Can You Treat A Labral Tear?

Labral tears of the hip or shoulder are generally regarded as very detrimental injuries. A result of significant trauma to the joint, such as from a car accident or sport impact, these tears to the joint cartilage are considered to be structurally limiting and requiring surgery in nearly all cases.

With that being said, many people tend to assume that there is little to be done in terms of rehab before (or unless) the operation has been done.

It's good to point out, however, how often labral tears are completely asymptomatic in individuals. For perspective, one study found 43% of tested subjects without symptoms to have a labral tear in their hips while another recorded that rate as high as 69%! As far as the shoulder goes, we found results of up to 72%.

So what does that imply?

It means that, while conservative therapy can't repair a torn labrum, that there is a possibility of relieving the symptoms as if it they weren't there. After all, look at those numbers of people walking with damaged labrums and had no idea!

Manual therapies such as massage in combination with active rehab and exercise can recondition the joint, in many cases, to perform its functions with minimal or no discomfort. True, other cases will certainly require surgery, but it goes to show that it's well-worth exploring the conservative options first.

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Remember, Scar Tissue Doesn't Break Down

Scar tissue is a natural product that comes out of a tissue injury. Skin, muscle, tendon; most of the body's bits and pieces will scar over when an injury occurs.

Realistically, the song, "Scar Tissue", probably also resulted from some type of past deep-hurt.

A lot of therapy claims center around the ability of a technique to break down scar tissue.

However, let us remind everyone of the deep, dark secret of the therapy world: Scar tissue does not "break down".

And it doesn't have to! (Just putting that out there before you lose hope and close your screen.)

To be quick and make things simple to understand, consider when you have a large cut on your skin which then scars over. Do you think any amount of aggressive massage would make that scar go away? Does manual pressure cause either that scar OR the skin to "break apart"?

No? Then you can imagine how counter-intuitive it is to think that those same forces can break down a scar inches beneath the skin.

However, this doesn't need to mean that all hope is lost in the recovery process, as we mentioned. Consider this; does the scar on your skin continue to be tender and cause pain years later, even when it remains visible? Does it do a poor job replacing the skin that was damaged?

No, that scar is an effective bridge between the gaps in healthy tissue. And the same goes for scarring that occurs within muscle, tendons, and ligaments.

Yes, muscles and ligaments are more complex in their functions to hold the joints securely together and will typically cause more pain at the onset of injury. But that's where the manual therapies come into play. While they do not physically break down any of that scarring, what these techniques do do is decrease the sensitivity and pain in the area to allow the healthy tissue to learn to carry on its function despite the presence of that scar.

(Remember, these therapies have a more direct effect on your nervous system rather than the tissue itself.)

In the end, none of this really changes the way that treatments work except for providing a better explanation behind them. That knowledge comes in very handy, however, in order to have the confidence to accelerate in your own recovery and to avoid false claims and money-grabs.

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Weightlifter's Guide To Warming Up

We're returning to the second-busiest season of the year for the fitness industry. As such, we created a quick guide to warming up for the weight room based on facts that aren't typically discussed in the mainstream.

1: Going heavy? The warm up should be heavy.

Working with athletes, Athletic Therapists see the difference between a good and bad warm up once the game starts.

The fact is, the light going-through-the-motions warm up commonly seen at the gym is often not going to be enough. Especially when intending to do a very heavy and hard workout, the warm up should build up to be equally so.

Realistically, a hard workout (or competition) should require a warm up that leaves you sweaty and out of breath. It seems counterproductive, but this is the only way to truly prepare your muscles for the work it's about to do.

2: Warm up all the joints you intend to work. As well as many that you don't.

Warm ups should be specific. If you plan to have a heavy arm workout, then 20 minutes on the treadmill won't effectively get your shoulders ready for the load. While getting a nice, systemic bloodflow effect, warming up should target the joints you intend to use.

But, let's remember that other joints are at play during exercise, even when you're not specifically exercising them. The shoulders are under a lot of stress when doing barbell squats on leg day. The lower back is under a lot of use when picking up your dumbbells for a shoulder workout. You'd be surprised how often injuries to the non-targeted joints occur during workouts.

As such, while you want to target the bulk of the warm up on the joints that are going to be worked the most when in the gym, a broader focus on the rest of the body, in general, will help avoid unexpected strain elsewhere.

3: Stretching? Well...

It's fairly common knowledge that an active warm up should be utilized prior to exercise while stretching is best reserved for after.

BUT, did you know that static stretching (stretch and hold) may not even be as beneficial as once thought when done at any time?

But how will everyone know that I just worked out if I don't stretch?

In reality, static stretching hasn't been shown to result in significant decreases in injury rates or long-term gains in range of motion.

In contrast, we actually see greater range of motion increases as we strengthen our muscles through their full range. As well, greater injury prevention rates have been found by means of an active warm up prior to exercise and an active cool-down after. (So basically a warm up, except backward.)

4: Don't mobilize in ranges you don't intend to use.

This is a fun one. "Mobility" is a big hot topic in gyms these days, and a lot of us assume that mobilizing and freeing up all the joints in every direction is the key to keeping them healthy.

However, this is a concept taken out of context. If you don't intend to use and strengthen through a particular range, then you shouldn't be trying to mobilize it. By increasing range and not replacing restriction with strength, all we're doing is creating laxity.

Preparing to do all those resisted shoulder hyperextensions
that we see ALL the time at the gym.

What's more, remember to mobilize gradually, even when hitting the properly-targeted joint. Otherwise, we see the same issue of too much laxity being created too soon before the musculature is ready to accommodate for it.

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