In our experience, we have found that you cannot simply offer a single platelet-rich plasma injection inside the joint and expect superior results. Prolotherapy: a non-invasive approach to lesions of the glenoid labrum; a non-controlled questionnaire-based study. The Open Rehabilitation Journal. Lesions of the glenoid labrum are a common cause of shoulder instability and a frequent finding in patients with shoulder pain.
Management of these patients typically involves an attempt to avoid surgery through conservative treatment. However, there is currently a dearth of conservative options that promote labral healing. We hope you found this article informative and it helped answer many of the questions you may have surrounding your shoulder problems. If you would like to get more information specific to your challenges please email us: Get help and information from our Caring Medical staff.
Subscribe to our newsletter. Open Access Journal of Sports Medicine. Postoperative Knee and Shoulder. Musculoskeletal Diseases Diagnostic Imaging [Internet]. Cham CH : Springer; Chapter 9. Factors influencing outcomes of nonsurgical treatment for baseball players with SLAP lesion. J Am Acad Orthop Surg. The open orthopaedics journal. SLAP lesions: a treatment algorithm.
Knee Surg Sports Traumatol Arthrosc. Am J Sports Med. Comparison of magnetic resonance arthrography with arthroscopy for imaging of shoulder injuries: retrospective study. Ann R Coll Surg Engl. Reliability of magnetic resonance imaging versus arthroscopy for the diagnosis and classification of superior glenoid labrum anterior to posterior lesions.
Arch Orthop Trauma Surg. Outcomes of revision arthroscopic type II superior labral anterior posterior repairs. The American journal of sports medicine. The American Journal of Sports Medicine. Return to play after treatment of superior labral tears in professional baseball players. Orthopaedic Journal of Sports Medicine. When should I involve a Prolotherapist in my care? Call Us: Email Us. Email Us Subscribe. Repairing a SLAP tear without surgery If you are reading this article you are likely someone very involved in sports or you have a physically demanding job.
You have probably already been to a doctor for your SLAP tear You went to the doctor with concerns of pain, possibly a clicking sound, and a sense of shoulder instability and loss of strength. In sports, like tennis, baseball, and softball, your serve and your pitch or throw from the outfield may have lost a lot of steam, there is painful motion. Your shoulder may be catching or gets stuck. You may be a frustrated parent looking for something that will work and get your player back on the field.
At the worksite, you have difficulty with things that require overhead movement. Whatever the reason, you have a shoulder problem. It is a tear in the Glenoid Labrum, the fibrocartilagenous structure that forms a deep pocket that helps keep the humerus bone in the shoulder socket and provides a pain-free range of motion.
I went to the doctor. I was told SLAP tear surgery is the only way to recover. So now I wait. Surgery may help improve symptoms but may not guarantee a return to the preinjury level of competition. What does this tell us? The stories go something like this: Pain after successful surgery I had shoulder labrum surgery recently.
Is non-surgical conservative care a realistic option? Research: The only traditional non-surgical treatment that worked was when shoulder muscular tightness was involved in the early stages of the tear and treatment focused on rest and rehabilitation. However, some patients cannot obtain a satisfactory improvement of their symptoms , leading to dysfunction of the shoulder and diminished pitching performance.
Playing positions included pitcher 21 patients , catcher 3 patients , infielder 13 patients , and outfielder 8 patients. Of interest to note is that these players had shoulder problems for an average of 8 and a half months before nonsurgical treatments included physical therapy, such as range of motion, stretching, and rotator cuff exercises, as well as prescription of nonsteroidal anti-inflammatory drugs, if necessary, were given.
Who non-surgical treatments would work for and who it was not likely going to work for: The older the player, the less likely non-surgical treatments would work. The longer you played baseball, the longer the length of your playing years, the less likely non-surgical treatments would work.
In what position you played, pitchers would likely be less successful at non-surgical treatment. The longer you had shoulder pain, the less likely non-surgical treatments would work. If you did not have full or at least a good partial range of motion in your shoulder, the less likely non-surgical treatments would work.
The presence of Bone or Bennett spurs the less likely non-surgical treatments would work. Partial-thickness tears of the articular-side rotator cuff the less likely non-surgical treatments would work. Is this why your SLAP tear conservative treatment failed? Because the treatments in general, beyond rest and shutdown, do not repair anything?
While outcomes are generally good after SLAP tear surgery, most people improve with non-surgical treatments. If you've had a SLAP tear, you will be advised to rest after your injury to allow the inflammation to subside. This may help to alleviate your symptoms. Common treatments for a SLAP tear include:. If your symptoms persist despite these treatments, your healthcare provider might recommend that you have minimally invasive arthroscopic surgery , with a small incision in your shoulder.
There are several different surgical procedures that can help you recover after a SLAP tear. Since SLAP tears often occur in conjunction with other shoulder problems, such as rotator cuff tears or shoulder arthritis , your surgical planning may have to take these factors into account. The primary surgical options for the SLAP tear are:. The results of different surgical procedures have been reported in a number of scientific studies.
The most commonly studied surgical procedure is the SLAP repair. Risks of surgical treatment include the usual risks of arthroscopic shoulder surgery. Your recovery from surgery can be affected if you also have had other shoulder injuries in addition to the SLAP tear. SLAP tears are a common cause of shoulder discomfort, especially for athletes who have frequent overhead movements.
However, if symptoms do not resolve after weeks of physical therapy, surgery is necessary for a full recovery. To better understand why surgery is often needed to recover from a SLAP injury, it is important to cover the different ways the labrum can tear and the location of the tear itself. The labrum can tear in 3 different ways: completely off the bone, just where the bicep tendon is attached, and along the edge of the labrum.
Tears along the edge of the labrum may or may not need surgery depending on the location and severity of the tear. Tears completely off the bone and where the bicep tendon is attached will usually need surgery to make a full recovery. Tears can also occur due to an injury such as a shoulder dislocation or pre-existing shoulder instability.
In this case, surgery is required to reattach the labrum to the rim of the socket. Your doctor will discuss your options with you to determine a treatment plan that works for you. In most cases, surgery will be required to make a full recovery. Typically, your doctor will be able to tell if you need surgery depending on specific factors or if you do not respond to conservative treatment methods. Those who fall into the following category usually need surgery to repair their SLAP injury:.
SLAP injuries that are left untreated can wreak havoc on your mobility, strength, and range of motion. Without proper treatment and physical rehabilitation, SLAP injuries can cause chronic stiffness, pain, and weakness in the affected arm.
Many labral tears can also lead to joint degeneration, which will just cause you more pain in the long run. While not all SLAP injuries need surgery, they do require medical attention. If you suspect you have a SLAP injury, it is important for you to get it checked out immediately to avoid long-term consequences. SLAP tears vary in severity and, depending on the location and severity of your tear, you have a variety of treatment options available to you.
Typically, your doctor will try to treat your injury conservatively first to see how you respond before recommending surgery. Nonsurgical options such as physical therapy are usually the first treatment method employed in repairing a torn labrum. Physical therapy focuses on strengthening the muscles in the arm while increasing mobility and range of motion in the affected shoulder.
A minimum of three months of physical therapy is usually prescribed for a labral tear, with a focus on strengthening the upper body. Your physical therapist can also assess the severity of your injury based on your response to treatment. Intraoperative arthroscopic image of an acute, traumatic SLAP tear.
To help resolve this controversy, Dhawan and colleagues conducted a comprehensive systematic review of the SLAP repair literature. The findings, recently accepted and soon-to-be published in the American Journal of Sports Medicine 1 , indicate that compared to younger patients, those over 40 years of age who undergo arthroscopic SLAP repair are more likely to experience post-repair complications.
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