SLAP Tear

SLAP Tear? What exactly is it? A SLAP Tear definitely can be a major slap as it was for me. If you're one of the many who have experienced a SLAP Tear, then you know that it can be quite painful. Speaking from personal experience, I've had a SLAP Tear in which the glenoid labrum of my left shoulder was torn along with a total detachment of the bicep muscle from the shoulder bone.

Having 2 separate shoulder surgeries to repair my SLAP Tear injury, presented me with many challenges over the past several years. The first repair surgery lasted over 3-1/2 hours ... much longer than my surgeon expected! Wow, was that experience ever a nightmare!

After that surgery, I couldn't get past the high level of pain. I was subsequently diagnosed with Reflex Sympathetic Disorder or RSD. That meant 2 full courses of pain management which was totally another kind of major pain!

When I began my third course of pain management, the doctor hit a nerve that sent spasms down my right arm. I did not go back for the other two treatments.

Have you also experienced a SLAP Tear and had surgery? I'd love to hear from you! Please leave me a comment in my guestbook. It's definitely more than the name might convey -- for me it was a major S-L-A-P that SLAP Tear! P.S. Thanks to Google for including my pictures post-surgery on the first page of the image search.

Photo Credit: SLAP Tear repair surgery on JaguarJulie's left shoulder.

Quick, cast your vote about the SLAP Tear!
Have you experienced a SLAP Tear? Google "slap tear" and see what search results you get. Try web and image searches. So, have you had a SLAP Tear?

1. Yes, and I had surgery!
2. Yes, although I haven't had surgery.
3. Well, I think I might have one.
4. Nope, never had--lucky I guess!

What's SLAP?
What exactly is a SLAP tear? Well ... S-L-A-P stands for:

1. Superior
2. Labrum from
3. Anterior to
4. Posterior!

Sub-types of SLAP Tears
At least ten types of this injury are recognized with varying degrees of damage seven of which are listed here:

1. Degenerative fraying of the superior portion of the labrum, with the labrum remaining firmly attached to the glenoid rim
2. Separation of the superior portion of the glenoid labrum and tendon of the biceps brachii muscle from the glenoid rim
3. Bucket-handle tears of the superior portion of the labrum without involvement of the biceps brachii (long head) attachment
4. Bucket-handle tears of the superior portion of the labrum extending into the biceps tendon
5. Anteroinferior Bankart lesion that extends upward to include a separation of the biceps tendon
6. Unstable radial of flap tears associated with separation of the biceps anchor
7. Anterior extension of the SLAP lesion beneath the middle glenohumeral ligament

Slap Tear Symptoms

1. A dull throbbing ache in the joint.
2. Difficulty sleeping due to shoulder discomfort.
3. For an athlete involved in a throwing sport such as baseball, pain and a catching feeling are prevalent.
4. Any applied force overhead or pushing directly into the shoulder can result in impingement and catching sensations.

Heat Patches
Experiencing a lot of pain in my shoulder and back, I found that using heat patches seemed to provide some temporary relief. I have used a lot of heat wraps and patches like ThermaCare Lower Back & Hip Heat Wraps.

Slap Tear Treatment

No Intervention? Very few patients with SLAP lesion injuries return to full capability without surgical intervention.

Physical Therapy? Very rarely physical therapy can strengthen the supporting muscles in the shoulder joint to the point of reestablishing stability. For all other cases the choice is do nothing or have surgery to reattach the labrum to the glenoid.

Arthroscopic Surgery? While the surgery can be performed as a traditional open procedure, the recommended course of action is an arthroscopic surgery. This type of procedure is vastly less intrusive to the body and reduces chances of infection.

• Procedure: During the procedure the surgeon should check the general health of the shoulder joint. There are at least twenty different items of conditions that he/she should examine or look for. These include:

• SLAP lesion - labrum/glenoid separation at the tendon of the biceps muscle.
• Bankart lesion - labrum/glenoid separation at the inferior glenohumeral ligament.
• Biceps Tendon.
• Bone - glenoid, humerus - general surface condition.
• Ligaments - check for tears and condition.

My First SLAP Tear Repair Surgery
I had 3 titanium anchors to reattach my biceps tendon to the bone along with the labral repair.

After my second SLAP surgery : surgeon's marks!
Photo of and by JaguarJulie.

The Surgical Procedure ...

1. Glenoid and labrum roughened to increase contact surface area and promote regrowth.
2. Locations for bone anchor are selected based on number and severity of tear. Bad tears involving SLAP and Bankart lesions may require 7 anchors. Simple tears may only require 1.
3. Glenoid is drilled for the anchor implantation.
4. Anchors are inserted in the glenoid.
5. The suture component of the implant is tied through the labrum and knotted so the labrum is in tight contact with the glenoid surface.

Surgical Recovery

It is difficult to be precise when predicting a person's recovery from a SLAP Tear Repair Arthroscopy. You can generally expect to experience something of the following. The timeline can vary a bit according to your own surgeon's preferences and the extent of damage and repair.

1. Stage one - For the first four weeks the arm is typically kept in a sling. There are some surgeons only have the patient in a sling for a week. Patients may find themselves in an immobilizer sling like the Corflex Neutral Abduction Pillow Sling for Shoulder Labral Tear-L, which adds in a waist support to prevent movement. The first stage of recovery is about not stressing the repair site. This is the initial healing phase of the recovery.
2. Stage two - Initial physical therapy. The goal here is to increase range of motion. Load bearing through the joint should be avoided to allow the repair to complete.
3. Stage three - Increased range of motion and initial strength training. At this point, about eight to ten weeks out, the repair should be complete but not ready for full loading yet. Return to day to day activities, but not strenuous activity.
4. Stage four - completion. At about six months out the repair should be strong enough for a return to full activity.

Physical Therapy

Going through several courses of physical therapy, I got to know the Tens Unit really well. And, I liked it! My hubby, now the ex, actually bought one for me as a Christmas present.

I used my Tens Unit so many times that the electrode pads started to feel not so sticky.

Also, I found that my hubby liked using it too. Thankfully, there was a second pair of electrodes that he used for his hairy back.

Ultimately, when I was getting my divorce, I left him that former Christmas present. And, I got myself another Tens Unit. I've actually got the Drive Medical AGF-05 one.

My Second SLAP Tear Repair Surgery

After my second SLAP surgery : lots of bruising!!

After my second SLAP surgery : lots of bruising!!
Photo of and by JaguarJulie.

I returned to my orthopedic surgeon for a second arthroscopy after the initial SLAP tear repair. I was experiencing limited motion in my left shoulder along with extreme, grabbing pain when I would reach out with my hand in a forward motion. You know as you reach across the table to grab the salt and pepper?

It was about a year later that I went back. Once the surgeon got in there, he found lots and lots of scar tissue. He said it was like a giant spider's web. He did a lot of cleanup and then it was recovery time again for me! You can see all the bruising I experienced after that second procedure!

P.S. How I am feeling since my SLAP Tear surgeries?
A whole different story is my experience with 3 courses of PAIN management! I've been hearing more and more from people who have also experienced a slap tear and want to know what to expect.

Similar shoulder injuries are more common than one might expect. In addition to my mother, I've now got 4-5 friends who have complained of the same types of shoulder pain common to a slap tear.

What is key to recovery is PT, physical rehabilitation and constant activity and exercise. As I was immobilized for 6 weeks, I had to deal with the buildup of scar tissue that was debrided in my second surgery. IMHO, I am not 'pain free' but am 'aware' that I had shoulder surgery.

Someone asked about activity AFTER surgery. Well, I was in a fully-restricting arm brace and experienced a fair level of pain. However, after 7 work days, I returned to work--one handed mind you--and was driving myself to work probably 2 weeks after surgery. But, I didn't need to shift or work a clutch thankfully.

P.S. Maybe someday I will take the time to talk about my experience with PAIN after being diagnosed with Reflex Sympathetic Dystrophy / Disorder RSD after my shoulder surgery. I ended up needing to have 3 courses of Pain Management which was NO fun! That included a series of 3 procedures for each course along with heavy duty meds and having a HUGE needle stuck in your spine!

Going Strapless!
When I first experienced the pain of my SLAP tear, I found wearing a bra with straps was unforgiveable. I went through a lot of bras before I found one that fit right.

Over the course of my treatment, I wasn't wearing any bras with straps.

Sometimes I would wear one of my tube tops as I didn't need to ask the hubby to hook me up! Later, when I was able to use both hands, I resorted to wearing strapless bras like the Wacoal Women's Full Figure Red Carpet Strapless Bra.

Thanks for visiting!
So, have you been diagnosed with a SLAP tear? I'd love to hear about your experiences as mine seemed to drag on for a few too many years. Had surgery or therapy? What worked for you ... or didn't?

History: SLAP Tear : What is it? was originally created on Squidoo by JaguarJulie on January 11, 2008. Highest lensrank ever achieved: #878 overall. Lens #236 in the quest for Giant Squid 300 Club.

Greater Trochanteric Pain Syndrome

What the royal heck is Trochanteric Bursitis? Yes, seriously indeed! Hey you there! Huh? What the heck is Greater Trochanteric Pain Syndrome you say? Yes, this is exactly what I am asking myself. You see, I finally paid a visit to my orthopedic surgeon, Dr. Hakim, at the prodding of my dear old ex-hubby.

The now ex-hubby said, you'd better get that hip of yours checked out so that you are OK for our upcoming vacation in Greece. You know, that is a trip of a lifetime, and I want you to be OK and able to hike the ruins of ancient Greece.

I am walking into the examination room and there I see Dr. Hakim sitting with the gang. "What are YOU doing here?" he asks. "Oh, I couldn't stay away from my favorite doctor!" You know, it helps that you would have a favorite doctor when you are wondering about your hip pain.

Welcome to my journey to conquer my hip joint pain! So you see, I left Dr. Hakim's office with a diagnosis of Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome. I had never heard of this before, but I did know a bit about bursitis.

Let me tell you more about my journey! This is my personal story of experiencing this painful condition. My story will unfold for you, just as it happens! I will update my story as it goes! You know, I've already been to Dr. Hakim twice! Read all about those visits! Say there! "What the Heck!

Photo Credit: A Lot of Hips Art Print by Shan Kelly.

The Trochanteric Bursitis Poll
Have you been diagnosed with Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome? Which of these statements best fits YOU?

1. I have personally been diagnosed with Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome!
2. I know someone who has Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome!
3. I have had hip replacement!
4. I have hip pain, but think it is arthritis or osteoarthritis!
5. I never heard of Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome!

My Initial Diagnosis of Trochanteric Bursitis
Greater Trochanteric Pain Syndrome - Do you have a pain in your groin?

Ah, when I was being escorted into the examination room, Dr. Hakim's assistant asked me "Do you have a pain in your groin?" I told her well not exactly as it wasn't my groin that had been bothering me. I gestured to the outside of my right hip, pointing at what us women affectionately like to call the "widest part." She shook her head and mumbled something which I think had to do with the greater trochanter portion of my femur.

I sat down in the chair in the corner of the exam room and went about completing the medical questionnaire. It had been a few years since I had last seen Dr. Hakim. You see, he and I went round and round several years ago when he performed a couple of surgeries on my left shoulder to repair a SLAP Tear. That was probably the most painful couple of years, requiring several courses of pain management until I was free of reflex sympathetic dystrophy. A few years later, I returned to Dr. Hakim for surgery to a repair Meniscus Tear of my left knee.

My pain can go from moderate to excruciating when I walk up an incline or up and down some steps. And, when it starts to hurt, it won't quit! I have used a lot of heat wraps and patches like ThermaCare Lower Back & Hip Heat Wraps.

A couple of x-rays were taken of my right hip and then Dr. Hakim came in for the exam. We talked about why I had waited three years or so before coming to see him. He mentioned that it would have been better that I came at the initial onset of the pain symptoms.

Dr. Hakim had me lie on the exam table and began a series of manipulations with my right leg and hip. He checked the length of both my legs to see if my right leg was a different length from my left leg. Glad to know I passed that test! When he pushed my leg and hip up and outwards, I felt discomfort. Then he began pressing on a variety of areas on the outside of my right hip and on the back side of my hip. Yes, Yes, No, YES! Bingo! You have Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome.

ICD-9-CM diagnosis code 726.5 Enthesopathy of hip region; ICD-9-CM diagnosis code 846.9 Unspecified site of sacroiliac region sprain.

Detailed Visit $200.00; Hip x-ray $55.00; AP Pelvis x-ray $50.00 = $305.00

A Trochanteric Bursitis Test
Here is a YouTube video that shows exactly what Dr. Hakim did in my exam!




The Initial Treatment for Trochanteric Bursitis
How would you like a cortisone shot in the hip? With the initial diagnosis of Trochanteric Bursitis being made, we next discussed treatment recommendations and options. What impressed me initially, was Dr. Hakim's query of why I had waited so long to seek a diagnosis. "Well, you see, my mom has a bad hip too" I said, "And my aunt had two hip replacements ... I think it runs in the family."

I had waited so long to seek a doctor's care because I was so sure it meant a hip replacement for me! I had NO IDEA that we would be talking about something else; i.e. Trochanteric Bursitis.

OK, so Dr. Hakim began talking about a cortisone injection into my hip; he said that he prepares the injection there in the office and that there would be a slight numbing effect up to say 12 hours and that the shot shouldn't hurt too bad. Well, by that time, his assistant was smiling and shaking her head. "Oh, I know how you are about shots and needles" she said. "Well, you think about it and I'll be back in a few minutes" Dr. Hakim calmly replied.

I got off the exam table, sat in the chair in the corner, wiped my sweaty hands and thought about it. You know, I had convinced myself that I would tough out the shot that day. However, when Dr. Hakim returned to the room, he had already figured I would say NO SHOT. "OK" he said, "I will give you a prescription for the Flector Patch and make an appointment for you to return in 2 weeks and we can give you the cortisone injection then."

Since my shoulder surgery several years earlier, I had purchased a Tens Unit that I was using frequently. I opted to use that Tens Unit on my hip.

Rx for Flector Patch
OMG! A one-month supply of the Flector Patch 1.3%
cost $283.54 out-of-pocket and I have health insurance too!

Two Weeks Follow Up Doctor Appointment
I returned to see Dr. Hakim on June 24, 2010, two weeks after my initial appointment. We had set up this appointment with the option of canceling if I opted to not want to return. It had been two weeks of wearing the Flector Patch. The doctor's assistant had mentioned that I might want to cut the patch in half to make it go further. That would be a good idea on a patch that costs just about $5.00 each!

Thus far, I have experienced no major improvements to the pain in my right hip after wearing that Flector Patch for two weeks. I didn't have any specific expectations, well other than the fact that the prescription cost almost $300.00 and I thought I'd have something really major to report. You know, less pain or pain-free? Well, I am still wearing the patch and still waiting.

Medishorts Exam Blue Large/xl 50/case

Preparing for the cortisone shot, the doctor's assistant handed me a pair of MediShorts. The label says Item #10001 by Graham Medical Products.

"Oh wow bloomers!" We were laughing about the shorts and asking some personal questions, like "should I take off my underwear?" Ha! Too much information for this article folks. Dr. Hakim came in and asked if I need somebody to hold my hand. Ah ... no thank you doctor. "Have you got a blindfold?" Ha!

Dr. Hakim pressed/poked a couple of spots to elicit a "bingo" or "eureka" from me. He then tore a hole in the shorts, at the side of my right hip, and proceeded to make 4 separate injections from the one needle. He mentioned that I should feel a bit of pressure -- sure sure -- and ouch from the injection.

My Next Doctor Appointment
My next appointment was set for July 16, 2010, a follow-up in three weeks. However, on July 12th, I called and cancelled that appointment although I am experiencing a bit of increased pain. I told Julie, in Dr. Hakim's office, that my finances at the moment didn't support extra expenses which I could control. I hope to reschedule in the near future.

So, today's visit cost $220.00. That included the office visit as an Expanded Prob 99213 = $100.00. The shot was the rest of the charges! Office Procedures of Major Joint/Bursa/Gan = 20610 = $100.00 + Xylocaine J2000 = $5.00 + Cortisone J0810 = $15.00.

Trochanteric Bursitis? Why These Hips Don't Lie

Adding a little humor to the equation! Hey Hey Hey! Hello there ... if anything we've learned over all these years of being impacted by age is to have a sense of humor about it all. After all, if you can't smile about it, what's the alternative? Shrivel up and die maybe? I think NOT.

Life has been a spiritual journey for me and I am feeling like I need to express this more these days. I think the end is surely near. My mom has been telling us more and more that she won't be around much longer. I've sat up and taken notice ... you see, me and my mom are pretty much alike ... in many ways! From the physical ailments to the mental to the spiritual ... and she can cook too.

Ah, Sit on IT!

Large Extra Firm Tush Cush Seat Cushion - Navy - Firm foam for those over 200 lbs or those who prefer a firmer cushion.

Full Size (14 inches by 18 inches) - The Original High Quality Tush Cush is designed to relieve and prevent back pain, numb buttocks and other discomforts associated with sitting.

Cutout section suspends your tailbone (coccyx) reducing pressure on your lower lumbar discs. Wedge shape (slant from the back 3" down to 1/2" in the front) tilts your pelvis forward to restore your spine's natural lumbar lordotic curve.

UPDATE!

It was June 2010 when I visited Dr. Hakim in Jacksonville, Florida. Fast forward to today ... it is Friday, May 31, 2019 ... that is nearly NINE years since my diagnosis of Trochanteric Bursitis in my right hip. Let me tell you, but the past year, the pain has escalated to be a daily challenge for me. I would say, at this point, it feels like Greater Trochanteric Pain Syndrome as it feels like it has radiated down from the outside of my right hip. When I am out in my gardens, I need to be careful not to rotate on my right hip or my leg will give out. I now know that this daily pain and limitations are impacting me greatly. I will be visiting my primary care physician soon and see what my course of treatment might be at this point!

Thanks for dropping by today.
Have you personally been diagnosed with Trochanteric Bursitis aka Greater Trochanteric Pain Syndrome? Or, perhaps you happen to know somebody who has this painful "affliction?" Trust me, it is NO picnic.

I'd surely love to hear from you especially if you have experience with this. It is just the beginning of my journey and I hope to be successful in my journey to overcome this painful condition and get back to "my hips don't lie" anymore! Hey, give me a shout out today!

History: Greater Trochanteric Pain Syndrome! What the Heck! was originally created on June 11, 2010. Highest lensrank ever achieved: #3,815 overall. Lens #644 in the quest for Giant Squid 700 Club.