sharp pain after bicep tenodesis

You are having a bicep tenodesis. The mean age of patients with complications was 44.67 Rerepaired 6/2/2017 . People who might benefit from this type of surgery include those with: Pain from the biceps tendon usually affects the front of the shoulder and the top of the humerus bone, which runs from the shoulder to the elbow. Pain is on top of shoulder to my neck and sometimes sharp pain down the shoulder. [] All procedures were performed by a single surgeon, concomitantly with subacromial decompression, acromioclavicular joint resection, and/or debridement surgeries for other shoulder pathologies (Table 1).Patients underwent tenotomy or tenodesis for proximal biceps or . Why do a bicep Tenodesis? Most people who work at a desk job can return to work in 1 to 2 weeks. Keep in mind that during this period you should not engage in any heavy lifting or massaging the tissues of your upper arm and shoulder area. In the biceps tenodesis procedure, your surgeon releases your . (2013). Post an update. Experts say biceps tenodesis is most likely to be effective if surgery happens within 3 months of the initial injury. You may be at increased risk of biceps tendonitis if you perform . Open subpectoral tenodesis anatomically restores the length-tension relationship of the biceps muscle and removes all diseased biceps from the bicipital groove. Are there alternatives to biceps tenodesis? Symptoms include: a sudden, sharp pain in the upper arm, sometimes accompanied by a popping or snapping sound. ricochetred. Pain scores improved from a mean of 6.9 (range, 4-9) preoperatively to 1.4 (range, 0.5-2) postoperatively on a scale of 1 to 10, with 10 indicating the most pain. Biceps tenodesis is an orthopedic surgery performed to repair the tendon that connects your bicep muscle to . cramping of the biceps during or after heavy use. If the tenodesis is part of a larger shoulder operation, possible complications include: Recovery from biceps tenodesis is a long process. Started PT as soon as possible, (I think it was week 3 after incision sites healed). The surgery should reduce shoulder and bicep pain. We look at the potential causes of lower biceps pain and the possible. 4420 North Fairfax Drive, Suite 100 Arlington, VA. Ph (703) 419-3002. Tenderness to touch at the front of the shoulder. Pain that radiates down the front of the arm or . Do not take a bath or use a swimming pool until 4 6 weeks after surgery. 2, 18 These studies have reported a revision rate as high as 45% after this operation. They pull your biceps tendon through the incision and release it from your labrum. McMahon PJ, et al. Sit in a reclined position. I cannot move arm behind my back at all still so likely you just upset the area but likely you didn't damage it. Corticosteroids, which can delay healing and cover up symptoms. Biceps tenodesis is used for both partial and full tendon tears, an unstable joint, or pain . Cosmetic deformity of the arm, cramping or soreness in the biceps muscle, and strength deficits in elbow flexion and supination are the three most common adverse events associated with tenotomy of the LHBT. Biceps tendinitis develops over time, with pain located at the front of the shoulder, and usually worsens with continued aggravating activity. Dont rush your recovery. Always speak to your doctor before acting and in cases of emergency seek This technique is the screw fixation technique. . Frustration and concern. It is well known that rotator cuff surgery is a major operation where the rotator cuff tendons (Figure 1) are sewn back to the upper arm bone (humerus) (Figures 2 and 3). Common causes of pain in the middle of the bicep include muscle strain, bruises, and DOMS after exercise. There was no difference between either the SLAP repair or the tenodesis from the sham or fake surgery. Why would you sign up to have your biceps tendon chopped off and then screwed back into bone and risk biceps tenodesis side effects when the research doesnt show that this procedure is any better than a fake surgery? Nerve injuries can occur during a surgery. Has this ever happened to anyone? severe pain in the upper part of your arm or at the elbow, depending on where the tendon is injured. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else. The overall reoperation rate was 4.8% (5/105 cases). Thanks again for commentseven though I'm a PT, I'm not a very good patient and I did not work with shoulder patients often as the OT's usually got them and I did home health for the last 21 years so usually see people in the first month after surgery when they are in the protection mode. Progress to anti-gravity exercises at 12 weeks. This observation is supported by a study showing that in patients who have had rotator cuff surgery, strength in the shoulder muscles is not fully recovered until nine months after the surgery. These apps may make it easier to quit smoking. Exercises for the biceps muscle are usually avoided until at least four to six weeks after surgery. This appears to be due to patient compliance and excessive force placed on repairs. Regrettably, like the rest of orthopedic surgery, there are few such studies. If you had open surgery, do not shower until your doctor says it is okay. You should already have an appointment scheduled for 7-10 days after surgery. If you dont have insurance or if youre on a high deductible health plan, youll need to shop around to compare prices. After the 6-week post-operative period the elbow is gradually stretched into full elbow extension and full pronation. cramping of the biceps during or after heavy use. By In these sessions, the person will gradually learn to: A trained physical therapist will guide the person on returning to full movement and activity. When is it too late to repair a torn bicep tendon? Wear your shoulder immobilizer or sling. What Are Schmorls Nodes, and Should I Be Concerned About Them? Here are some examples of activities they may suggest. bandrsntch. Rehabilitation and physical therapy will begin 710 days after surgery and continue for several weeks. Your email address will not be published. Biceps tenodesis is an orthopedic surgery performed to repair the tendon that connects your bicep muscle to the shoulder. About shoulder biceps tenodesis. It typically presents in the early postoperative period. They drill a small hole in your upper arm bone. Inflammation and wear and tear to the tendon due to injury, overuse, and aging are some of the common reasons for this type of shoulder pain. Total shoulder arthroplasty is becoming increasingly common. , continuity between the collagen fibres of the tendon and the surrounding bone was observed throughout the length of the bone tunnel, resembling a fibrous enthesis. What are the symptoms of rotator cuff tendinitis? . I have called my Ortho (he was in surgery today) and sent e mail to my PT for advice and have not heard from either of them. Most people have a functional range of motion and adequate strength by four to six months after surgery. Hello there. Those on high deductible health plans or without insurance can save when they buy their procedure upfront through MDsave. A biceps tenodesis is often done along with other shoulder surgery. The labrum is the lip of the socket where the ball of the shoulder joint fits. A doctor can help the individual decide which treatment they need, if any. -Biceps cramping resulting from strenuous use. Biceps tenotomy versus tenodesis in active patients younger than 55 years: Is there a difference in strength and outcomes? Why is the humeral head jutting out? Eliminate pain medication as quickly as possible. Biceps tenodesis is an option for treating shoulder pain that results from inflammation or tissue damage. The long head of the biceps tendon attaches to the top of the shoulder socket, known as the glenoid. A: A Popeye deformity is defined as any abnormal shortening or defect of the biceps muscle. When asked if a biceps . your first clinic visit after surgery. This new study looked at patients who had a type-2 SLAP tear, SLAP repair and the tenodesis procedure were, we keep a list of our Regenexx providers who have mastered this delicate injection, IOF (a nonprofitInterventional Orthopedics Foundation, precise injections into the irritated tendon or into the SLAP tear. Biceps tenotomy means cutting off one tendon and not reattaching it, allowing it to heal to the humerus over a few weeks. Inflammation and wear and tear to the tendon due to injury, overuse, and aging are some of the common reasons for this type of shoulder pain. Kelly's injury was gradual and it kept . Biceps Tenodesis. Some symptoms of bicep tears include: Sharp upper arm pain sometimes accompanied . The purpose of this study was to evaluate the postoperative outcome after interlocking plate fixation and biceps tenodesis for treating proximal humerus fractures. If you sleep on your side, keep switching up which side you sleep on. This procedure can help if pain or an injury affects the biceps tendon in and around the shoulder. While most patients experience some improvement within four to six months, How long does it take to recover from biceps tendon surgery? 26 weeks During biceps tenodesis, the surgeon connects the tendon to a new location on the arm bone. What is a bicep tear and how does it happen? Hence, many surgeons decide to perform a tenodesis of the LHB tendon simultaneous to ORIF. I am now 58 and I am also a PTso this seemed way out of the ordinary type of pain for the little stretch that my arm got. While most patients experience some improvement within four to six months, complete recovery can take as long as a year. In a biceps tenodesis, the surgeon disconnects the long head of the biceps tendon from its attachment at the top of the shoulder joint socket. Copyright Regenexx 2023. If you are having a tenotomy, your biceps tendon is cut at its base by the top of your shoulder socket and the tendon is allowed to retract out of the joint. Sudden, sharp pain in the upper arm; As we age, our tendons stiffen, making us more susceptible to tendonitis. bruising. These procedures involve repair to the tendons or fibrocartilage that hold the upper arm into the shoulder. Sounds like a nerve injury because a burning sensation is involved. However, there is a subset of arthroscopic shoulder surgery patients who have pain in the axilla even in the setting of a functioning interscalene brachial plexus nerve block. You are not alone. Advocates of high fixation claim, however, that even in patients with substantial inflammation and degeneration in the intertubercular groove, a high tenodesis eliminates the motion within the groove and thereby effectively treats any biceps related pain . The most common type of biceps tendon injury is in the long head biceps tendon (sometimes abbreviated as LHB). It's a process. Rehabilitation Guidelines for Biceps Tenodesis This protocol is intended to guide clinicians through the post-operative course for biceps tenodesis. Can a torn bicep be repaired years later? Sharp pain at the shoulder or elbow. What does Enterococcus faecalis look like? I am 6 weeks post rotator cuff/SAD/bicep tenodesis. Since the damaged tendon is no longer attached to the shoulder joint, you will experience less pain. Ice. when I was getting the nerve stabbing pains I used rest, ice, positioning and then proceeding with cautious movement the next day. Open subpectoral tenodesis anatomically restores the length-tension relationship of the biceps muscle and removes all diseased biceps from the bicipital groove. A pain block is often used to keep the shoulder numb for about 12 to 18 hours after surgery. If you are familiar with Charlie Brown and his Peanuts Gang, I flew like Charlie Brown when Lucy yanks the football away. Another option for biceps repair is SLAP repair. What i did not realize is how much the surgery/therapy affects the surrounding muscles and joints. The pain is caused by inflammation in the long head of biceps, which is part of the biceps tendon that enters into the shoulder joint and attaches on the top of the glenoid (socket). The long head of biceps can result in anterior shoulder pain after shoulder arthroplasty. During distal biceps tendon repair, your surgeon makes a small incision over the upper forearm, where the biceps muscle attaches to the radius bone. cramping of the biceps during or after heavy use. Or you can avoid side-sleeping altogether and sleep on your back. Most people have a functional range of motion and adequate strength by four to six months after surgery. You may hear or feel a pop when a tendon tears. During distal biceps tendon repair, your surgeon makes a small incision over the upper forearm, where the biceps muscle attaches to the radius bone. EMMY NOMINATIONS 2022: Outstanding Limited Or Anthology Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Supporting Actor In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Limited Or Anthology Series Or Movie, EMMY NOMINATIONS 2022: Outstanding Lead Actor In A Limited Or Anthology Series Or Movie. They may only need simple treatments, like icing, aspirin or ibuprofen (Advil), and rest. Symptoms of a torn bicep tendon include: a "pop" or tearing sensation when the injury happens. On MDsave, the cost of a Biceps or Triceps Tendon Repair ranges from $4,063 to $13,119. cramping of the biceps during or after heavy use. Then the tendon will be attached to your upper arm bone (called the humerus). Your arm may be in a splint or an elbow brace for 4 to 6 weeks. Nobody concerned but me. Another study of people with an average age of roughly 50 years found a greater likelihood of the Popeye muscle effect in those who had a tenotomy versus a tenodesis. A diagnosis of biceps tendinosis was made using a specific diagnostic protocol coupled with observation of biceps tendon fraying and increased . Full recovery from biceps tendon surgery can be anywhere from six months to a year. According to MDsave, a distal biceps tendon repair costs between $7,874 and $12,118. Treatment for Pagets disease depends on the type. Hi, I am recovering from a shoulder operation (8 days post op) - I had a Distal Clavicle resection and Decompression plus a Biceps Tenodesis which I think I picked up from going too heavy on biceps curls a couple of years ago. Surgical Treatment. People may also experience cramping, tingling, swelling, and have difficulty moving their shoulders or arms. Where do I put my arms when sleeping on my side? Biceps Tenodesis Side Effects: They Did What to You? Sometimes . In the first 4 weeks, the person will start to do cardiovascular exercise, such as walking or riding a stationary bike. If you are feeling abnormal pain or notice signs of infection, contact your surgeon immediately. Since I've been home I didn't need to wear the sling. The outcome? Not much pain. Initial recovery after shoulder surgery entails healing, controlling swelling and discomfort and regaining some shoulder motion. So needless to say I'm coming along as best I can but find it hard moving my arm as before due to the fact it was in the sling nonstop for two weeks. However, 20 percent had a second rupture of the tendon. Why Do Cross Country Runners Have Skinny Legs? Generally, you will need to wear a sling for four to six weeks after surgery. Here's what you need to know about finding relief. On MDsave, the cost of an Arthroscopic Biceps Tenodesis ranges from $9,143 to $13,478. The goal is to reattach the tendon to the radius bone using either sutures or anchor with sutures. However, your arm will most likely lose strength if the tendon is not repaired. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. A 2020 review found that around 13.5% of people experienced complications after surgery. pain or tenderness at the shoulder and elbow, or weakness in those areas. First, make sure that your arms are down by your side. Mechanical failure presents similar to a biceps tendon rupture, with cosmetic deformity and possible pain or cramping. Popeye deformity is often treated conservatively, but sometimes surgery may be used to repair the tendon. Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS, Biceps Tendinitis: Treatment, Testing, and Taping, cramping of the biceps during or after heavy use, appearance of bruises from the middle of the bicep down toward the elbow, difficulty rotating the arm to a palm upward (or downward) position, a bulge in the upper arm, known as a Popeye muscle, injury to nerves surrounding the shoulder, damage to the cartilage of the shoulder joint, known as chondrolysis. One small study found that 90 percent of people had excellent outcomes, but some did experience a recurrent rupture. What Is the Average Cost for a Distal Biceps Tendon Tear/Rupture Repair? Biceps tendinitis is typically first treated with simple methods. [1,2] While complications of biceps tenodesis in other locations have been studied extensively, limited data exist on the complications of a tenodesis in the . Conclusion: The re-rupture rate after primary repair of the distal biceps tendon is low at 1.5% and occurs within 3 weeks of index repair. One practitioner reports that 80 to 95 percent of people achieve a satisfactory result from biceps tenodesis. Other signs that you may have torn a biceps tendon can include: Sharp pain at the shoulder or elbow. Before recommending surgery, a doctor will usually recommend treating biceps pain with conservative methods, such as: If these treatments do not relieve pain and restore freedom of movement, a person may need surgery. It is 6 weeks today since my surgery. Studies suggest there is very little difference in outcomes between these two procedures. Methods: Patients who underwent subpectoral biceps tenodesis with a minimum follow-up of 1 year were evaluated using a battery of clinical outcome measures, biceps apex difference, and pain scores. This tendon is located at the top of your bicep muscle. The torn biceps tendon is brought up through the incision. I got up, happily removed sling, went to bathroom, pulled up my pants and went to adjust pants by slightly reaching behind and got a stabbing, knifelike . I have gone through this too. Asked By : Christopher Morris. My elbow, why is it screaming in pain intermittently? Only my feet were higher, and I was coming down (back of the) head first. I am 6 weeks post rotator cuff/SAD/bicep tenodesis. Complete recovery may take up to a year. HEAVIER THAN A COFFEE CUP FOR 6 WEEKS AFTER A BICEPS TENODESIS. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Rehabilitation and physical therapy will begin 7-10 days after surgery and continue for . I can do pendulums without pain and the shoulder flexion exercise carefully, but any bicep movement and it starts to cramp and stab at me. *IMPORTANT*: Avoid any resistive twisting motions of your wrist and forearm. Guidelines: No isolated biceps activation. The tenodesis may be performed alone or as part of a larger procedure on the shoulder. However, some people report a positive outcome even if they wait longer than 3 months. I am 68 years old. Tenotomy is a more straightforward procedure with a shorter recovery time, but it may increase the risk of cramping and developing Popeye deformity, a change in the appearance of the arm. Registered in England and Wales. The tendon retracts too far and then gets bound down in scar tissue. Fascia blasting has become a popular technique for loosening the fascia and treating conditions like pain and cellulite. The biceps tendon is identified, and re-attached to the bone through a drill hole, or using special instruments call anchors. You may NOT move your shoulder by yourself in certain directions. [17] Failure of tenodesis can include mechanical failure or persistent bicipital pain. Recovery from biceps tenodesis is a long process. Trends in long head biceps tenodesis. Monitor incisions and keep them clean as your surgeon suggests. Resting at home for one to two days is advised. The goal of surgery is to relieve shoulder pain associated with inflammation and tendon wear due to injury, overuse, or aging. , Nonsteroidal anti-inflammatory medicines. This nerve controls the muscles that pull your wrist up and straighten your fingers. Hold your dumbbells (5 to 8 pounds) like you are holding a hammer with your palms facing each other. According to MDsave, a distal biceps tendon repair costs between $7,874 and $12,118. Your hand and arm may also be swollen. If a person needs surgery, their doctor will explain the options. After removing the damaged part of the tendon, a surgeon may attach the remaining tendon to surrounding soft tissues. After my first PT, I thought OMG are the screws pulled out? Hold your arm out like you would flex in the mirror, with your elbow bent at a 90-degree angle. Your doctor can perform a number of different manipulations of your arm and shoulder to help determine how severe your injury is. Hope you feel better soon. Bicep tendonitis is inflammation of the tendon along the long head of the muscle.Swimmers who have developed this condition typically experience: Dull, aching or cramping pain at the front of the shoulder. You will feel tired for several days. The other major reason patients have pain after rotator cuff surgery is due to stiffness of that shoulder. Bulking, cumbersome!?! In biceps tenodesis, a surgeon removes a damaged section of the biceps and reattaches the rest of the tendon to the bone of the upper arm. Pedro Beredjiklian MD: In my experience, weakness in supination, fatigue pain, and deformity are predictable consequences of untreated distal biceps tendon ruptures. Lots of stress is placed on the back, neck, forearm, wrist and even fingers. I had rotator cuff surgery on 08/27/2012 surgery went well, but still have pain and can not sleep very uncomfortable. Why is my bicep so painful. However, this is dependent on a smooth, systematic recovery. Place your opposite hand on top of your forearm. You may find it more comfortable to sleep on your back initially, with a pillow under your operated arm for support. Similar to case 1, the patient reported sudden onset severe pain and stiffness in her right shoulder and arm pain that started 112 days after the arthroscopic surgery. Ryu JH, Pedowitz RA. Feel pain across your back? Upgrade to Patient Pro Medical Professional? . Fifteen (4.2%) of patients had a biceps tenodesis only. The functional role of the long head of biceps in shoulder is controversial but it is well accepted as a pain generating structure. Exercises to Relieve the Pain of Biceps Tendonitis. A 2017 study found that 91% of people who underwent biceps tenotomy were either satisfied or very satisfied with the result, and 95% said they would have the surgery again. Went back to the doc and the repair failed and to go along with it my bicep tendon was frayed all to hell. Fix your shoulder pain with these simple methods.Get More Great Tips - Subscribe http. The pain may radiate to other parts of the arm and back. 85 clinic locations offering non-surgical Regenexx solutions for musculoskeletal pain. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. Tenotomy is a simple procedure, but it may produce visible deformity, subjective cramping, or loss of supination strength. (2015). How painful is a biceps tenodesis? Propping yourself on pillows will keep you from turning over and sleeping on the recovering shoulder. That means that an orthopedic surgeon or the average physician who injects PRP or stem cells is very unlikely to have the expertise to perform this procedure. Answer. The concept behind both of these procedures is that they take pressure off the biceps tendon itself, or in the latter instance, this takes pressure off the healing superior labral tear. At my two week follow up the stitches came off and I scheduled my physical therapy sessions today is my third session. wear and tear to the tendon, for example, from aging, overuse or injury due to high-impact or contact sports and activities that involve repetitive motions, a persons health status before the injury, whether they follow a rehabilitation program, moving the elbow and wrist with the arm in a neutral position by the side, exercises for the elbow and wrist, such as wall walks and using pulleys, finger isometrics, such as slowly forming a fist and then slowly uncurling the fingers, using a stationary bicycle while wearing a sling for support, rotator cuff strengthening exercises using a resistance band, resistive wrist and elbow exercises using a light dumbbell, doing activities to gradually increase range of motion, progressing from wall pushups to table pushups, tossing a light ball with the arm at their side, using a seated rowing machine with light weights, working with progressively heavier weights, transitioning to a program for home or gym use, Popeye deformity, which changes the appearance of the arm, applying ice packs, wrapped in a towel to prevent skin damage, receiving steroid injections to reduce inflammation, in some cases. If you try to do too much you will re-tear the biceps tendon. All rights reserved. The damage may begin to weaken the biceps tendon and cause it to become inflamed. These newer procedures often use platelet-rich plasma or bone marrow concentrate injected into the tears. Friedman JL, et al. Biceps tendon tear at the shoulder. Make sure to have your pain under control before you sleep. I am now scared that my arm will never get better and don't know how this good go from good to bad so quickly. pain or tenderness at the shoulder and elbow, or weakness in those areas. The long head of the biceps tendon (LHBT) is a frequent source of disorders and pathology in the shoulder. Tighten your biceps muscle to meet this resistance while keeping it bent at 90 degrees. Surgery to repair the tendon should be performed during the first 2 to 3 weeks after injury. It involves rest, wearing a sling, and physical therapy. 99 Keep incisions clean and dry until told by physician to get wet. MNT is the registered trade mark of Healthline Media. Good Luck, stay calm. Do Men Still Wear Button Holes At Weddings? Your risk factors for tearing a biceps include: Many people with a biceps tendon tear can still function well. The sling with foam block? Biceps tenodesis is a surgical procedure used to treat biceps tendonitis, which is also known as a biceps tendon tear. Lie flat on your back with your injured arm propped up with a pillow. When you tear your bicep tendon at the elbow, your other arm muscles will compensate, so youll still have full range of motion. I'm just being very careful how I move my arm and avoiding intentional biceps contractions till I see the Dr on Tuesday. Slow and steady. Sometimes, a second incision in the back of the elbow may be needed. Obtain tools for bathroom access and safety. The only way to tell if biceps tenodesis is effective is to perform studies where people arerandomized into groups where the tendon is cut or not (sham surgery) and then measure outcomes. Join Date: Jan 2011. For three days before biceps tenodesis surgery, you must not take any aspirin or nonsteroidal anti-inflammatories, such as ibuprofen (Advil) and naproxen (Aleve). Do not raise your arm. Sitting up for desk work can usually be started around a few days after surgery, especially if you can keep the arm at your side and use an ice pack at your desk. This is a less invasive option. Overuse, powerful pulling on the arm, falling on an outstretched arm, and other accidents can all cause SLAP tears. Patients who present to me for treatment of an old, untreated distal biceps rupture have one or more of these symptoms. Tenodesis of the long head of the biceps during shoulder arthroplasty is a safe and easy procedure, which minimizes the risk of postoperative "Popeye" deformity and . Hence, most biceps tenodesis surgeries should soon go away. Do not Fall: Take all precautions possible to AVOID FALLING. Had a lot of pain after surgery, but it was beginning to get better up until last week. I had the subacromial decompression and distal clavicle excision, like I did on the right shoulder, but I also had a bicep tenodesis. The biceps tendon attaches between the elbow and the shoulder. Biceps tenotomy means cutting off one tendon and not reattaching it, allowing it to heal to the humerus over a few weeks. Few would suspect the cause of shoulder pain to be something as typical and inactive as sitting at our desks. THE PROCEDURE. The most obvious symptom will be a sudden, severe pain in the upper part of your arm or at the elbow, depending on where the tendon is injured. They can also involve the biceps tendon. -Bruising from the middle of upper arm down towards elbow. Rest: Take a break from the activity that's causing pain or soreness. The patient must go through rehabilitation to regain maximum use of the arm. Others stress the importance of releasing the biceps sheath during tenodesis. Repeat 10 times, working up to three sets . What can you not do after bicep Tenodesis? Passive range of motion starts within the first or second week after operation. Rarely using otc pills. Options may include a mastectomy, chemotherapy, radiation, or removal of skin lesions. It may be suitable for people with an injury called superior labral anterior-posterior (SLAP) tears. Swimming, weight lifting, and throwing sports are the last activities to be reintroduced.