| T O P I C R E V I E W |
| slap |
Posted - 04/09/2007 : 15:53:38
Has anyone been diagnosed with a torn labrum in the shoulder (a "SLAP" tear)? From what I understand, arthroscopic surgery for this problem has a long healing period so some people choose to live with the pain (which usually occurs during overhead throwing motions). Any thoughts on links to TMS? Do a lot of people have "tears" in the labrum but only those who have TMS experience pain? Any thoughts (especially from those who have been diagnosed with a "SLAP" tear) would be appreciated. Thanks. |
| 6 L A T E S T R E P L I E S (Newest First) |
| tennis tom |
Posted - 08/30/2012 : 09:27:54
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"...a 73% rate of abnormal findings in patients with NO pain (also known as a false positive) should gives us more than enough reason to pause for reflection as we consider the relevance of imaging studies in a patient with chronic pain, here specifically of the hip."
February 11, 2012
The Healthy Mind Network
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Thanks for that info Dr. Zafirides and your contributions to the TMS Help Forum. Since my structural symptom is my right hip, literally a pain in the ass, it strikes close to home. I have paused for TMS reflection for many years, resisting the constant urgings of well meaning people, to get a hip-replacement. This is despite being told by two Dr. Sarno trained TMS doctors that my hip problem was NOT TMS but significant arthritis.
When I was shown my imaging, I had trouble seeing what they were talking about when pointing out the difference in cartilage space between my right and my left hip. So I've been stuck, limping around the tennis courts for years now. My question is how would I determine if I should get a hip-replacement or if it's TMS? I have contemplated arthroscopic surgery, as it's less invasive and to get in there and see what's going on. Maybe a little nip and tuck would help, but I've been told it's too late for that by an ortho. Arthroscopic surgery also takes months to rehabilitate from--so I'm off to play tennis in a little fun tournament on grass courts, kicking off my shoes.
Cheers,
Shoeless Tennis Tom |
| Dr. Zafirides |
Posted - 08/29/2012 : 20:53:09
quote:
Do a lot of people have "tears" in the labrum but only those who have TMS experience pain? Any thoughts (especially from those who have been diagnosed with a "SLAP" tear) would be appreciated. Thanks.
Slap,
You may find this article on labral tears (of the hip) helpful:
http://www.thehealthymind.com/2012/02/11/chronic-pain-treatment-shouldnt-be-based-solely-on-mri-results/
In the study, labral tears were read out in a large majority of patients - yet NONE of the individuals were in pain.
Please take the time to review the article. You may even want print it out and have your doctor read it.
Kindly,
Dr. Zafirides |
| eric watson |
Posted - 08/23/2012 : 15:05:47
what happened to slap |
| allen_non |
Posted - 04/11/2007 : 07:24:54
Hi Slap, sorry it took so long to get back to you.
My SLAP tear was minor, but the Dr didn't find that out until he got inside my shoulder. He went in expecting to find a major SLAP and minor superspinatus tears, but instead found a 95% torn SS and just a minor slap. I opted for the surgery because it had become obvious at that point (from Nov 2003 to Aug 2004), after months of resting, physical therapy, cortizone injections, etc, that it wasn't getting better. It didn't even hurt all that badly, but like I said earlier, I like to workout pretty hard core, and my functional strength was decreasing. I remember even as they were putting in the IV and asking what my pain level was (it was zero at the time), I contemplated hopping off the table and saying "no thanks". But it was God's providence that I didn't, because I would likely have torn the remaining 1 mm of tendon I had left within a week or two.
I basically saw that surgical repair was the only way to get from Point A (injured) to Point B (able to train again). In your case, depending on your preferences & responsibilities, there's not really a rush to surgery. As long as you're not throwing, doing overhead lifts, or anything else that causes pain, you're probably not making it any worse. Because the SLAP is a tear of the Labrum (cartilage) from glenoid fossa (socket, bone) and there is poor blood flow to that area anyway, spontaneous healing (without surgery) is VERY unlikely. Also keep in mind that one of your bicep tendons also attaches to the labrum, so I'd avoid pull ups and curls until your MRI shows what you have.
Now, TMS & SLAP tears- or TMS and any "injury"- there is the rub. If I had known about TMS during the period before my shoulder, I might have tried (out of wishful thinking) to write it off as TMS. TMS is very adept at "faking" painful injury. If I had done that, I would have skipped surgery, torn the tendon the rest of the way, and had surgery later anyway, only under more duress. Like I said earlier, even Sarno warns to get checked out for real injuries. If you broke your humerus, it would hurt, might look real weird, you'd get an xray, diagnosis, and a cast. Shoulder pain, because there are so many tendons in the area, is an easy mark for TMS showing up as tendonitis or bursitis. But you must remember, tendonitis is irritation and inflamation of a tendon, NOT a tear. If the MRI shows a tear of your labrum or RC tendons, it will require a repair. If the MRI does not show a tear, and your DR diagnoses you with an -itis, you will probably have good success treating it as a TMS symptom.
Whichever you end up with, you can count on this being a future target for TMS, now that your conscious mind recognizes that you've had trouble there before. I am just recently "recovering" from some shoulder woes where I had my surgery. No reason (logically) to think I had re-injured my shoulder, but the pain was undeniably back. Then I re-traced the history and found that on the very same day my pain returned, I had received some job related news that disturbed me greatly. I started treating it as TMS, and almost immediately my shoulder improved, and is still improving.
If I were you, I'd definitely proceed with the arthogram MRI and see what you're dealing with. Know going in that they are accurate, but occasionally do mis-diagnose. Unless the tear is really bad, I see no reason why you'd need to rush to have surgery. You will be out of commission (no lifting ANYTHING) with your shoulder for at least a couple of months, plus it would put an extra load on your wife to help you with things, when you will want to be helping her with things. On the bright side, with a second baby, you won't have a lot of time for tennis or lifting anyway, and you'll probably want to enjoy that time with your new blessing, plus spend lots of time with your older child as well. Once things settle down, you can think about surgery, if it is necessary.
Well, hope I've answered your questions (without putting you to sleep). I remember before surgery thinking that I'll be out of commission for 4-6 months, no training, and that it would take me a year or more to get back to my former level of conditioning. About 6 weeks after my surgery, I started back doing exercises with my good shoulder to keep that side strong and maintain some conditioning, so that once my surgery was healed, I wouldn't be starting from zero. At 13 months from the day of my surgery, I participated in a competition for my sport (kettlebell lifting) and won nationally for my event. And I was 42 years old at the time of my surgery (supposedly takes longer to heal). All that just to encourage you that there is life and strength at the end of the recovery.
My faith in God, people praying for me, and having a doc & physical therapist that I was comfortable with got me thru it. If you're anywhere near Atlanta, I can give you some really good medical people to help.
Let me know if you have any other questions, and also what your dr/ MRI says.
Take care,
Allen |
| slap |
Posted - 04/10/2007 : 11:30:57
Many thanks for the response Allen. The doctor suspects a SLAP tear but I have an arthrogram MRI scheduled in 2 weeks to get the full picture. I don't really have much day to day pain but it hurts when I throw a ball or serve in tennis or try to lift weights, so it's more a quality of life issue I guess. I'm not sure that I want to go through the whole surgery rehab process right now since I have a 2nd baby on the way and I suspect my wife wouldn't be thrilled if I couldn't help out. I'd like to hear more about why you decided to have the surgery and how bad the recovery process was, and whether it's as good as new afterwards. Is it true that it only gets worse with time and there's no real success with physical therapy (instead of surgery)? Thanks! |
| allen_non |
Posted - 04/09/2007 : 18:26:01
Hi Slap,
I don't have long to post right now but I will get back to you in more detail probably tomorrow. Just wanted to let you know that there is indeed a SLAP tear, it is a real diagnosis, and recovery after surgery is about 4-6 months, depending on the damage.
This does not take anything away from the TMS diagnosis either. I had a minor slap tear back in 2003, along with a severely torn superspinatus. This was before I learned about TMS, but it wouldn't have mattered. It wasn't just in my brain/ emotions, and it wasn't healing on it's own (tried to rehab from Oct 2003-Aug 2004). Had surgery in 2004, healed up just fine, except the TMS likes to taunt me once in awhile regarding my shoulder (how 'bout last week, as a matter of fact?).
In my opinion, (and I have been there, got the scars to prove it) RC tears and slap tears are physical diagnoses, much like a broken bone. It's damaged or it's not. There's bursitis, tendonitis, etc, in the shoulder that most often IS TMS. Like Dr.Sarno mentions, one does need to get checked out to eliminate real physical issues. It's usually when the scans come back "clean", or have readily recognizable assignable causes (like the famous "bulged disks, degenerated discs, etc.) that the problem, usually chronic (but not always) is attributed to TMS. Often TMS will "take advantage" of an event to make you think you've injured yourself. But hey, if you fall off a ladder, land on your shoulder, and afterwards can't raise your arm, have major "clunking", and pain, it probably ain't TMS in that situation.
My counsel would be to get checked out (if you haven't already). Slaps are real hard to detect, usually takes an arthrogram MRI (uses the dye).
Sorry to cut off here, but I have to sign off for now. Feel free to post back with questions. I'll try my best to get on tomorrow to answer you. Even if you need the surgery, it's not the end of the world. I had a major, major repair (had to open my shoulder, couldn't keep it orthoscopic). Didn't really hurt that bad, and I take very few pain meds ever. Hardest part is I'm a hard core workout freak, and sitting still feeling my strength progress evaporating about drove me nuts.
Hang in there. Catch ya later.
Allen |
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