Labral Tear Repair Surgery
What happens During Surgery?
Surgery takes between 45 minutes to 1 hour. It is done with general anesthesia meaning the person is asleep. It can be done arthroscopically or through a cut in the skin depending on what type of tear is being repaired. Often the person will have a nerve block placed in their neck which makes their shoulder and arm numb for 6 to 48 hours.
Immediately after Surgery
The person will wake from surgery in the recovery room where they will spend 1 to 3 hours. They will either be allowed to go home or be moved up to their room in the hospital for the night. If they are allowed to go home they will need a ride since they cannot drive or take public transportation.
If they are kept in the hospital, they will be given a bed with a special range-of-motion machine. The nurse will hook the person up to the machine and teach the person how to use the machine. This machine should be used as often as possible.
A person may have questions following your surgery. Many of these frequently asked questions about surgery can be answered here.
Therapy after Surgery
After surgery to fix the labrum, an intense therapy program is started right away.
What to expect after Surgery: Week 0 through Week 6 (Phase One)
- Pain: It is normal for a person to experience moderate to severe pain for the first few days after surgery. A person will be given pain pills to take for the first 5 days after surgery. After that, only Tylenol is recommended (if a person’s Primary Care Provider (Medical Provider) says Tylenol is a safe medication for a person to take). Pain from the surgery should decrease by half, with each passing day. Pain is usually improved with the stretches that are taught. If a person wakes up with pain in the middle of the night, they should do their stretching exercises, as stretching usually makes the pain better.
- Therapy: After waking up from surgery and being brought up to their room, a therapist will visit the person to teach the person the 40/140 Therapy Program. This therapy program involves stretching the shoulder that had the surgery with the help of the other arm. The person will be taught 2 sets of exercises. Each set must be done 5 times a day.
During the surgery, the person’s arm will be given full range-of-motion. After surgery it is extremely important to maintain that motion by stretching 5 times a day. The likelihood of a person having a long term good result highly corresponds to their range-of-motion immediately after surgery. If a person’s shoulder is too sore to be stretched, it’s very important they communicate this to their provider and therapist, so the team can help them get back on track. Every day that passes that a person does not achieve their range-of-motion goals makes it extra difficult to get back on track.
- Precautions: For the first 6 weeks after surgery, a person may do Passive Range-of-Motion only. It is extremely important that the person not actively uses their arm (Active Range-of-Motion), and keep it completely relaxed for the first six weeks after surgery. The reason for this is that the repair must be given time to heal. If a person actively uses their shoulder before full healing, the surgical repair could pull apart, and the person may need another surgery.
Although a person will not be permitted to move their arm/shoulder away from their body, they will still be able to move their elbows and wrists- this means they can do things like type, write, cut their food, feed themselves, wash their face, etc.
The only form of exercise a person should do at this point, is: 1) walk on a paved, even road with their arm in a sling or relaxed at their side OR 2) ride a stationary bike with their arm in a sling or relaxed at their side
- Work: Because the stretching therapy is so important after surgery, if a person is able to take the first 6 weeks off from work, they are often encouraged to do so. Even if a person has a “desk job” or a non-physically demanding job, may not have the time or the space to lie down and stretch 5 times a day. For this reason, it makes sense to take the time off from work so that a person can focus on their stretching. If a person works from home, or has a job where they can take the time and space to stretch the 5 times a day, then a person like this usually takes about 1 week off.
What to expect after Surgery: Week 6 through Week 12 (Phase Two)
- Pain: It is expected that there will be pain with movement of the shoulder. Pain should be much less than during the first few weeks after surgery, and most people are comfortable if they are resting.
- Therapy: Every person at this point is expected to be extremely weak. Most people are not able to raise their arm to the level of their shoulder. This is completely normal, as the person had been instructed for the previous 6 weeks not to use the muscles of their arm. At this point, the person will also begin a light weight, high repetition strengthening exercise program.
Most people are able to raise their arm about their head completely, somewhere between weeks eight and ten. A person should not be discouraged if they do not yet have the strength to do this since everyone progresses differently.
- Precautions: After 6 weeks, the tendon is essentially healed. At this point, a person’s restrictions are lifted. In other words, a person may begin activity as guided by “pain and common sense”. If it hurts a little when doing a certain activity, a person may continue doing the activity. If it hurts too much, that’s the body’s way of saying that the person needs to slow down and back off whatever activity they were just attempting. A person should begin activities cautiously and using “common sense”. For example, if a person wants to try to go swimming, they should try it from the shallow end of a pool not in the ocean when the surf is big and the current is strong.
- Work: Most people who have jobs that require physical labor are not ready to return to work at the 6 week mark. Some may be ready to go back around week 8-10.
What to expect after Surgery: Week 12 through 1 year and beyond (Phase Three)
- Pain: Pain is either going down or is gone.
- Therapy: At the 12 week mark, it is likely that the person is flexible and strong, like they were prior to their injury. It is normal not to feel 100% strong at this point. Some people continue to do therapy but many do not.
- Precautions: Most people have no restrictions
- Work: Most people have returned to work.