevent the survey, or anyone who had this injury and recovered fully by sticking with the physical therapy?


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  2. #2
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    My experience- 47 year old male, hit a tree with left shoulder biking at Snowshoe beginning August 2012. Slow speed, didn't even knock me off the bike and just kept going. Got home week later and shoulder started bothering me, but figured it was tendonitis. Went to doctor in September and they thought the same. Went on medication & cortisone shot and started rehab in September, continued mountain biking with soreness after rides. Beginning November some improvement, but kept losing strength and could not do anything close to what I was doing prior to the "tree". Finally, MRI ordered then rejected by insurance, appeal, then finally MRI. Results, shoulder was a mess. Surgery 2/4/13, Doctor went in thinking it was just the clavicle needing to be shaved, but discovered the labrum was severely torn. It took 3 anchors, he said it looked like a tornado went through my shoulder. 4 weeks of nothing but sling/ice, then rehab started. Healed well and went mountain biking 3 days short of 4 months from surgery and no problems since. In fact, I think my left shoulder is now in better shape then my right.

    So to answer your question, surgery ASAP, so you can get back living again. Dr. stated that you can live with it(torn labrum) - if your going to sit on you couch. If you want to be active you really don't have much of choice. Good Luck and most importantly be sure to follow all rehab instructions.

  3. #3
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    My experience with a labrum tear:

    Late last April i crashed off my Cross-check bike on a bike path (hit a dirt jump off to the side, intended to roll it. Went airborne instead, Doh) and plowed into the ground left shoulder first. I came up spitting dirt, checking for missing teeth and with a massive flair of pain in my shoulder. Since my arm still worked I pretty much ignored it, washed the dirt rash off at a rest stop and pushed another 20 miles to my car. Most of which was spent with my left hand holding onto my jersey to try and support the shoulder/arm as much as possible. That should've been a clue to get into an ER and call my Ortho asap...

    But being (relatively) young and invincible (6 knee surgeries and compound fracture of the rt arm haven't been able to stop me yet) i ignored it and soldiered on. My gf noticed me holding onto to my shirt with my left hand more and more frequently and "polity" told me to call my Ortho as it wasn't improving but getting worse as May wore on. Got in pretty fast as I'm a "frequent flyer" with my Ortho and was sent for an MRI as the shoulder was unstable and painful. The MRI was done in late May, it came back positive for two Labrum tears- small one in the front of the shoulder and huge one in the back. The doc and I had a chat about the what was ahead: the shoulder won't heal on its own, its a surgical repair (anchors pounded into the shoulder to tie everything down and together) and pretty much required for someone active. Once the surgery happened, I would then be locked in a sling for a month solid and then slowly be allowed for longer periods of time. Cycling (and most other outdoor activities) would be off the activities list for at least 6 months post-op. Intense PT would be though.

    The timing of the surgery was up to me, essentially i could have it done whenever i wanted (the "benefit" of being one of my Ortho's best customers...). However the longer i waited the harder the rehab would be as there was only so much i could do to keep the shoulder functional and stable with the size and location of the tears. I opted to delay the surgery till the end of August as i had committed to a ride (ADA Tour de Cure around Lake Seneca, great event) with a friend i don't see much along with still wanted to have a summer packed with as much riding and whatever else i could do.

    PT before surgery was worth it imho- it kept me on the bike and hiking for the ~3 months i delayed it. Towards the end i was getting weaker and having more problems but not enough to make me advance the day of the surgery. The surgery itself hurts like hell once the nerve block wore off and going from being left handed to right handed for 6 weeks wasn't all that much fun. I ended up with 3 anchors in the back and 1 up front to help hold everything together. Rehab has been tough and there is still pain when i push the left arm too hard- like humping 600 pound barrels of haz-waste all day @ work.

    My surgical photos-

    The tears

    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possible?-mtbr-shoulder-image-upload-2.jpg

    The repair work

    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possible?-mtbr-shoulder-image-upload.jpg
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  4. #4
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    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possible?

    Thank you both for your experiences with this type of injury. I am trying to deal with the pain the best I can (only taking Advil and icing it when possible) but laying down at night and when I wake up in the morning is almost unbearable. Its now been over a month since the crash but only my second week of physical therapy so ill keep at it as long as i can stand it. I am hoping to put it off until after our vacation and get the surgery in October. I would much rather give up weight lifting and bike rides on the trainer than the rest of the summer and beach vacation.


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  5. #5
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    My experience is a bit different. I got my SLAP injury kayaking the Gauley river at low water. Went to roll and clobbered at rock just as I put pressure to the paddle. Getting out of the Gauley is no fun once you are injured.

    I felt okay by a couple of days latter and let it go. Over the course of the next two years I kept getting weaker and more muscle imbalanced over time. Finally I would gasp in pain if I tried to do something like use a hand drill. When things progressed to the point of every day life interference I sought help.

    My recovery? Two years or just about the same amount of time I physically went downhill. The problem isn't the healing from surgery but the imbalances in muscle groups throughout the upper body. The muscle imbalance creeps up slowly and seems to goes away just as slowly. I think I could have shortened the time of recovery knowing what I know now.

    The point is, others that I have talked to all seem to follow a pattern of longer total recovey time ( back to never thinking about your shoulder) with longer times between injury and surgery. I learned my lesson and now seek surgery sooner rather than latter. I tore and ACL since then and had surgery within two months. The recovery was faster than the doc predicted.

    If you wait I would suggest PT to preserve more muscle balance. Just my opinions, I am by no means a big authority on the subject.

  6. #6
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    Sorry about your shoulder.

    I've been down the torn labrum path 3 times - left anterior (volleyball), left posterior (ski crash), right completely torn off (a collection of incidents based mostly on me being uncoordinated).

    I have tried the PT and strengthening exercise route, it didn't work for me. The shoulder just kept getting worse, and I started cutting out activities until I broke down and had the surgery.

    IMHO - If you're going to continue to active, just get the surgery. Your doc is correct, it's not going to heal on its' own.

    Talk to your doc about how long you can hold off if you want to wait for a better time of year to be laid up. I had one where the doc had no problem with me holding off until fall/winter. My latest one, the same doc was concerned about arthritis and further damage to the joint so I didn't really have a choice.

    Good luck.

  7. #7
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    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Pos...

    Sorry to hear about the shoulder. My story was a rt slap tear from collage volleyball. I avoided surgery, and played through the pain with lots of Advil for many years. Fast forward 15 years,and the pain got worse just doing every day activities. At the time of the surgery. I was 40. The dr was not going to do the procedure due to the age factor but I had a cyst in the shoulder which needed to come out, so he said since he was going in might as well fix it. Recovery was tough. You really need to do what is recommended. 3 years later I have torn it again. Not sure how. This time the surgeon will not do the repair but a bicep Tenodesis. Reason I'm to old. Get it done if you can and don't cheat on the rehab exercises.

  8. #8
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    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possible?

    I made it through 5 weeks of physical therapy and pretty much it just maintained the limited range of motion and pain level that I had, not that it was a bad thing or a waste of time since I'm glad it didn't get worse in the 5 weeks. I had my follow up with the doctor last week and decided that I need to get it fixed sooner rather than later since my muscles are definitely getting weaker, already not able to do a lot of stuff, and just sick of dealing with the pain. So I have a surgery date of August 9th, this way I can make arrangements at work and train someone from another department to fill-in while I'm off. I'm just really bummed about giving up our beach vacation that we look forward to each year. The doctor did say the physical therapy that I've done should help me with the recovery time, so I'm hoping I can recover sooner than expected. I'll let you know how it goes.

    Thanks again for sharing all of your experiences.


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  9. #9
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    Do you have a recliner? Much better than trying to sleep in a bed.

    Good luck with the surgery, be patient with the recovery, it takes a while.....

    Hope you heal quickly.

  10. #10
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    Quote Originally Posted by godot View Post
    Do you have a recliner? Much better than trying to sleep in a bed.

    Good luck with the surgery, be patient with the recovery, it takes a while.....

    Hope you heal quickly.
    Very good suggestion. It's pretty painful to sleep on in a bed for the first month. Also ice, LOTS of ice. I purchased a shoulder wrap used for baseball pitchers. I always had 2 in the freezer and would wear it for hours. Sounds very silly, but start practicing being 1 handed. I am right handed and had to learn to be a lefty. Simple things became very frustrating. Try putting your sock on with 1 hand, try eating with one hand. All frustrating at times depression when your in pain, so get the practice in now.

    I'm not looking forward to this again, my drive is for next summer to go out and have a catch with my daughter.

  11. #11
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    Trivan's suggestion to start practicing being one handed is a good one -

    Toothpaste - find some in a can Sensodyne. It's difficult to get toothpaste out of a normal tube one handed.

    Shoes - you won't be able to tie them. Get some slip on shoes, or shoes that have a speed lacing system. I've had good luck with Salomon trail running shoes.

    Buy a few very large t shirts, plan on living in them for a while.

    Talk to your doc and insurance company about renting a "Game Ready" for the first week or two after surgery. Money well spent.

  12. #12
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    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possi

    I went over my bars and landed on my right shoulder pretty bad. Actually landed on a large root. That was in may. I was in major pain for months with very limited motion. I could not lift weights and dropped from 195 to 170lbs. I could not sleep on my right side. I could not even lift up my laptop. I never went to the doc though. I finally started lighting weights again(last month) and I'm fine until I do anything that is over my shoulder. Like laying on the bench and trying to work out my triceps. I still don't have the motion I use to, but it only pains me when I do certain movements . However, the last week it hasn't been bothering me. I figured the weights helped break up scar tissue. Maybe I got Lucky. Unfortunately I clipped a tree with my left shoulder while MTB tonight. I was practicing for a time trail and I clipped the tree at 18mph. It did throw me off the bike and I landed on my back. It was intense because when I tried to stand up I got dizzy and fell. My head has been hurting since and I have a nasty bruise on my shoulder. To make it worse, my back is starting to hurt. To be clear i never hit my head. I guess it's time to go see the doc.

  13. #13
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    Definitely work on the one handed stuff- especially if it's your dominant arm that's going be locked in a sling. I spent last summer working on how to live without my left hand, saved a whole bunch of frustration at home and work (i went back to work on reduced hours 1.5 weeks from the surgery with a Minion to act as my left hand at the laser welder). As others have said, everything gets a whole lot more difficult including the things you don't think about like brushing your teeth or getting dressed.

    The biggest problem I've run into on the backside of the surgery (almost a year out now) has been muscle weakness in the left arm/shoulder/upper back and getting the strength back. I barely lost any mobility going into the surgery and regained what little lost right back away with the help of PT. Muscle strength on the other hand has been a real pain and problem to recover.
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  14. #14
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    Your mention of shoulder injuries is interesting to say the least. There is plenty of info on the Nat'l Institute of Health website on these ortho problems and surgical alternatives.

    I was clotheslined by a car door in 6/2008 and MRIs showed a 1/2 inch SLAP tear and partly sheared biceps tendon on LH shoulder. Got several opinions and glad I did not have arthroscopic surgery because it has a low success rate for folks with cartilage loss due to arthritis. Like I have. Cedars-Sinai ortho in LA does titanium acromial head replacement with supposedly high success rate, but it isn't cheap and I don't have any insurance coverage. Answer to your original post is a definite no, five years on its hard to do any lifting above shoulder level, or even hang or do any kind of lat pulldowns. Easy to reinjure, hurts like fury at the strangest times (crossing arms while riding on a bus, straphanging) even though lifting while bending down is possible.

    Along came another car door accident in 7/2010, caused similar injury to RH shoulder, also tore meniscus in RH knee. Of course there was and still is plenty of aggravation of earlier injuries, pain, little commitment to PT at free clinic, incompetent attorneys, shark auto insurance opposition and no insurance coverage of my own. So this has thrown me back on SSA, who says I am not disabled and still several years away from Medicare benefits plunks me in a hole. County medical system will not provide elective ortho surgery, period.

    Prior to my 2008 accident I made the most of my time between contract work and rode both mtb and road about 200 miles a week. No one is hiring partly disabled folks over 45 no matter how well-qualified. I ride only between bus stops and do short local commutes now on a beater.

    Assuming you're in a position to do so, get the best, most well-qualified surgeon you can find - who has actually done lots of these surgeries, get testimonials and try to get healed the soonest you can.

  15. #15
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    Just a follow up
    Last Friday the surgery went as planned and he said there was no additional damage, which is great. I've been doing the ROM exercises everyday like they instructed. Things seem to be feeling decent and improving quickly in the first week. I've been sleeping in the recliner a lot better than I thought i would, of course the pain meds a few hours before bed are helping I'm sure. But I swear the weather this week has been unbelievably beautiful everyday since my surgery... and it's killing me to just stare out the window or sit on the back deck, not able to do anything active. It's only been a week and already I'm bored out of my mind. I have a Post-Op appointment next Wednesday the 21st so I'm hoping he will say I can ditch the immobilizer brace and can go walk just to get some exercise in and get out of the house, but that may be too soon yet.

    Thank you all for the help and suggestions.
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    No additional damage is great, tear in rotator cuff would be bad. Just be patient, it's going to be hard as is rehab. The shoulder is going to be tight and is suppose to be that way until you start stretching it out(through rehab). My experience went like this: felt pretty good after surgery then the good and bad was up and down. Just stay the course and follow instructions and you will be golden. As mentioned earlier, 4 months I was mountain biking with no real issues. As I progressed I would experience minor soreness but it would be gone quickly. I'm well over 6 months now and have experienced no setbacks and heading to Colorado/Utah next month as a reward! Being injured is just the cost of doing business when mountain biking, do it long enough and accidents will happen. Good luck dude!

  17. #17
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    Quote Originally Posted by MhzMonster View Post
    Just a follow up
    Last Friday the surgery went as planned and he said there was no additional damage, which is great. I've been doing the ROM exercises everyday like they instructed. Things seem to be feeling decent and improving quickly in the first week. I've been sleeping in the recliner a lot better than I thought i would, of course the pain meds a few hours before bed are helping I'm sure. But I swear the weather this week has been unbelievably beautiful everyday since my surgery... and it's killing me to just stare out the window or sit on the back deck, not able to do anything active. It's only been a week and already I'm bored out of my mind. I have a Post-Op appointment next Wednesday the 21st so I'm hoping he will say I can ditch the immobilizer brace and can go walk just to get some exercise in and get out of the house, but that may be too soon yet.

    Thank you all for the help and suggestions.
    Are you back on the bike yet? I torn the labrum in my right shoulder while kayaking about 25 years ago. The tear was small and has been manageable with regular exercise. Torn the labrum on my left side about 4 months ago and tried rest and rehab but no go. The tear was from 1 o'clock to 5:30 it really did need surgery. I Had surgery 5 weeks ago and the rehab is going ok but it feels like it will be along time before I'm back on the bike...

  18. #18
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    Quote Originally Posted by noosa2 View Post
    Are you back on the bike yet? I torn the labrum in my right shoulder while kayaking about 25 years ago. The tear was small and has been manageable with regular exercise. Torn the labrum on my left side about 4 months ago and tried rest and rehab but no go. The tear was from 1 o'clock to 5:30 it really did need surgery. I Had surgery 5 weeks ago and the rehab is going ok but it feels like it will be along time before I'm back on the bike...
    Well first let me say that I'm stubborn and hard headed so with that in mind, I had my surgery on August 9th and decided to ride the indoor trainer to test it out on September 3rd and 4th... then it was rail trails for the rest of the season. The pain was tolerable if I managed to ice it and rest it off the bike. But I am still doing physical therapy 2-3 days a week hoping that I'm almost done with it in a few weeks. My last measurement was 85% range of motion. Last week I was given the okay to finally start lifting weights for strengthening, before that it's been stretching, ROM, and resistance bands so it feels good to hit real weights even if I hit my limit pretty fast. I would say if I was to go hit a trail right now, I feel I could definitely stand and mash (rock the bike, which I couldn't do), climb, without trouble but not sure if I could bunny hop or anything like that. Best advice I could give anyone is to give 110% effort during rehab, and try to be as patient as possible, trust me I know it's difficult.
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  19. #19
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    Quote Originally Posted by MhzMonster View Post
    Well first let me say that I'm stubborn and hard headed so with that in mind, I had my surgery on August 9th and decided to ride the indoor trainer to test it out on September 3rd and 4th... then it was rail trails for the rest of the season. The pain was tolerable if I managed to ice it and rest it off the bike. But I am still doing physical therapy 2-3 days a week hoping that I'm almost done with it in a few weeks. My last measurement was 85% range of motion. Last week I was given the okay to finally start lifting weights for strengthening, before that it's been stretching, ROM, and resistance bands so it feels good to hit real weights even if I hit my limit pretty fast. I would say if I was to go hit a trail right now, I feel I could definitely stand and mash (rock the bike, which I couldn't do), climb, without trouble but not sure if I could bunny hop or anything like that. Best advice I could give anyone is to give 110% effort during rehab, and try to be as patient as possible, trust me I know it's difficult.
    Thanks for the update. I'll try and stay patient.

  20. #20
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    I've had a SLAP since 1990 - diagnosed in 2000. Might have it repaired this year, because of new injury. But the SLAP only bothers me when I throw a football, paint crown moulding... I ride (a lot), lift weights - shoulder presses, dumb-bell flies, bench, etc.
    Mountain bikers who don't road ride are usually slow.
    Roadies who don't mountain bike are usually d***s.

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    I was hit by a minivan in January and am set to undergo surgery for the resulting SLAP tear this month.

    For those who have had the surgery:
    1. How long before you were able to hop on a trainer? How intensely could you ride?

    2. How long before you were able to ride again (commute or road)?

    3. Any advice for having to go through recovery during the summer months?

    Any advice/insight is much appreciated.

  22. #22
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    My own experience-

    #1. I was allowed on the trainer roughly a month after the surgery but i couldn't but any weight on the handlebar, even with the non-surgical arm. Not really helpful there doc... At 2 months out, i was free of the cursed sling and allowed to put the non-surgical arm on the handlebar. At 4 months i was free to grab the handlebar with both hands.

    #2. At 6 months post-op i was allowed to play outside but only on the road. I choice not to since the weather was crap, roads were covered in alternating layers of sand and ice. Ended up on the road at the 7 month mark once the conditions got better.

    Getting back into the woods was dependent on how everything felt, I delayed till 9 months since bombing dirt roads on the cross bike was still causing me pain and irritation. I resumed Dh'ing 1 yr and 2 months post op since it is the most abusive thing i do on a bike and it took that long for woods ride not to hurt. I had a stupid short season of only 1 day since knee surgery was scheduled for 2 days later to hog out yet another chunk of torn meniscus. Thank you small dog for sleeping on the stairs, resulting in me tripping down them.

    3. Sitting upright for hours at a time on a standard seat is painful in my experience. I picked up a Brooks B66 for my father and broke it in for him over the course of the winter on the trainer. He love the saddle and the fact that it came to him "soft" already. The B66 is enormously wide without looking a standard comfort bike saddle with 5" of useless foam padding.

    Also- find something to keep you mind occupied. I burned through a massive amount of movies while rehabbing the shoulder and picked up a few video games for my tablet that i could use with 1.5 hands. During the knee rehab this past winter i started to build Lego sets on the stationary trainer, a half hour at a time and then spend the rest of the spin on a workout session. Seriously helped to break up the sheer monotony of the trainer and keep my mind busy.
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  23. #23
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    SLAP Tear (torn labrum left shoulder), Is a Full Recovery Without Surgery Possible?

    Not sure if any others touched on it.
    Don't go beyond what you are doing in rehab and don't do more then what you PT is telling you to do.
    Like don't try to lift a gallon if milk because you felt good that day. Decisions like that will cause setbacks which will delay your recovery.
    I have 20 years in sports med/physical therapy.
    Athletic types always recover better then non.
    Labral repairs also heal up nicely as long as you don't do too much too soon.
    Everybody is giving pretty good advice. Learning from others is great.
    Good luck
    And heal well

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    Thank you. It's hard to take being off the bike so long-- it's pretty much the only thing I do to vent/clear my head these days...

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    Quote Originally Posted by dwrz View Post
    I was hit by a minivan in January and am set to undergo surgery for the resulting SLAP tear this month.

    For those who have had the surgery:
    1. How long before you were able to hop on a trainer? How intensely could you ride?

    2. How long before you were able to ride again (commute or road)?

    3. Any advice for having to go through recovery during the summer months?

    Any advice/insight is much appreciated.
    My only advice is LISTEN TO THE DOCS AND THE PHYSICAL THERAPIST. I am 7 years post op from a torn labrum and super sloppy rotor cuff muscles (which equals regular shoulder dislocations). I tried going the "strength training will suffice, I'll be fine" route. Dumbest idea ever. If it wasn't for the 4 inch scare on my shoulder, I would forget which one had the operation. Just as good if not better than the right which is still OEM. Good luck.

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