The scapula, otherwise known as the shoulder blade, plays a vital role in shoulder mechanics. If the shoulder blade is not controlled well via the muscles that attach to it, problems ranging from neck pain to rotator cuff tendonitis are often the result.
Scapular strengthening is often overlooked both in patients that are trying to avoid shoulder surgery and with patients recovering from shoulder surgery.
In particular, the muscles that help to “upwardly rotate” the scapula need to be strengthened and work in concert with one another.
What are the principal muscles that control upward rotation of the scapula?
1. Upper Trapezium.
People with weakness in the upper trapezium will often present with collarbones that are horizontal rather than the normal position of “slightly pitched.”
View the “Shoulder Shrugs” exercise:
2. Serratus anterior.
This muscle originates on the underside of the shoulder blade and attaches on to the ribcage. Weakness in this muscle is often seen with “winging” of the shoulder blades when observing the patient from behind.
View the “Serratus Forward Hugs” exercise:
3. Lower trapezium / middle trapezium.
These muscles when strengthened appropriately help to keep the shoulder blade from moving away from the spine in addition to helping with upward rotation.
View the shoulder exercise “Physioball Middle Trapezium”:
View the shoulder exercise “Seated Shoulder Pinches”:
Top image credit: © Lev Dolgachov/Fotolia
Hi Dan,
I had a SLAP II injury and had surgery about 5 years ago. What are exercises I should be doing in order to reinforce the whole area as I feel that it is not fully strenghtened in all manners.
The reason I ask is because I do a lot of crossfit style training with circuits and some kind of calisthenics. What I noticed is that by doing a hindu pushup, the moment I push too hard, i feel a discomfort. Now it is taking several days to recover as their is a specific point in the shoulder which I feel the discomfort should i do any movement in a plank position or what not. Is this related to the bicep tendon attached to the glenoid and if so, what exercises should i perform?
Thanks.
I would stay away from the Hindu push ups and planks Jonathan. That could be either a rotator cuff tendon or perhaps the biceps tendon that is strained: the attachments are so close to one another it is often difficult to tell which is more involved.
I would build the scapular muscles. Middle traps, upper traps, lower traps, and serratus anterior in particular. Gentle rotator cuff strengthening is usually fine as well. There are tons of exercise demonstrations out there. Feel free to check out the shoulder exercises on our site. The password to get in is “patient”.
Hello,
I had the torn labrum in my right shoulder surgically repaired 2.5 years ago. There is 1 anchor in my shoulder. I am back to doing excercise routines like p90x at about 90-95% the level I was before the injury. I still get “clicks and pops” when doing certain movements. However there is no real pain, and no difficulty raising my shoulder or extreme shoulder fatigue like pre-surgery.
I do have some discomfort when doing certain yoga poses. Chair pose – both arms perfectly straight, and overhead…I can do it, but holding it for 60 seconds is uncomfortable. Discomfort disappears if I bend right elbow slightly. The worst discomfort is holding a reverse table pose.
My questions are: are these clicks and pops still expected 2.5 years post surgery? And am I always going to have this discomfort at the extreme edges of normal ROM in my repaired shoulder?
The clicks and pops wouldn’t concern me as long as they are not accompanied by pain. The yoga position overhead is probably putting the shoulder into a tiny bit of impingement. It is tough to say whether or not you can get rid of that. At the very least you would need to have optimal strength of the muscles that rotate your shoulder blade upwards (lower trapezium, upper trapezium, serratus anterior). It wouldn’t hurt to have that assessed.
Hi Dan,
I am 10 weeks postop SLAP surgery. Three anchors placed to hold long bicep tendon and labrum. I started PT two days after surgery, and have been going twice per week. I’m told that my ROM is not where it needs to be. I have a great deal of trap pain along with a significant winged scapula the last five weeks. I feel that the scapula is holding me back from the ROM. What are your thoughts? I have addressed my concern with the PTs, but they continue to work only on stretching my arm. The ROM I struggle the most with is straight up, and across my body in front and back. What are your thoughts? Thanks
The winging scapula thing may very well be a strength issue (serratus anterior), and unfortunately that may have to take the back-burner until you are cleared for strength training from the surgeon. Maybe at about 16 weeks post-op????
The range of motion should come back slowly, be patient with it. I would say that the behind the back is the last thing to come back.
I am about 10 weeks post opp with slap surgry. Tear in cuff, anchor for labrum, and work on meniscus following a fall and grade 3 seperation. I have been doing therapy exercises since week 5. For the most part I feel great. I’m a dog groomer, arm gets sore but it’s mild, even working.
I am still having pain in bicep and can’t get arms in sleeves or fasten bra. This and reaching up and out, literally knock me on the floor in pain sometimes, bringing tears. Should I be concerned or do I just need more time ?
More time Jen, the pain is probably normal given that this is only at ten weeks. Most docs will not recommend strengthening until at least 12-16 weeks, so you still probably need to be a little bit careful in terms of doing anything that involves a lot of weight. I would try to keep the hand in front of you as you work, avoid extreme reaching and twisting. It will come in time.
I had slap tear surgery in the beginning of August.. I had to be in the sling for only two weeks and then began a very aggressive course of physical therapy. I regained all range of motion and was back on a ladder plastering ceilings 3 months from the day of surgery. I was thrilled with the results. Unfortunately, I tripped down a flight if stairs in January and injured the front of the labrum. I am having the surgery to repair this tomorrow morning. This time, my doctor said I will be in a sling for four weeks and the recovery will take about four months. I am confused because I thought this would be an easier surgery. (The first surgery included moving the bicep tendon.) I don’t understand why the recovery time for this surgery is going to be that much longer. I do have a lot of popping with this injury that I didn’t have prior to the first . Could this account for the longer estimate in recovery time?
Surgery stacked on top of surgery does significantly increase the recuperation time. Tissue just does not like to be cut into in general, and when it happens multiple times in the same place the tissue takes longer to heal. I would tend to agree with your doc, at least 4 months, maybe longer. Be patient. Sorry to hear about your fall.
I am 19 months post labrum and supraspanatis surgery. Basically had 360 degree tear, 7 anchors and full thickness tear of the RC. My strength has gradually gotten better but nowhere near 100%, I would say in the 75% range. ROM is probaly in the 90ish range except for external rotation. Shoulder abduction is still very very weak and painful at times. This is very frustrating considering the amount of time it has been.
I go to the gym at least 4 times a week so it’s not like I have given up on PT. BTW I attended 50 sessions until I was cleared to go on my own.
Do you have any advise or exercises that I should concentrate on to strengthen the shoulder abduction? Any and all advise would be appreciated
Mickey you probably had one of the worst tears I have heard of. 360 degrees and 7 anchors is quite involved. I would work on the scapular muscles that upwardly rotate: namely the lower trapezium, upper trapezium, and serratus anterior. Sometimes having better control of upward rotation helps quite a bit with abduction of the arm.
It is also not a bad idea to get a “body blade”. They can help quite a bit in strengthening the rotator cuff.
Hi Dan:
I am 3 months post op on a SLAP 1 repair which had excessive debridement in the rotator cuff and labrum performed.
My PT exercises consist of push up holds, internal and external rotation with cables on both arms, cable triceps extensions, side planks on elbows, machine rows, lateral and forward raises and something that comes close to your first 2 exercises listed.
My question is what is the average full recovery for this type of tear that you see in your practice and why does it take so long?
The average full recovery time is probably at least six months. Shoulders are inherently unstable, and the soft tissue structures take their time healing. Resisted exercises are usually not kosher until 12-16 weeks. Stick to the doc’s protocol. You are getting there.
Hi Dan.
First, great info and thanks for sharing. I am 6 months post SLAP 1 anchor. I spent 6 weeks in an air cast and had a machine for passive movement after 3 weeks. I did not start PT until week 7. I made great strides with lots of hands on to recover ROM. I am not 100% by any means. My insurance started denying my PT 6 weeks ago so now my recovery seems to be up to me. My arm and shoulder are weak and I have developed lots of popping and clicking that are mostly pain free but annoying. Can you give me some idea what I should be doing to get better? I am afraid I will injure myself again left to my own plan. Thanks!
LB
At six months you should be hopefully doing some strengthening exercises. I think that doing some exercises over an exercise ball is a great idea. We have a couple of those videos on our website (password is “patient”), check out the shoulder exercises. No weight is necessary. Start light. It is recommended that you have some watch you while you try these to make sure that the form looks good. It might be worth having one more visit wit the PT to go over a routine.
Hello Dan ,
I am from India , I am 24yr old and had my labrum tear when I was 16, had a surgery which didn’t work out . I had another surgery in august 2013 but I didn’t do my rehab religiously coz I was emotionally drained by the time . I have lost my childhood to this injury , I can throw or lift weights . I feel this injury has beaten the life out of me and I have lost the will to live . Do you think if I start my physio again now three years after my surgery I can have a decent lifestyle which includes lifting weights at the gym . As soon as I stop pt my scapula becomes dyskinetic. Do I have to do pt all my life ? So now it’s been 8 yrs since the injury for me .
Can I expect any chance at leading a normal fit life again ? I was a national level sports person aas a teenager .
This sounds likes the shoulder needs to be evaluated by someone. I would try to find a physical therapist with many years of experience. It is possible that this can improve, but it is very hard for me to comment on this because I have no idea what your shoulder actually looks like. It may be possible regardless to get some solid improvement through strengthening certain muscle groups that assist rotation of your shoulder blade. See if you can find someone in your region who is an expert on evaluating shoulders, preferably a physical therapist.
I meant I CANT throw or lift weights. And also my bicep tendon seems strained all the time and my trap is always sore.
Hi. I am 1.5 years out of surgery for a labrum repair, clean up and bicep move. I feel twice within days of the surgery and had surgery sure issues. At some point I also pinched the nerve in my neck after over a year of pt and weekly massages in close to being able to move with a level 3 pain. I want to start to lift weights to build the muscle up to see if that will help keep my arm from slipping out of socket or at least that it how it feels, kind of drops down when I lay down or stand. With the move of my bicep do I need to modify my exercise since it is no longer attached our in the same place anymore? Thanks!
I would guess that you can do weights again, but I wouldn’t go too heavy with the biceps work. It might be safer to do regular standing biceps curls rather than preacher curls, or sitting down isolation curls. It would also take a little bit of stress off the biceps if you did a straight bar and worked both arms at the same time rather than isolating one at a time.
Hello doc my name is jim I had 2 tears only labrum my bicep tendion moved and 2 bone spures removed all in my left should!der I am still having some discomfort and some pain and they wold like to release me back to work on sept 23 my surgery was on April 18 should I ask for more time or just return to work
That is a difficult question to answer given that I can’t see how your shoulder is doing. I would see a PT, get it evaluated, and ask the PT the same question based on how everything looks and feels.
hi Dan, after several months of failed PT I had last week a labrum tear operation, used 2 anchors. My main complaint was lateral movement. I was initially told that I would be in considerable pain, so far no pain at all. I am of course very happy with this but wonder how normal is it not to experience any real pain after such surgeries? Just sounds too good to be true, or should I be very happy and unconcerned? I know, sounds like a silly question but I have always been sporty and would love to be able to exercise normally again, thanks for ur feedback
Kr
Pedro
That is great. There are some people that just don’t feel much in terms of pain. Remember that this shouldn’t be a license for you to go past protocol. Stick to the timelines of weight bearing and resisted exercise etc..
thanks a lot for ur quick feedback, much appreciated.
Sorry Dan, couple of more questions if u dont mind.
I was wondering whether light exercises on other unrelated muscle groups such as legs, abdominal region are out of the question at this stage? my idea is, keeping the arm sling in place, do exercises such as: simple squats & gently riding stationary horizontal bike thus not needing to grip the handle bar while exercising…so isolating exercise to legs only; laying on the ground on my back-raise and lower legs for lower abs (90 degree angle/puckered position).
Just trying to keep busy and healthy without risking any damage to shoulder, gets boring just sitting at home doing nothing.
thanks a lot for ur feedback
Br, Pedro
You are probably safe doing those exercises, but make sure that you run this by the doctor. I would start with something simple, like a recumbent bicycle.
thanks a lot Dan , appreciate your reply and will run it past my Doc just to make sure as you rightly suggested. thanks again
Hello, I am a frequent skydiver and wonder how long it might take till I can skydive again after a SLAP 2 repair. I had my other shoulder done years ago and had 4 pins placed and now my other shoulder needs a surgery.
To be safe I would probably give it 4 months, and you need to get the blessing of the surgeon.
I have had 3 total shoulder surgeries. 2 on the left and 1 on the right. My concern is I had my 1st on the left 9 years ago. It was unstable and had several sub luxations over many years same with the right that was done 7 years ago. Most recently in June 2016 I had to habr the left repaired again and was told there was a tear. The pictures from surgery show the sutures had just shredded and let everything go. I have been very cautious since the most recent surgery and attended therapy regularly. With 2 repairs to the same shoulder with debridement both times my doctor is recommending that I find a less physical occupation and really take time healing. I have been told that if there is a repeat tear or injury to that shoulder that there is no usable tissue left to fix and will be facing a replacement at age 32. Does it seem reasonable that this is a possibility? I have had pain since the operation especially in the rear of shoulder and now 6 months later still not at full range. They had to over tighten a bit because of the lack of usable tissue. Any advice or recommendations? Thank you
That is a tough one. I would minimize overhead activity to be sure as it looks like your shoulders are naturally prone to instability. I would work on gradually strengthening all of the muscles surrounding the shoulder blade and rotator cuff. I would find a really good PT who deals with chronic cases. Modification is key here.
Hi Dan, I’m 8 mos post bankhart repair with 3 anchors and retensioning of the lower ligament. Im struggling with recovery. I have full ROM but scapular dyskinesis. I’m doing scapular strengthening (theraband rows, ext rotation,shoulder retraction and supine Ys). I feel stiff most of the time but especially after daily activity and exercise and I have pain in the front and rear of my shoulder. My scapula aches most of the time and this shoulder and scapula sit lower than the other one. Ive had another MRI that only revealed tendinopathy in 3 of my rotator cuff tendons. Im continuing with my rehab to the best of my ability but Im concerned as things seem to be getting worse – pain now behind and under shoulder with turning car steering wheel, lifting any object and and when weightbearing through arm. It looks like all of my problems are soft tissue but maybe also irritated by the unstable scapula. Im worried that activity and exercise may be contributing to my stiff, snapping tissues. Is it advised to do exercises daily as per my PT and any suggestions? Thanks and looking forward to your response.
Hello,
Thank you so much for putting together this material. I had SLAP repair 2 years ago and my shoulder is still weaker on that side. I have been doing physiotherapy on it on and off, but have no been too consistent. I was wondering how effect the body blade would be in my recovery. I will be doing the excercises as you mentioned above, but should i supplement those with a body blade?
The body blade would a good addition to your routine. The main exercise that we do with patients here in the clinic is the “elbow at the side” form. I think that some of the exercises that come with the DVD are a bit too much. Stick with the more simple stuff.
I had left shoulder surgery Oct 24, 2016. At this point I’ve been told I have frozen shoulder. Dr took X-ray 2 weeks ago and wants to go back into shoulder to remove scar tissue. I’ve been doing therapy at home and a local PT 3 times a week. So far no much results. I’d like someone else’s input on the matter. I’ve been thinking of waiting on another surgery and continueing PT for a couple more months to see if scar tissue can break loose. What input can you add that may be helpful. Also, I’m viewing your exercises of which these are no ones I have been doing at home or at PT. I am going to start these and see if they help. I still have the tightness and only take something to help relieve tension when I have to.
If it were me, I would probably not have the surgery. The problem with going in a second time is that it will inflame the shoulder more. You can “ride out” a frozen shoulder, it just takes a bit of time to run its course. One piece of information that would be useful to know is what “frozen shoulder stage” your shoulder is in. If you read the blog article that we have on this subject you should be able to figure that out. If it is the earliest stage, I would only do very gentle stretching and exercises, don’t provoke it.
My 16yo son just had labrum tear due to a sport….arthroscopic surgery from the “best of the best” facility. We are in the northeast, tri state area. 2 lower tears bilaterally in which 5 anchors were used with stabilization in the back. Front was ok. Physical therapy will be Rx at the 4 week mark post op. I cannot use PT that this Hospital is affiliated with because travel time is an hour each way. In your opinion what am I looking for in a PT other than being certified and are there any red flags? What letters should come after their name? Small practice or affiliated with an orthopedic group or Hospital? What questions should I ask? What equipment must they have? Bands? Stability ball? Im assuming to go with PTs with a sports background. Any exercises that they may try that can be harmful? Our chiropractor friend said be careful of this one move some PTs may try in which your shoulder may lock and it’s permanent. He told my son and my son could not explain exactly what he meant. It was some sort of arm lift. I plan to ask chiro next time I see him. Thank you
I don’t understand what the chiropractor means either. Ignore his comments. I would call around and find a PT who has at least ten (10) years of experience if you want to be assured that the PT knows what he or she is doing. A sportsmed background would be nice, but not necessary. All PT practices are equipped with the necessary post-op exercise devices etc..
It is important that you get a written protocol from the doc in terms of what exercises are okay to do and when it is okay to do them. This varies a bit from doc to doc and depends on the procedure done, the number of anchors, etc.. The PT needs to see the protocol.
Thank you! Yes we are getting a protocol from Dr. Follow up post op visit today.
My daughter is 17 years old and plays softball. She injured her shoulder playing softball She had 2 SLAP tears which they were able to do a labrum debridement on them (one anterior and one posterior) in November 2016. She is still in therapy. They have tried 2 separate times to have her start throwing, but each time it causes the front of her shoulder pain. In fact, she says she has more pain in the front of her shoulder now than before the surgery. The doctor also said that she still has shoulder instability (the ball of her shoulder is coming out when he has her puts her arm in the throwing motion). Her therapist has been doing strengthen exercises to try and strengthen the muscle around the tendons, but she said her shoulder isn’t responding to it. She goes to therapy twice a week and has at home exercises she has to do also. Thanks for your help.
This does not sound great. As long as that shoulder is unstable I would recommend that she not throw. I would perhaps have her strengthen her internal and external rotators slowly to see if she feels more stable after a month or two of that type of program.
I have problem in upper back..imbalance shoulder muscles..winging of scapula..and also pelvic instability..left knee hyper extension..
I have big doubt in my mind.. shoulder problem comes due to hip..or that is different..
Help me doctor..
It is possible that the shoulder is in some form a compensation for the hip and pelvis issue. I would have an expert look at your posture. I would try to find a good physical therapist for an evaluation.
Doctor
I have seen many physiotherapist and experts..some doctors telling i don’t have any problem.. some physiotherapist said because your right shoulder scapula coming out..that’s why I have instability in hip..but still I am feeling difficulty on my posture..not corrected yet..I don’t know wat to do doctor..
Hey doc, I had slap tear surgery about three and a half months ago. Is it normal to still feel sore all the time from the shoulder I had surgery on ? Thanks.
It is not uncommon to have pain four months after surgery, although I would want the pain to be slowly tracking down from week to week or month to month. I would stick to gradually strengthening the shoulder under the supervision of the doc and the PT.
Doctor,
My 18yo son had surgery for a labrum tear back in December from a hockey injury. The MRI showed a 3mm posterior tear, but during surgery it was found that my son had a 180 degree tear. It took 5 anchors to repair what ended up being an anterior, inferior, posterior tear. He went through 8 weeks of PT and was released. He went back to the doctor at 16 weeks and was released to start weight training and get back on the ice for passing & shooting but no contact. After surgery he developed tendonitis in the anterior part of his shoulder which has been painful, after starting back to hockey he is noticing a dull pain posteriorly also pain with external rotation. When he experiences pain he discontinues on his strengthening exercises but continues his stretching. Is this par for the course or is this something we need to be concerned about? He’s disappointed that he is still having pain and doesn’t see how he is ever going to be able to get his shoulder strong enough to play hockey with full contact. Do you have any recommendations for exercises, ice, or heat application?
Thanks,
Joy
The surgery really was not that long ago, I would give it at least another 3-4 months before a full assessment can be made. A 180° tear is substantial, I would expect for there to be pain and bumps along the road. In the mean time he should be doing a scapular training and rotator cuff training routine to tolerance, with rests in between workouts.
Dr. Baumstark,
I stumbled upon your website after searching exercises for my rt shoulder and rt hip. I played football for years and I’m now feeling the effects. After watching some of your videos and performing some of the exercises I noticed you pay attention to the details, which are most important.
I had shoulder surgery 3 years ago, torn labrum and bone spur. I had hip surgery this past August 2016, torn labrum and bone spur. The Dr stated if I were to have waited another 8 months, I would have needed a hip replacement. I’m 36.
I started having pain 5 years ago. It initially locked up the whole rt side of my body. Previously, I was suffering from sciatica pain that I mostly felt on the bottom of my rt foot, felt and still feels like I’m stepping on a tendon under the toe next to my big toe. Currently I notice I’m lifting my shoulders which is causing me severe pain at the bottom of my neck in my spine. My rt shoulder has never really felt the same after surgery. I have muscle atrophy in my Lat as well as severe scar tissue and I believe that’s the reason why I’m subconsciously lifting my shoulder.
Dr’s were telling me for 2 years that my MRI on my back is showing a bulged disc, L5 S1, and that’s the reason I’m having back and hip pain. I asked them if the pain could be from when I dislocated my hip in HS and tore my hip flexor. They said no, it’s your bulged disc. After visiting with 2 neurosurgeons and 3 Orthopedic Drs, they said I have to live with the pain, essentially. I’m just stating this for others that might have back pain… please take a look at your hips.
Long story short, I’ve been to countless Physical Therapists, Chiropractors, Drs, etc. and I would like to know how to get relief. I have continuous pain in my lower back, sciatica, and issues around the shoulder. Any recommendations?
Thank you!
Your case certainly sounds complex. I would call around and find the best, most experienced physical therapist that you can find. Get an evaluation and a plan of action in terms of dealing with any biomechanical issues that you might have.
Dr. Baumstark,
I hope you are well. Thank you for your advice in advance.
I am 30 years old. I played college baseball and never had any shoulder issues while I was competing at a high level. However, after I stopped playing baseball at a high level I started playing recreational softball and flag football. I injured my labrum throwing a softball from the outfield as hard as I was able to. I then had about 5 years of throwing pain which I tried to manage. I went to an athletic therapist for months at a time. In the end I opted for SLAP repair surgery Nov 2016. I’m now 6 months post-op and have been seeing therapists. My range of motion is good in all directions except for pulling my shoulder across my chest. I hit some golf wedges from 100 yards and it wasn’t painful during, but felt some stiffness the next day. The most difficult thing to gauge is when to know how and when to progress into throwing/golfing/lifting..ect. I am fully willing to put in the time, effort, and patience required to ensure this heals properly and allows me to carry on my throwing sports for leisure in the future, but it seems like it might be 7 months for some and 12 months for others. Is there a litmus test for when you would suggest a patient could begin a light throwing program/golfing/lifting and progress from there?
That is a tough question to answer. At 7 months, I don’t think that there is a specific litmus test for throwing. You should be able to perhaps try some very light throwing and just see how it feels. Very light. 5 minutes of throwing lightly, and stop after 5 minutes even if you feel great. Give it a few days and see how it feels. If it feels good you could try it again and slightly increase the duration or the distance. Run this by your doc and PT by the way!
Hi Dr. Dan,
On 7 Jun 17,I had labral repair surgery, cyst and bone spur removed in my right (predominant) shoulder. I was in a sling for 5 weeks but started PT within 7 days of surgery. It is almost 3 months now and my outward rotational ROM is awful. I am still having a lot of pain at PT as my therapist is pushing me through pain that she feels is holding me back. My shoulder is still super stiff and cannot even reach into a cabinet to get a cup. She mentioned that if it wasn’t better in 4 weeks that i would be looking at another surgery as the Dr. would have to manipulate things. I had severe bicep pain and numbness after the surgery for about 7 weeks. Is any of this normal and will i get my ROM back over time without another surgery. I cannot perform my job duties if i do not get my ROM back. Your time and thoughts are greatly appreciated!
Ugh. You may be developing a “frozen shoulder” from the trauma of the surgery. The doc would need to diagnose this. I do think that it is important to find out if this is the diagnosis, because aggressive stretching might be contra-indicated during the early phases.
I would stick to light stretching only in the mean time.
Hi Dr. Dan,
Good evening! I am 9 months post shoulder labrum surgery in my left shoulder. This is my second labrum surgery in this shoulder, the first being 10 years ago which I fully recovered from and even played college football on. The more recent tear was a rear labral tear and a bicep tendon fix as well. I have quite a bit of pain in the top of the capsule and the front of the shoulder. Lately I’ve been doing PT on my own and working out, nothing more than body weight work. I’ve been incorporating quite a bit of TRX push ups and rows as of late and it feels pretty strong. However, I’ve noticed at times some twinges of pain in the shoulder while working out and have been very sore at times as well, especially post workout. It clicks like crazy and snaps at times, but the snapping sensation brings a feeling of relief to the shoulder. Range of motion has never really been affected, but I feel like I’ve plateaued quite a bit even though I work on strengthening roughly 3-4 days a week. I’ve had a Pt and the physician conduct physical exams, of which check out very well and alleviate some concern. But, with the pain I’ve experienced and this feeling of plateauing taking place, am I at risk for a potential re tear? Am I more susceptible to damaging another part like the rotator cuff? Thank you!!
If the PT and the doc are okay with how everything looks, my guess is that you should tweak the gym exercises that you are doing in order to find out if one or more of them are causing some irritation. The TRX push ups for example might put some stress on the anterior portion of the shoulder, especially at the end range when you are pitched forward. It might be a good idea to have a PT take a look at everything that you are doing at the gym for assessment purposes.
Dr. Dan,
I’ve been reading all of these stories of people who have had shoulder surgery. I had my labrum and a small rotator cuff tear repaired in Apr 2017 and am now six months post op. Still having pain at the top of my shoulder where the labrum was torn. My ortho last month said was inflammed so took steriods for six days and laid off some stretching exercises above the head. Same area is sore again and will be going for an ultrasound next week. I am encouraged by your replies that healing is a slow process and you remind patients not to get too frustrated and keep going. What’s odd is my PT has also been telling me the same thing. So thanks for all of the encouragement you have given patients. Not giving up, I want my shoulder to have full ROM and strength eventually so will continue to be patient and not quit.
Stephanie
I had slap surgery 3 months ago (2 anchors anterior inferior tare) currently have around 70% ROM (front raise fine, side raise 70% and shoulder press motion is wayy off) is this normal?
My strengh seems good can utilise resistance band well for front raises and have been able to swim ( breast stroke and front crawl) as well as bicep/tricep workouts.
At what point can i expext full range of movement in regards to shoylder press movement? Is this usually the last to come?
Thanks
This takes time, in most cases probably six months? I would continue to work on the strength and the ranges, and do allow for appropriate rest in between sessions.
Hello. So glad to find this thread. Help please. 2/6 surgery for torn labrum, Adhesive Capitylitis/ Frozen, Cortisone shot and a bone spur. Been going to physical therapy 2x each week and doing daily exercises at home since day 8. Today is day 37. I still don’t have 100% mobility and can hardly lift even light items. Still taking Naproxen 500 and on 50 Tamaradone. I keep trying to stop meds but only last half a day and need them again. Tried to sleep in bed with pillows twice, still in recliner. I am really worried I won’t get arm back. Still doing stretches at PT. Am I just rushing? What is the timeline for this? Also, I don’t like meds, When will I be able to stop both meds? Thank you!
Clever username by the way. The frozen shoulder really throws a monkey wrench into all of this, and you really have no choice but to ride it out until the inflammatory phase of the frozen shoulder is over. I am going to assume here that the frozen shoulder was sparked by the surgery, in which case the inflammatory phase may last for many months. I wish that there was a way around it, but a frozen shoulder needs to run its course. I do think that medication does help with the pain during the inflammatory phase. You won’t need to meds forever. AGGRESSIVE RANGE OF MOTION DURING THE INITIAL PHASE OF THE FROZEN SHOULDER CAN MAKE THINGS WORSE. Read the blog article that we have on frozen shoulders, it should explain a lot to you. You will get your arm back, it is just going to take much more time because of the frozen shoulder.
Sorry, I should clarify. Surgery was for torn labrum, bone spur and also for frozen. Surgeon did shave labrum, scrap bone spur and did MUA.
1.How long till inflammation settles down? I’d like to stop taking all meds especially the Naproxen.
2.what is timeframe I should have 100% ROM?
3. When could I expect to stop Tramadol?
4. Ice? Summer heat is starts soon here in CA. Will I be using ice (May-September) all summer?
5. How long should I plan on doing PT?
Thank you the first name I had was Shoulder Rebel😂
The inflammatory phase is variable. It ranges from several weeks to several months. I cannot tell you exactly when people in your shoes get back full range, but I would give it a year. The pharmaceutical question is best directed to your doc. Ice? Heat? It is subjective, whatever you feel helps. The PT duration totally depends on things progress. Ask your treating PT that one.
Thank you :) it is really helpful to bounce questions off of you. My PT is terrific I will talk with Him tomorrow.
Is it normal to get Neck pain at 9 weeks after surgery? I am still taking naproxen and Tramodol also still in P.T. shoulder is still healing but neck is painful now.
That is probably a postural thing. When the shoulder is protracted forward from the immobilization etc. it tends to bother the neck. I would ask the PT to work on your pect minor and levator scapulae muscles. That typically helps.
Tried those. Thank you the stretch is exactly my trouble areas and doing them is helping a lot.
Is there any truth to the broken fibers from MUA traveling to neck then across to other shoulder and causes the opposite shoulder to freeze?
I would have to see if there is any current research on that topic. I do think that the whole frozen shoulder causality thing is a bit of a mystery.
Hello me naughty shoulder is still naughty. Question? I have supraclavicular swelling left side that won’t go away. Thoughts? Should I call the surgeon? The therapist says it happens but it has been 3 weeks and I still have it. TIA
That is not very common, I would ask the doc about it.
Thanks I will call them today
Doc,
I’m a 44 year old high school baseball coach in TX. I’m in relatively good physical shape and work out several times a week. I tore my labrum in late August the day after I threw batting practice by throwing a baseball sidearm. I had 10 anchors put in my shoulder and it was almost a full tear of the labrum. I also had part of my clavicle shaved down due to some early arthritis. I am now 7 months post op and went through physical therapy for several months. I’ve tossed at short distance some, but it doesn’t feel very good. Do you think I will be able to ever throw batting practice from 40-50 feet again, or be fairly comfortable while throwing?
Thanks,
Coach
10 anchors is a mighty big tear Barry. I would give it a full year of rehab from the surgical date before trying to throw aggressively. We in the “forty and over crowd” don’t heal as quickly and our strength gains are slower. I do think that you will be able to throw from that distance eventually, but I would certainly consider being conservative about how you throw.
Hello, I had the bankart labral repair surgery back on April 24th, 2018.
I have been doing physio for the past 3 weeks but feel I may have overexerted myself showing my nephew a push-up position just the other night, I now have renewed pain that was decreasing with the ongoing physiotherapy, and fear I may have re tore the repaired area.
How possible could it be?
More likely a strain due to a slight lack of strength. Let it calm down for a week or two. The likelihood of pulling an anchor that many weeks after surgery is not great.
Hi, I broke my clavicle three years ago but had to wait 5 months for surgery resulting in a frozen shoulder. The shoulder was manipulated under surgery which has left me with a slight click when I move my arm in forward verticals motion and side vertical.
My main problems now is when I sleep on my side I feel I have a lose shoulder blade which collapses under me, I have neck stiffness, aching scapular, and weakness inside my bicep ( feels like a muscle under the bicep). I know I have to keep practicing the rotator cuff exercises. Should I do the jscapular strengthening at the same time?
Thanks Nadia
I do think that scapular strengthening would be a great idea at this point, but I would get the “okay” from your doc or your PT. The shoulder blade is intimately tied in to the clavicle, so weakness in the support muscles can easily manifest in the way that you describe.
Hello Doctor,
I am Viraj Desai (Age 37) and i live in Philadelphia. I play club level cricket & softball throughout the summer here. I have SLAP injury and doctor suggested SLAP surgery (with clean up for spur) after my MRI. I have the injury from few years but didn’t bother much while playing cricket. I do have much strength in my shoulder but this year some daily activity and few movements giving some pain. I can bat and bowl with full strength but when i throw mostly it bothers. I have been dealing with throwing action for few years but now the daily activity pain is worrisome. I am scared of doing the surgery with fear of not gaining full strength to bat and bowl after 6 months of rehabs.I have done PT already but no improvement. It would be a setback if i lose my playing ability after surgery which at least i am able to do it now with pain. Please advice me if i should go forward with surgery or no. How long will it take after surgery to bowl and bat again?
Thanks, Viraj Desai
If you have already done the conservative route, the surgery may be a good idea, but realize that it is a long process and you will have to be patient. My guess is that the rehab back to throwing would be 6-12 months and will involve quite a bit of physical therapy.
Hi Dan,
I had bankart surgery 1 year ago, and still have some issues with the shoulder, it does not feel stable enough, recently had another MRI and the doctor says everything is ok. So I am confused, the feeling is when I do relax all shoulder muscles (rotator cuff + all big muscles) and pull with the arm, I notice how the labrum makes a pop sound, it feels as it is not reattached although I had 3 anchors. I did not have any further subluxations episodes, and right now I am training with heavier weights. No issues here, only when I put all my surrounding shoulder muscles on relax mode, I feel the instability.
2.Question: I had 3 anchors on 1,2,4 o`clock position (anterior bankart tear), what are the best exercises for an anterior labrum tear; pulling o pushing exercises? I´ve read about “humeral anterior translation” for example in Rows, or in the flat phase of push-ups. Too much humeral anterior translation is what I have to avoid precisely in an anterior labrum tear, right?
thank you, great blog by the way
I would say that internal rotation RC strengthening is a good idea. One of my sentimental favorites is the “internal rotation” exercise in our exercise library (it is #20 under shoulder on the website). I would also think that for your activity level with weights etc. I would invest in a “body blade” and start stabilizing with that.
Hi doc,
I recently had surgery labrum repair anterior location one screw and decompression and debriment and impingement and am 6 weeks post op. My AROM is about 100 shld flex and 90 abd. Limited internal and external rotation. I am still in a lot of pain specifically when I do my home exercises and after PT , I haven’t been able to sleep due to pain, I still bruise easily after sessions MD said it’s probably scar tissue breakdown. After exercise I feel extremely stiff and my arm feels heavy all day and night , i have mild scapula winging . I recently went to PT and they have been ranging me however I have severe pain on lateral side near middle deltoid. PT said it was consistent with supraspinatus or could be lots of tightness as my previous PT did not do much ROM. PT just started incorporating weighted exercises with 1 # for traps/ rhomboids triceps ,light theraband for internal/external. I attempted to do an exercise recommended where you grab the towel and begin to lift your arm with dorsal aspect of hand on lower back and now I feel like my shoulder is Out of place ( super sore ). I still have clicking and it feels like my deltoid or rotator cuff is catching( gets stuck which hurts like hell) when lifting arm then it goes back to place during PT, he said it could be due to swelling and weakness of muscles but to continue to monitor . What are your thoughts? I’m going to see dr soon but he was not concerned when I saw him a week ago.
Six weeks really isn’t a huge amount of time for recovery. It is not surprising that there is still considerable inflammation etc.. Add on top of this that a considerable number of people post-op develop capsular tightness due to the surgical trauma.
If this was my shoulder I would back off the intensity of the stretching a bit. Keep it gentle. I would ask the doc / PT maybe if you could get a set of pulleys and perform some gentle stretching at home?
I’m currently 4 weeks post surgery for my labrum on the left side of my shoulder. I had an anterior and posterior tear that was repaired. A few days ago I fell at a friends house. I was in the middle of a conversation when I was bumped and accidentally fell forward onto the person i was talking to landing forward with my arm in the sling. Luckily i was wearing my sling as well as the immobilizer. After i fell i felt some pain , but nothing major. It has been three days now since i fell. I’m not in excruciating pain, but my shoulder feels really achy on my trap as well as i have some pain when I put some pressure on my anterior incision sights. my shoulder feels really irritated. What should i do? Dose it sound like i re injured something?
If you were wearing the sling your surgery was most likely protected. A lot of that new aching may just be other parts of your neck and shoulder letting you know that you got smacked around. If you are really concerned of course I would just go and see the doc to be sure that the anchors have held etc..