Shoulder Labral Tear Surgery Pros and Cons: Hidden Shoulder Instability

by Chris Centeno, MD /

Shoulder Labral Tear Surgery Pros and Cons

I evaluated a patient this week who shows off the warts of our modern orthopedic care system; he was diagnosed with a shoulder labral tear and offered surgery. Why? His shoulder labral tear was the bright, shiny object, and nobody ever asked how he got the tear in the first place. As he considered shoulder labral tear surgery pros and cons, I made the decision easy for him. Like many patients with a shoulder labral tear, the real diagnosis and its treatment was missed by the five-minute visit with the orthopedic surgeon. Let me explain.

What Is a Shoulder Labral Tear?

shoulder_anatomyThink of the shoulder labrum as a lip around the socket of the ball-and-socket shoulder joint. It’s there to help guide the shoulder joint in movement and to make the shallow socket a bit deeper, allowing for better stability. A tear in the labrum used to be ignored, considered just part of the spectrum of shoulder-joint arthritis, but then orthopedic surgeons figured out they could sew it together and an industry was born. This isn’t to say that one doesn’t need to worry about healing a labral tear, but for most patients, surgically sewing it back together is likely not the right choice.

Why Did Your Labrum Tear in the First Place?

In our modern orthopedic surgery system, dictated by insurance contracts and managed care, most patients spend more time with an assistant than the surgeon. If they do see the surgeon, they’re one of 30–40 patients seen that day, each of which garner 5–10 minutes of attention. In this world of factory-type, high-volume medicine, asking how the labrum was torn in the first place just slows down the manufacturing line, so the question is rarely asked and answered.

While labral tears can occur in big traumas, like a car crash or a serious fall, many just kind of happen with seemingly innocuous activities. Why? The answer is simple, but it is often completely ignored by surgeons—hidden shoulder instability.

What Is Shoulder Instability and Why Should You Care?

The shoulder is a strange joint in that it has to allow for maximum movement in many directions, but it also has to remain stable at the same time. There’s a symphony of millisecond-timed and millimeter-oriented precision that allows the ball to stay in one tight region in relation to the socket as you move. While the rotator cuff and other muscles play a big role in this, there are also strong ligaments that make sure the ball joint stays perfectly seated in its shallow socket.

Surgeons usually pay attention to these ligaments only when the joint has been dislocated out of its socket, and everything else might as well be invisible. However, for each patient who has dislocated a shoulder and is left with a horribly unstable joint, in my experience there are five or six patients who also have an unstable shoulder that goes undiagnosed – hidden shoulder instability. Oftentimes this is from an old injury that the patient may have long since discounted. However, at some point that unstable shoulder that seems fine comes back to bite them in the form of a labral tear. Hence one of the biggest cons in evaluating shoulder labral tear surgery pros and cons is hidden shoulder instability.

How Is a Labral Tear Related to Hidden Instability?

ezgif.com-video-to-gif (1)

Check out the animated GIF above. The left shows the ball in a shoulder socket that is stable. It moves a little, bit it doesn’t bang into the labrum (lip of the socket, represented by the little triangles). The image on the right shows what can happen when the ligaments are loose (hidden shoulder instability) and the ball moves too far out of the socket and crashes into the labrum. Ouch!!! While you would think you would know if your shoulder is unstable, it rarely works out that way.

Two Patients Who Show How Common This Problem Is and How Often It’s Missed

Hidden shoulder instability is very common and is almost always missed by orthopedic surgeons. Case in point is two patients I evaluated this week. Both saw me because they were evaluating shoulder labral tear surgery pros and cons.

One was a patient in his 20s who rock climbs, and during a workout, he felt a tearing sensation in his shoulder and then had chronic pain. He was diagnosed with a torn shoulder labrum in the front and the back, and the recommendation was surgery. Nobody asked why a normally healthy guy would suddenly get a labral tear doing what everyone else does without injury. On exam his shoulder ball was unstable in its socket, a fact the orthopedic surgeon missed. So hidden shoulder instability is why the ball suddenly shifted out of its socket and banged his labrum. How did he get the instability? He remembered a bad mountain-bike fall 7 years ago where his shoulder hurt, but he’d never had it checked out.kimura lock shoulder injury

The second active guy I evaluated in clinic this week was similar. He tore his left shoulder labrum while dead-lifting 450 pounds. His right shoulder had no issues and was also loaded with the same weight. Why did he tear his left shoulder labrum and not his right? He, too, saw an orthopedic surgeon who told him he needed surgery. On exam his left shoulder joint was unstable and knew immediately when it happened. While in a mixed martial arts (MMA) fight, his opponent wrenched his shoulder (the “Kimura Lock” as shown) the year before the dead lift. He, too, had shoulder pain for a few weeks, but blew it off. Again, the hidden shoulder instability was completely missed by the orthopedic surgeon.

What Happens if You Get Shoulder Labrum Surgery and Have Hidden Shoulder Instability?

It doesn’t take a rocket scientist to understand that if you have hidden shoulder instability and someone surgically repairs the labral tear, as soon as the shoulder gets into a weird loaded situation, the socket will shift out of place and the labrum will tear again. How can you prevent this? By skipping the 20th-century orthopedic surgery and using 21st-century interventional orthopedics. This means placing precise imaging-guided injections of your own advanced platelet and stem cell mixes directly into the labral tear and also into the weak ligaments. The downtime is a fraction of that of surgery, and in our experience of treating hundreds of shoulders, the results are as good as or better than surgery—and with the hidden shoulder instability issue fixed.

The upshot? Hidden shoulder instability is very common and almost always missed by surgeons who spend 5-10 minutes with a patient. So if you’re looking at shoulder labral tear surgery pros and cons, a huge con is that you may have hidden shoulder instability that was undiagnosed, meaning that this shoulder labral tear repair will be your first of many shoulder surgery rodeos. Save yourself the brain damage and get a good exam (which means a 60-minute evaluation by the doctor-not the assistant). In addition, why go with 20th-century technology when addressing your labral tear? Why not go with advanced interventional orthopedics and skip the surgery?

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60 thoughts on “Shoulder Labral Tear Surgery Pros and Cons: Hidden Shoulder Instability

  1. Janet

    I have had shoulder pain since Thanksgiving. I had an MRI the end of December. My doctor said I have two tears one in the front and one in the back. I did two months of physical therapy which helped some. I continue to do the exercises at home. I’ve tried to play tennis a handful of times but it’s to painful and weak. At my doctor appointment last week he recommended surgery. Your article here is very, very interesting. I wish I could get involved in your trial. Thank you for all your wonderful information.

    1. Regenexx Team Post author

      Janet,
      We’re still recruiting for the Rotator Cuff Tear trial, but because of the nature of RCT’s the inclusion and exclusion criteria are very specific: http://www.regenexx.com/stem-cell-research/#studies. While it’s always better to begin with the most conservative treatment like Physical therapy, if that hasn’t helped, being evaluated for treatment with your own platelets or stem cells, rather than surgery would be important. That way you’re giving the injury what it needs to heal, rather than giving it the bigger problem of needing to heal from the surgery without discovering and treating the cause of the tears…most probably, instability: http://www.regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/ If you’d like to be evaluated for a Regenexx procedure, fill out the Candidate form, and we can take a look.

      1. Janet

        Hi,
        I contacted your office several weeks ago to find out more information regarding the trial but was told by your office that it was only for those living in the state. I was disappointed because I do believe I meet your criteria.

        After being told this I went back to the Regenexx website and found a doctor several hours away from where I live. I have an appointment with him this Wednesday which I am looking forward to.

        Thank for responding to my first email.

        Janet

        1. Regenexx Team Post author

          Janet,
          That’s good news! Good for you for taking the initiative to look further! Given the amount of times the patient would need travel to Colorado, it’s simply unrealistic for a patient to be able to do that if they don’t live in Colorado. Will be thinking of you on Wednesday…

  2. barbara pool

    I have either rotation cuff or unstable shoulder with pain and aching on movement and even at nite. Any doctor in Tn? That does stem cell?

    1. Regenexx Team Post author

      Barbara,
      Here’s some additional info on Rotator Cuff Tears and shoulder pain. If you’d like to be evaluated for a Regenexx procedure please fill out the Candidate form: http://www.regenexx.com/blog/rotator-cuff-tear-causing-shoulder-pain/ http://www.regenexx.com/blog/most-common-shoulder-problems/ Nearest to you would be Louisville, KY: Here is the interactive list of all the Regenexx Providers. Depending on where in Tennessee, a different one might be closer: http://www.regenexx.com/find-a-physician/

  3. Lilly severson

    Hi I also have a shoulder injury it’s a labral tear, would I qualify for this? Where can I go for treatment here in Arizona?

    1. Regenexx Team Post author

      Lilly,

      Shoulder labral tears are something we treat regularly. Here is the Interactive list of Regenexx Providers. There’s one in Phoenix, but depending on where in Arizona you live, one of the others may be closer: http://www.regenexx.com/find-a-physician/ Please see:http://www.regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/ and http://www.regenexx.com/blog/shoulder-labrum-surgery-alternative/ If you’d like to see if your particular shoulder would be a good Candidate for a Regenexx procedure, please submit the Candidate form.

  4. Trent Kozman

    Hi I’m a chiropractor, and avid athlete. I just had mri that revealed a 12 to 6 posterior labral tear with a 2cm pseudocyst at 9 o’clock. Tendons are all strong and tree shoulder is stable. But I get excruciating pain with any attempt at vertical or horizontal pulls.i have no pain benching or any other movements except pulling. I don’t want surgery. What is your track record with labral tear?

    1. Regenexx Team Post author

      Trent,
      The track record is good not only because of the exact placement of cells and the effectiveness of the labral tear treatment, but because we make sure any underlying instability is treated. Please see: http://www.regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/

  5. Andrew

    So I’ve been having right shoulder pain for almost a year since a motorcycle accident, but no amount of physical therapy has helped. I’m in the military if that tells you anything. Anyways, I just had an MRI done, and when I saw the results (mild tendinosis of the supraspinatus and infraspinatus tendons without tear in the rotator cuff, labrum tear from anterior to posterior, mild AC joint arthrosis, trace joint effusion). I’ve been doing some research on my own before I meet with my military doctor. I broke my right collar bone when I was 15. I was 38 when the motorcycle accident occurred. I’m 39 now. I think the broken clavicle contributed to the shoulder instability, which then led to my labrum tear. Also, I don’t think the crash itself caused the injury. When I got up from the accident, I was somewhat frustrated because I had been riding for 12 years a that point, and to have some gravel force me to lay it down pissed me off. So I picked the bike up on my own. I think picking the bike up caused the injury to my labrum. Anyways, I will discuss this with my military doc, and see where it goes. Thanks for giving me a bit more information as to what treatment options I should look at. I am in New Orleans, and since we have no military surgical facilities in the area, stuff like this is usually referred out to the local civilian surgeons. If you know of any in the area that might be able to help with this, please let me know! Thanks!

    1. Regenexx Team Post author

      Andrew,
      Would they pay for Regenerative treatment rather than surgery?

    2. Regenexx Team Post author

      Andrew,
      The best person to contact would be Dr. Thomas Bond, TotalCare Health & Wellness Medical, 1101 South College Suite 201, Lafayette, Louisiana 70503 His website: http://totalcare-la.com/. He is the president of the American Association of Orthopedic Medicine (AAOM), has the largest skillet to draw from, and would be able to refer you to a good surgeon if needed.

  6. Adrian Balogh

    When I was 20 I started getting pain in my right shoulder (didn’t know form what at the time). After 2.5 years of getting nowhere with a surgeon I decided to go to another surgeon who “repaired” 4 tears in my labrum. That was 2012 and over 5 years later I feel no better. My shoulder hurts, my rotator cuff hurts, and my bicep tendon hurts. All the while I had back/neck pain that felt like a pinched nerve and was dismissed by professionals. That pain has led to a tingling and burning near my scapula (which wings). I’m convinced that these are all related and the neck issue is what caused the scapula to wing and that caused the shoulder to be misaligned or unstable. If I were to be evaluated again I would want all of this to be taken into account. So my question is do Regenexx doctors evaluate all of this info during a consultation? Do I need up to date MRIs? Where do I go to find this information out? I split time between Buffalo, NY and Tampa. Who should I talk to?

    1. Regenexx Team Post author

      Adrian,
      Yes, this is the prospective from which we examine patients. What the situation is, but not what caused it, is not enough information to effectively treat patients. You do need up to date MRI’s for the Candidacy Evaluation The two locations that look like they’d work in your case would be Vermont or Tampa, FL. Would you like staff to contact you by email to assist you in the processan answer any questions? Please see: http://vermontregenerativemedicine.com/ and http://newregenortho.com/. Here is the entire list: https://regenexx.com/find-a-physician/

  7. Rebecca Zager

    My 18 year old son injured his shoulder while wrestling. Orthopedist accessed it was a labrum tear. Opted for no surgery just PT to make it stronger. Wears brace while wrestling but is still popping out of socket. Thoughts?? No MRI done.

    1. Regenexx Team Post author

      Rebecca,
      Yes. This is something that should be treated as the instability it’s causing will cause wear and tear and ultimately arthritis in the shoulder, which you really don’t want at 18. No surgery, and therefore lengthy surgical rehab, is needed as this can all be handled through injections of his own stem cells or platelets. If you would like us to take a look to see if he’d be a good Candidate for a Regenexx procedure, get the MRI done, then submit Candidate form which would allow you to upload it. Please see: https://regenexx.com/blog/shoulder-labrum-surgery-side-effects/ and https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/

  8. Carlo Ferri

    I’ve had Labrum “repairs” done in both shoulders about 8 years ago. My passion is weight lifting. My shoulders have never been the same. 6 weeks ago I’m feeling bi lateral pain in both shoulders but not in the “old labrum” spot as before, and also both pectoral tendon areas. My physician wants me to wait 6 weeks for our follow up appointment. I’m going to ask for MRI on both shoulders, and also to check for pectoral tendon damage.

    If I have damage in shoulders and Pec I would like to do regenex and skip surgery!! I live in Michigan, but I’ve been told to make the trip to Colorado.
    Can regenexx help my pectoral tendons and shoulders? If both sides need it, can they do it all at once? That way it’s not inconvenient with the numerous travel trips!

    Thanks

    Carlo

    1. Regenexx Team Post author

      Carlo,
      Labral “repairs” generally leave the shoulder unstable and the effect of that over time has consequences. Once you have the MRI’s, you can upload them and a medical history by submitting the “Candidate” form (to the right of the blog). A time will be set for one of our Physicians to call and grade your Candidacy, learn more about what’s going on, as well let you know what type of procedure or procedures will likely be needed in your case. Some procedures use stem cells, some platelets. Stem cell procedures require a certain dose of stem cells, so if stem cell procedures will be planned for bilateral shoulders, there are things you can do in advance of the procedure to increase your chances of having enough for both shoulders. Please see: https://regenexx.com/blog/8-ways-improve-your-stem-cells-prior-treatment/

  9. phyllis

    I am female 56. AUG 2016 was pulling the LG metal heavy dock plate with a metal hook back toward me to drop on the back of a semi to load. The curve tipped hook slid out and I fell backwards at high speed onto concrete and the pointes ends of a palate jack. A bit afterwards I had numbness and tingling in my right arm I couldn’t sleep on my rt side for months, had pain in the shoulder area. In Feb 2017 was walking up a steep ramp and hit black ice didn’t want to fall on my right arm so I twisted to the left fell back but my right arm took the blow. I think this is what caused a tear that they haven found yet. Have ortho appointment on Aug 18. If I lay on my left side the pain in my right shoulder and bicep is like a 9. I have to roll to my right so the weight is under me. If I’m on my left side and try to raise my arm, I really cant. The MRI isn’t showing anything but I’m sure it’s atleast a labrum tear.
    I was researching options to surgery before I see this Ortho doctor. I am very interested in your procedure. I head a doctor in Stevensville MT. has done this. Do you know who to recommend in MT.?
    I have relatives in Col. So that is an option. Have you found that workman’s comp. Approves your procedure?

    1. Regenexx Team Post author

      phyllis,

      It sounds like you really need a good exam – the type that actually seeks to track down what’s going on as this could be a shoulder issue, a spinal issue, or both. An MRI is a snapshot. A dyamic ultrasound to watch what the shoulder is doing upon movement is a much better diagnostic tool. Unfortunately, we can’t recommend anyone in Montana, as there’s not a Regenexx Provider there, and all you read here pertains only to Regenexx procedures. Some of our Providers work with Workman’s comp cases, as it is up to the individual practice. If you’d like to see if you’d be a Candidate, please submit the Candidate form. Please see: https://regenexx.com/blog/a-colorado-regenexx-patient-review-pain-free/ and https://regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/ and https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/

  10. Jessica

    I am currently active duty Army and I originally injured my shoulder playing softball (pitcher) in High School I went to 2 different doctors both gave me x rays and said they couldn’t do anything and one was the orthopedics which the Rays Baseball team players go too. After I joined the Army during combative’s my shoulder froze and I assume it tore more, again the Army didn’t go anything, so 3 years later while still in the Army I went back to our Aid Station and complained of the pain, they gave me a x ray and MRI and the MRI showed I had a labrum tear in my right shoulder from the 1 o clock to 5 o clock position along with my entire shoulder is tendinitis. Anything I can do to relieve the pain or tell the Army Orthopedics when I see them September 26th? My pain is a constant 7 out of 10.

    1. Regenexx Team Post author

      Jessica,
      Thank you for your service! We’d need to examine you to diagnose the issue and confirm the source of your pain as it is not necessarily the obvious. These blogs have additional information on what you were told the problem was. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/blog/shoulder-labrum-surgery-side-effects/

  11. Mark

    I’m very interested in this program, is there any providers that practice these procedures in honolulu, hawaii?

    1. Regenexx Team Post author

      Mark,
      Not yet. But we’re always looking for physicians who have the rare high level injection skill set required to qualify for Regenexx training. Here is the interactive list of Regenexx Providers: https://regenexx.com/find-a-physician/

  12. Ross

    I just had a 2nd surgery for my right shoulder labrum that was torn posteriorly (bankhart) in January 2017. It held very well(felt tight and stable, was awesome) for 7 months until July 2017. During a 70lb lat pulldown it was jerked upward out of the socket and re tore, it is now catching multiple times a day. The surgeon said I have lax joints (too flexible) which has pre disposed me too instability(also have mild hill Sachs and mild osteoarthritis developing). He said the tissue quality was poor and that there is not sufficient tissue for another labral repair. The next surgical option would be a more serious open surgery, which doesn’t really want to do since I’m only 24. He’s hoping it will stabilize enough through PT to let me live my life. I am totally fine living with some shoulder pain, it’s the instability and subluxing that I want fixed.

    I used to be very active so living a life with a subluxing shoulder is just unacceptable to me, but I also do not want to get a serious surgery as an artificial joint won’t hold for 40+ years. This article reasonates with me and makes some very attractive claims, if they were true I would pay for this treatment in a heartbeat. I would need to see some trials/case studies(image backed, not patient feedback) that have been well evaluated. Again, I’m focused on stability, pain is a distant 2nd.

    1. Regenexx Team Post author

      Ross,
      It’s very wise to be concerned about the instability as it causes additional wear and tear, arthritis, and bone spurs – and to seek non-surgical solutions, especially at 24. Unfortunately, image based tests like MRI and Xray don’t show instability. We see these patients day in and day out and they do very well with the appropriate treatment based on exam. Our Shoulder paper (all are peer reviewed) focuses on using bone marrow concentrate on shoulder rotator cuff tears and osteoarthritis, however you might find it and our other published papers interesting. https://regenexx.com/stem-cell-research/ The thing that will likely give you the most information is watching a shoulder procedure: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ If you’d like to speak to one of our Physicians about your case, please submit the candidate form. https://regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/

  13. Theresa

    I’m my 8 weeks post op labrum tear surgery due to a auto accident. Started pt 3 wks after, still had a lot of pain. Six wk follow up with surgeon and he stopped pt for 3wks, said I should not still be having this type of pain. Both shoulder and bicep pain. I’m really concerned

    1. Regenexx Team Post author

      Theresa,
      So sorry to hear that. Unfortunately, this is a surgery that research has shown not to work, but can create new problems. Please see: https://regenexx.com/blog/shoulder-labrum-surgery-side-effects/ If you’d like us to weigh in on whether there is something we can do to help in your particular case, please submit the Candidate form.

  14. Chris Kenney

    My 16 year old son was just diagnosed with a “bad Labrum tear”. They did an MRI and confirmed the tear. They recommended surgery to fix the damage. Are you stating that this will fix the issue in less than time than the surgery?
    Anything to avoid surgery is always best

    1. Regenexx Team Post author

      Chris,
      We treat shoulder labrum tears regularly, and because we are not causing any surgical trauma or damage, but rather getting what’s needed to heal directly into the tear, recovery time is significantly less than surgery. In addition, we do an extensive exam to make sure we are treating the whole issue as well as the cause. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/blog/shoulder-dislocation-surgery-recovery-time/ and https://regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/ and https://regenexx.com/blog/shoulder-labrum-surgery-side-effects/ If you’d like to see if your son would be a candidate, please submit the Candidate form.

  15. mike O'Neil

    My shoulder subluxed 10-15 times since 2013 when I returned to hardball at 42 years old. It happened a few times while pitching, then started happening on deep or off balanced throws from the infield. Each occurrence required a little longer to heal. It made me more and more apprehensive each time. An MRI revealed a full anterior labral tear. I just had surgery (two push anchors) and am in week five of recovery. My question is this: With the repair, will my shoulder now be stable? Could it still sublux even though the labrum is repaired? Thank you.

    1. Regenexx Team Post author

      mike,
      That would be a question for your surgeon. If in addition to “repairing” the labrum they tightened the lax ligaments which allowed your shoulder to repeated subluxate, which caused the labrum to tear, then hopefully not. If not, then best to get those ligaments treated once your shoulder has healed. Please see: https://regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/

  16. Julio César Gallizzi

    Hola. Mi nombre es JULIO. Soy de Argentina de 35 años. Tengo mi hombro izquierdo con subluxaciones, un pequeño desgarro del infraespinoso y el supraespinoso, y también un pequeño desgarro anterior del labrum. Y como si fuera poco…una pequeña lesión de Hill Sachs que no compromete las superficies articulares ni del humero ni de la glenoides. Los traumatologos quieren operarme y debido a que soy muy activo la cirugía no es una opción para mí y que es muy largo el tiempo de recuperación. Actualmente estoy en mi primer sesión de proloterapia y según el doctor que me atiende dice que los desgarros labrales se pueden solucionar pero yo no confío en esto. Realmente es cierto??

    1. Regenexx Team Post author

      Julio,
      Based on what you’ve said, you would need more than prolotherapy to repair the tears and solve the instability in your shoulder. Hill Sachs lesions are not uncommon in recurrent shoulder locations. You’d need to go through a candidacy review to see if you would be a candidate. It’s likely that in your case, you would need platelet and stem cell procedures. To do that, please submit the Candidate form. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/

  17. Aric Lobenstein

    Would a similar approach be available for a hip socket? I have had pain in the hip adductor muscle group area for over 18 months (since a slip on glacial ice – a specific event creating onset of the pain). I met with a non-surgical orthopedist this morning who is more concerned about a labral tear, as opposed to an injured muscle or tendon. I’ve previously had a labral repair in the shoulder, but felt no “change” post-surgery, as compared to pre-surgery. (My other shoulder is also hurting, but since I didn’t experience noticeable improvement, I never had the second shoulder operated on.) I’m very interested in non-surgical options for both my hip and my shoulders. I am located in Central Alabama.

    1. Regenexx Team Post author

      Aric,
      Yes. There are several things that can cause instability in a hip joint. One of the less commonly heard of is a loose ligamentum teres. Please see: https://regenexx.com/blog/loose-ligamentum-teres/ and https://regenexx.com/blog/loose-hip-joint/ and https://regenexx.com/blog/hip-labrum-stem-cell-procedure/ and https://regenexx.com/blog/hip-impingement-causes/ and https://regenexx.com/blog/hip-impingement-causes/ The closest Clinic would likely be Atlanta: https://ioaregenerative.com/?utm_source=regenexxreferral&utm_medium=webreferral&utm_campaign=regenexxlocations But another may be closer. Just put in your zip code. Please see: https://regenexx.com/find-a-physician/

  18. norberto

    3 years ago i was diagnosed with a posterior labrum tear though the MRI did not show a tear, only a paralabral cyst. Because of the cyst they are convinced i should have a tear. I don’t agree thats what is causing my pain and don’t want surgery. During those 3 years i have gone months where i have no pain and lift heavy at the gym. Then i will do something (like a twin race) and i will be in pain for weeks. I had a cortisone shot after that which helped. Most of my pain is localized at the deltoid insertion (sharp) and surrounding delt (dull). My chiro is confident this is more of a rotator cuff issue but my kaiser doctor refuses to look at any other pathology and is only pushing for labrum surgery. I would be extremely interested in you trial for rotator cuff. Your thoughts?

    1. Chris Centeno Post author

      While you wouldn’t be a candidate for our rotator cuff trial, we would be happy to look at the shoulder to try to find what’s really wrong.

  19. Lucy Li

    I had a car accident 3 yeasts ahi, slap tear, suprasounatus partial tear, high riding of Humeral head and subacrimial impingement. I had arthroscopic surgery 10 days ago and man I wish I didn’t do that! Not to speak of a lot of pain, I noticed my Humeral headive forward and upward way more than before. In following up with surgeon and reading the operation report, when suturing my rotator cuff, they performed as subacial decompression which involving respecting part of acromiom and releasing the CAL completely. No wonder I felt my shoulder was lacking a strap to keep in place. Instability beyond the GH joint just as you said. While I don’t know what else ligament/supporting structure is severed, that CAL seem to have found its attachment again over the past week now I feel pain upon small straining of provocative bending forward motion but not gross migration of the Humeral head superior and antirior. Now I am curious if the. CAL will regenerate again with proper tension and function? Do I need to treat other ligament that cause instability? ( the original high riding Humeral head evudebt on mri that was clearly not treated by the surgery ). 36 year old female.

    1. Regenexx Team Post author

      Lucy,
      Please see: https://regenexx.com/blog/shoulder-surgery-complications-caused-by-acromioplasty/ We’d be glad to take a look once you’re fully healed.

  20. Debra Steffen

    I just received news that I have a labrum tear. I have not seen an ortho Dr yet. I do not want surgery! I’ve been dealing with pain for nearly 2 years,
    To be proactive I’d like to know who to contact for 2nd opinion. Would insurance cover stem cell? I live in Bettendorf IA

    1. Regenexx Team Post author

      Debra,
      An educated patient is an empowered patient! Glad to hear you’re looking into other things. We’ll have our Iowa Regenexx provider contact you. If you’re in network, the exam and some other things may be covered, but not the procedure.

  21. Tom Tweed

    I have been diagnosed with glenoid labrum tear; disorder of the bursa of shoulder; localized, primary osteoarthritis of the left shoulder; incomplete rotator cuff/rupture of shoulder, not trauma.
    I had surgery and Dr. removed some bone. That was 10 months ago, and I seem to be in worse pain than before the surgery. Just got a cortisone shot today., and I have my fingers crossed.
    Read your article and it was interesting. You describe the 5-10 minute visit with Dr. accurately. Thank you.
    Tom Tweed
    Rochester, NY.

    1. Regenexx Team Post author

      Tom,
      Keeping our fingers crossed with you, but unfortunately we see this regularly. What you describe leaves the shoulder unstable.

  22. Tom Tweed

    The cortisone is not working. I have shooting pains coming from my left shoulder which I didn’t have before surgery. That surgeon left me with an unstable shoulder, and now I’ll have to have a new ball and socket.

  23. Brad

    hi, I’m 24, Spring 2018 I had arthroscopic shoulder surgery
    I had 2 slap tears repaired plus the capsular shift procedure they’re doing nowadays–7 weeks ago. Pain and strength are a distant second to stability for me, and so far I haven’t re-dislocated it. Initial injury was a fall from the hearth of a stone fireplace, onto the wood floor. Knocked me out and dislocated my shoulder. My shoulder gets fatigued very quickly, but I am optimistic.
    MLB players have the best ortho surgeons money can buy, and then take PhyTher like their career depended on it, and they’re out 8 months MINIMUM.

    1. Regenexx Team Post author

      Brad,
      We treat these issues regularly with precise image guided injections of the patients own stem cells and platelets. Now that you’ve had the surgeries, we really hope it works out for you! Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/blog/shoulder-dislocation-surgery-recovery-time/

  24. Elizabeth

    Hi, I’m 28. I have an extensive labral tear in my right shoulder. I’ve done physical therapy, which helped my range of motion but inceased my pain.
    I believe the tear was caused by using a cane but am not completely sure. I do believe I have some shoulder instability in both shoulders, possibly from being a gymnast when I was younger.
    I saw the orthopedic surgeons assistant today, he recommended an arthroscopy. While I would like to avoid surgery if possible, I’m at a point where I will do just about anything if it will help the pain.

    1. Regenexx Team Post author

      Elizabeth,

      Was this tear diagnosed with an MRI?

  25. christina schumacher

    Hello my daughter is currently a freshman in college as a goalkeeper and has SLAP tears in both shoulders. Both confirmed with MRI’s. We are in the process of appealing a denial for surgery and came across your article. Would like more information and if you are still taking trial patients? Christina

    1. Regenexx Team Post author

      Christina,
      Yes we are, but the trial is a Rotator Cuff Tear trial. We treat SLAP tears regularly. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/blog/shoulder-dislocation-surgery-recovery-time/ We would not recommend surgery in a patient of that age, unless there were no other options. Please see: https://regenexx.com/blog/biceps-tenodesis-side-effects/ If you would like to see If your Daughter’s SLAP tears would be a Candidate for these procedures, please let us know here, or submit the Are You a Candidate form, or call 866 684 9919.

  26. Jimmy

    My son is a 15 1/2 year old high school sophomore. He plays high school and summer competitive baseball. He is a pitcher and catcher. He has had pain in the shoulder only in the cocking phase of throwing a baseball and has noticed fatigue and loss of velocity.
    Recently diagnosed with labrum tear. Below is the exact wording on the MRI report

    “tearing of the superior labrum anterior posterior with fluid-filled separation along the biceps labral junction and tearing extending into the peripheral aspect of the posterosuperior labrum to the 10 o’clock location . There is no tear of the remaining labrum. There is no humeral head subluxation. There is no paralabral cyst.

    Doctor is recommending surgery to, in his words “stitch up the tears”. My son does not want surgery and wants to try PRP.

    No known previous injury – Condition likely resulting from years of throwing with imperfect mechanics.

    Is Regenxx a possible alternative to surgery in this case for a boy who wants to continue playing baseball at a high level? If so, do you have locations in or near Oklahoma.

    Thanks,

    Jimmy

    1. Chris Centeno Post author

      Yes, PRP is what I would do if this were my son. However, these procedures are technically demanding (i.e. extensive experience a must). Most of these kids have an unstable shoulder, which is what causes the labral tear. Hence, it’s usually critical that the shoulder capsular ligaments are targeted in addition to the labral and biceps tear.

      1. Jimmy

        Thank You. According to the Location link we can get this extensive experience at RegenOrthoSport – Dallas, TX, is that correct?

        Thanks,

        Jimmy

        1. Regenexx Team Post author

          Jimmy,
          RegenOrthoSport in Dallas can treat your son’s shoulder issue.

  27. Vinay Dhamija

    Dear Dr Centeno, thank you for this ground breaking article. Do you know if there is a similar expert in London, UK? Thank you so much.

    1. Regenexx Team

      hi Vinay,

      Thanks! We now have a Regenexx provider in the UK. Please see: https://www.algocells.com/?utm_source=regenexxreferral&utm_medium=webreferral&utm_campaign=regenexxlocations

  28. Lisa

    I had a fall facing forward with my right arm yanked by a run away horse. Initially just had pain thought pulled muscle but after 2 wks chiropractic treatment (and still had FULL range of motion)…suggested MRI…GLAD lesion and mild tendinosis. Anyway then went to orthopedic doc who does Prolotherapy (not PRP this time)…two weeks ago. Pain is far worse now, waking me up at night. I was told 2 to 3 months and am scheduled for another treatment this week. I am dreading it…and wonder…he does PRP as well but did not offer…what are your thoughts on Prolotherapy vs PRP or Regnexx?? is one better than the other? I am in South Florida

    1. Regenexx Team

      Hi Lisa,
      Prolotherapy, PRP, and Stem Cells, do very different things and we’d need more information through a Candidacy Review to determine what would be the appropriate treatment in your case. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/blog/regenexx-flexible-lab-platform/ If you’d like to us to do that, please submit the candidate form here: https://regenexx.com/conditions-treated/shoulder/

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
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Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

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*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.