Nonsurgical Approach to Shoulder Labral Tear & Dislocation

What is your story about?
When I was about 19 years old I tore my shoulder labrum. In subsequent years, I had multiple subluxations and dislocations. My approach to resuming activities has been aggressive rehab that carefully increases the intensity until I've regained normal function. Although I'll likely need surgery in the future, this approach has worked for me thus far.
What is your shoulder injury history?
The original SLAP tear occurred when I was 19 or 20. I was training MMA at the time and working on my BJJ, got caught in a keylock and decided not to tap. Go figure, the shoulder lock damaged my shoulder. I've also had a few subluxations and dislocations. Most recently, I had two in the summer of 2018. The first was probably just a subluxation. I got it while practicing an aerial straps move (go figure doing a performance art that's very hard on the shoulders damaged my already damaged shoulder). It set itself just fine. After I got off the straps I felt all of the shoulder girdle musculature ...(more)
How have you approached recovering from these injuries?
After shoulder injuries, with the direction of an ortho and a PT, I get right back to training. But, everything is extremely light and only done in a range of motion that can be uncomfortable but not necessarily painful. The movement helps prevent atrophy and maintains the motor patterns, whilst maintaining some mobility. The increased blood flow helps promote healing in those areas with very little blood flow. I also always do rehab/prehab exercises for my shoulder with a band/light weights. Also stretching, within reasonable amounts, is important to maintain mobility. This is what I've done ...(more)
How long does it take to resume activities using this approach?
I don't remember how long after the original injury I started to use my arm again. It wasn't long at all. The fact that I even had a tear was only found out last fall after an MRI. I can guarantee you I probably just sucked it up and used it again after a few days or a week. After the two injuries in Summer '18 I resumed normal activities the following day, with copious amounts of NSAIDs. It took a few weeks for me to resume "normal" training. I'll define normal training as doing exercises at the same intensity with the same range of motion as I was doing before the injuries. After the second ...(more)
How did you decide not to pursue surgery?
Disclaimer: I've been told by a Ortho surgeon specializing in shoulders that even though function has come back and is fantastic my shoulder is mostly held together by the musculature crossing the joint. I'm most likely going to have terrible arthritis in the AC joint unless I get surgery. The original thought process was "I don't really care to get it checked out it'll get better on it's own". The current thought process is that I don't have health insurance at the moment, until next month that is. After I got the MRI I stopped working full time and switched to a per diem gig and lost my ins ...(more)
What rehab exercises made the biggest difference?
The most useful rehab exercises I've found are standing external rotations done with a band. Humerus is positioned parallel to the floor (so it looks similar to a Cuban rotation) and the shoulder is horizontally adducted to about 45°. Coupling that with face pulls and general balanced strength work in all ranges of motion (except adduction and abduction which irritate the joint) my shoulder has gotten much better. Stretching the anterior muscles has also been extremely important for me and where as my range of motion still isn't fantastic it is better than most people's.
Are there any movements you currently avoid?
Adduction and abduction of the shoulder with any meaningful resistance is still a no go. I've tried working iron cross progressions but trying to adduct anything more than 35lbs results in a lot of clicking, which isn't necessarily bad but I know that's a great indication to not push my shoulder more. Also, dislocate drills for shoulder mobility basically 100% of the time give me a subluxation. I like olympic lifting too and the snatch position is uncomfortable.
What advice would you give others with your condition?
One thing I'd tell people is that they should most definitely do their physical therapy and strength training after a bad shoulder injury. They should also really consider surgery, even if they don't want it. When I'm prepared and have my muscles firing my shoulder is very stable. When I'm relaxed it's a different story. My dog has subluxed my shoulder by running towards a squirrel and pulling on his leash when I wasn't paying attention. I've subluxed it by flailing my arms backwards trying to catch my balance while slipping on ice. The more you hurt it the easier it gets hurt and unfortunatel ...(more)