Understanding My Shoulder MRI – Is Surgery Necessary?
I recently received the results related to my left shoulder. Since I just got them, I’m still waiting to hear from my doctor for further insight. Background: I experienced my sixth dislocation of the left shoulder in March, following 15 years of similar issues. I underwent an MRI and managed to play golf throughout the summer. While it doesn’t quite feel like my right shoulder, I generally cope well – though it has a tendency to dislocate easily. The last mishap occurred while I was on my couch, enthusiastically cheering during a sports event and I raised my arm too quickly. After my second dislocation back in January 2010, I opted for a surgery to repair my labrum. Since then, I dislocated my shoulder for a third time towards the end of 2010 while playing hockey, again in 2015, then 2024, and one more time in 2025 (the sixth dislocation). I’m hoping to avoid another surgery, especially as I’m a single father to a six-year-old daughter. Would physical therapy be beneficial in my case? Here’s a summary of the MRI findings: TECHNIQUE: 1. Multiplanar and multisequence MR imaging of the left shoulder was performed without contrast. 2. A thin-section CT of the left shoulder was conducted without contrast, with multiple reconstructions analyzed. FINDINGS: **Bones:** A Hill-Sachs impaction fracture of the posterolateral humeral head is observed, measuring a maximum depth of 6 mm, with no fractures detected in the glenoid region. A small area of signal abnormality in the anterior glenoid indicates a prior labral repair. **AC joint:** No signs of arthritis in the AC joint. No spurs or enthesophytes present under the acromion. **Subacromial/Subdeltoid bursa:** There is an absence of any notable fluid accumulation around the bursa. **Rotator cuff:** The rotator cuff appears intact and exhibits no signs of muscle atrophy or edema. **Biceps tendon:** The long head of the biceps tendon is intact and shows no abnormalities. **Labrum and capsule:** There are some postoperative changes from the previous labral repair. The anterior-inferior labrum shows reduced size, which is nonspecific and might be associated with a prior or recurring tear. There’s no evidence of labral fragment displacement or surrounding cysts, and the cartilage next to the labrum looks normal. **Other:** There is no observable joint effusion, nor are there any full-thickness defects in the articular cartilage of the glenohumeral joint. **IMPRESSION:** 1. A history of anterior glenohumeral joint dislocation undergoing previous labral repair. 2. The anterior-inferior labrum appears reduced in size with no evidence of a Bankart fracture or glenoid cartilage defects. 3. Presence of a Hill-Sachs impaction fracture.
Answers (1)
8/27/2025, 12:53:21 AM
OpenHealth AI
It sounds like you're facing a challenging situation with your shoulder, especially considering your history of dislocations and your desire to avoid further surgery. While the MRI findings suggest some changes, including a Hill-Sachs lesion and potential labral issues, there are avenues to explore that may help manage your symptoms and improve stability, especially considering your role as a single parent.
Key Points:
- MRI Findings: You have a Hill-Sachs impaction fracture and changes related to a previous labral repair. The rotator cuff and biceps tendon are intact, which is a positive sign.
- Surgery vs. Therapy: Surgery might not be immediately necessary, as many patients benefit from conservative treatments.
- Physical Therapy: Engaging in a structured physical therapy program can significantly improve shoulder function, stability, and reduce the likelihood of future dislocations.
Explanation:
The Hill-Sachs lesion indicates that there has been prior dislocation trauma, and your ongoing history shows that the shoulder is prone to instability. Physical therapy can help strengthen the muscles around the shoulder, improving stability and potentially minimizing further dislocation occurrences. It's understandable to want to avoid surgery, especially when managing your responsibilities as a parent.
Prioritized Next Steps:
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Consult a Physical Therapist: Seek guidance from a physical therapist who specializes in shoulder rehabilitation. They can tailor a program focusing on strengthening and stabilizing your shoulder. Aim for a combination of exercises that enhance both strength and mobility.
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Focus on Specific Exercises: Work on stability exercises for the shoulder girdle, like rotator cuff strengthening exercises (e.g., external rotations, and scaption). Your therapist will likely introduce these progressively.
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Monitor Symptoms: Keep track of any changes in your shoulder's stability or pain levels during activities, especially any that lead to discomfort or dislocation. This information will be helpful during follow-ups with your doctor.
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Gradual Return to Activities: While you enjoy golfing and sports, gradually reintroducing these activities after working on your shoulder strength may help you avoid injury during enthusiastic movements.
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Evaluate Progress Regularly: Set a schedule to reassess your shoulder's condition every few weeks. If you experience repeated dislocations or if symptoms worsen, this would be a good time to revisit the conversation around surgical options with your doctor.
Supporting your shoulder recovery while balancing your responsibilities is crucial. With structured support, you may find improvement and confidence in using your shoulder without fearing dislocation. If questions arise or if you need clarification on any rehab techniques, please feel free to ask.
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