Partially Torn Superior Labrum - 13 Year Old Girl

[Patsfan12]

About 10 days ago my 13 year old daughter had to pull out of a tournament with a sore shoulder. We took her to our General Practitioner and based on the area of soreness, and associated movements, the doctor's diagnosis was an inflamed bursa sac. Not wanting to take any chances, we scheduled an MRI. The results came in this morning and it turns out she has a minor tear (12:00 to 2:00) of the Superior Labrum and a Glenoid Cyst. She scheduled to see an orthopedic surgeon in 5 days (next Wednesday). In searching through the forums, I've seen several post on labrum tears, but I'm trying to get a good understanding of how severe (or minor) this condition is and what the likelihood is that she will require surgery. She's a highly ranked sectional player and will be heartbroken if she can't play high school tennis this Fall. Any information, including past experiences, would be greatly appreciated. I'm also trying to understand what could have caused this type of injury and how it can be prevented in the future.

Thanks in advance for the help.

 

[SystemicAnomaly]

Not really had any experience with a Labral tear. From what I've read, it is not uncommon for tennis & basketball players. High velocity overhead motions are the most likely culprit. You should do some research outside these forums for more informed advice. In the meantime take a look at these 2 links:

www.Cedars-Sinai.edu/12906.html

University of Michigan Health System

 

[Patsfan12]

Not really had any experience with a Labral tear. From what I've read, it is not uncommon for tennis & basketball players. High velocity overhead motions are the most likely culprit. You should do some research outside these forums for more informed advice. In the meantime take a look at these 2 links:

www.Cedars-Sinai.edu/12906.html

University of Michigan Health System

Thanks for the links. They contained good informative information. I did conduct some internet research on this type of injury, including the viewing several arthroscopic surgeries on YouTube (My daughter found those!) and I'm hoping to confirm that the severity is not that bad. Based on the information in the links you provided it appears that cases may be treated differently as determined by multiple factors.

Ironically, her serve had improved significantly in the month prior to getting hurt, both in velocity and and spin (kick). In addition, her coach has also been working with her to hit a "heavier" ball on the groundstrokes. She has a (bad) habit of creating the spin primarily with her arm, rather than using the core. Either of these could be contributing factors.

Thanks again!

 

[dtd82]

Patsfan12, sorry to hear about your daughter...13's a tough age to start the injury treadmill. If you search my name, you'll get a jist of my fairly ugly background.....on your point, I have two tears in my Labrum, superior and anterior.....I got them hitting a bad overhead many years ago - I felt the shoulder go, but have continued to play with it rather than rip apart the whole thing. What I can tell you, from the 20 years of playing with it, it won't go away, won't get better, it won't nothin......but the pain and restriction can be managed.....but I was 24 by then, and done with HS and college teams, had won my share of club tornys, etc, and could let tennis go...not what you have with a 13 year old.

But times have changed, arthroscopic surgery is much improved from the '80s, so based on a highly specialized shoulder surgeon's agreement, I'm scheduled for surgery to fix whatever he finds Sept 18th......supposedly, I'll be functional in 2 months, back to sports in 6.......but nobody knows until it's done.....read the shoulder threads, and you'll find good stories and timeframes, and bad ones......I'm hopeful, and heck, it's long overdue for a change...

So.....my advice.......don't blow this problem off - see a shoulder specialist - repeat - see a shoulder specialist. These buggers are difficult for the best to figure out, and a good GP, or a good general orthopedic doc just won't cut it.....especially given her age, and all that ahead for her.

Keep us posted, good luck!

Oh, if you're brave, there are several video's posted around the web of Labrum surgeries.....cool stuff, gives you a very clear idea of what's wrong and how they fix it......

 

[Patsfan12]

dtd82

Thanks for the reply. I have read up on many of the shoulder injury related posts, including several of yours. I'm praying/hoping it's not too severe and can be handled without surgery. As I had mentioned in my initial post, the MRI indicated that her labrum had a 12:00 to 2:00 tear. Do you happen to know the severity of your tears? One thing on her side (I think) is she can't pinpoint when she hurt it. A few days before her last tournament she had told me it was a little sore but indicated it wasn't that bad. It was only in the 3rd match of that tournament when it really started to bother her. (She lost that pretty bad and pulled out of the back draw. Following the MRI diagnosis, she's been taking 4 Ibuprofens 3 times a day, and been icing it down at least twice a day. She has no pain in the shoulder except when she raises her arm above and behind her head. Our appointment on Wednesday (in two days) is with an Orthopedic Surgeon that specializing in shoulders. He's also registered in Sports Medicine.


Concerning the "injury treadmill" she's had her share at the tender age of 13. About a year and a half ago she had patella tendonitis that kept her off the court for 2 months. Had several weeks of physical therapy to get through that. Last year was out for 5 weeks with a nasty kidney stone. (Very unusual for some that young). She had 2 stays in the hospital and 3 procedures before the good the little "booger" out. The doctor believed this could have been caused by dehydration. (We're in the South where those summertime tournaments can get a little "steamy".

Once again, thanks for post and I'll let you know how the Wednesday appointment goes.

Patsfan12

 

[Patsfan12]

Had our appointment with the Orthopedic Surgeon this morning. Based on the specifics of my daughter's pain and looseness of the joint he has diagnosed the injury as a Type II tear. He basically said that surgery would be required to get her back to pre-injury form, but did suggest that she perform 2 weeks of Physical Therapy to see if it would get her strong enough to compete in a portion of the high school season. The goal is to get the muscles strong enough to keep the joint in place. He indicated that there was minimal risk relative to further injury. If the PT does not have positive results the plan is to schedule the surgury ASAP and shoot for Spring time return to the court.

The Surgeon did make the statement that he's never seen a SLAP tear on a 13 year old (lucky her!). The youngest patients he has seen it on were a couple of 15 year old baseball players.

Patsfan12

 

[dtd82]

Thats a brass ring she didn't need to pull....! Sorry to hear it's a tear, glad that it's diagnosed. I've been told they don't get worse with play, but they certainly don't get better - no blood flow in the labrum, so no healing.....hard choice between playing the season, and just getting it fixed.....considering my history, you'd probably see I'd play the season, then fix....but I'm a stubborn .... . As always, the practical will decide - if she can manage the shoulder, play....if not, fight another day. Good luck and keep us posted...

 

[Say Chi Sin Lo]

... I'd get the surgery if I were the father or her. Over working another group of muscles to compensate the lack of stability is not a smart idea.

Labrum as in all ligaments doesn't heal on their own. If it's repairable, she's better off having it repaired. If there's too much fraying, they're going to have to get rid of it to it from getting "caught"

 

[zacinnc78]

can SLAP tears cause rotator cuff tears and tendonitis?

 

[Tofuspeedstar]

I tore the superior labrum as well when I was 14, I had surgery to repair it, best of luck on the appointment.

 

[princemidplus]

SLAP lesions are not the easiest to overcome. from physiotherapist point of view, the advice I give is to try rest from abduction combined with external rotation (know as the "**** phase" of a throw or serve) and try to strengthen the rotator cuff as that can easily get involved too.

Usually take afew months to heal at best and present with a lot of clicking and feeling of instability.

If it is limiting your sport and you do not wish to stop then surgery is the best option as physiotherapy takes a long time and is not usually very helpful in terms as competitive athletes.

 

[Andres]

The tricky things about labral tears is the newly found shoulder unstability. Unless she gets the tear repaired, the re-injury % rises drastically.

If the capsule is intact, then the labrum can be repaired with an arthroscopic surgery, and she can be playing again in 3 to 4 months.

On the other hand, if the capsule is also tore, then she might need the real deal: scalpel and stuff. She'll be back in 6 months or so, if she does her homework properly (physio).

I had two shoulder surgeries, with the biggest cartilage tear possible, and I healed just fine. Of course, my shoulders were absolutely f#cked up, to the point I actually needed shoulder implants.

Cartilage tears are certainly not fun, but the surgeries aren't that invasive anyway.

I'd say get the surgery. She'll thank