McMahon’s Labrum Tear & Upcoming MRI
Announced on March 21st, 2022, Eagle McMahon said that he is going to have an MRI during the last week of March. This all stems from the shoulder subluxation that occurred when filming videos with Jomez during the week of the Disc Golf Pro Tour Championship event. I do want to share the difference between a dislocation and subluxation. Please note that this is a generalization and the nitty gritty is outside the scope of this video. A subluxation can be called a partial dislocation. Basically, in the shoulder the humeral head comes out part of the way and typically goes back in on its own. A dislocation is when the humeral head comes out completely and usually needs to be put back in place by a qualified healthcare professional. From Eagle’s original Instagram post, “I don’t believe I fully dislocated my shoulder but it did feel like it briefly popped out of place.”
You look at the available research 90% of all shoulder dislocations happen anteriorly. What the heck does that mean? That means the humeral head or the top of the bone that make up your shoulder comes out forward when we watch the video you can clearly see that’s what happens. The position his arm is in and the motion of his body is nearly textbook in the way he dislocates.
We can see Eagle run up and spin counter clockwise. As he returns to facing forward his arm lags behind putting enormous stress on the joint and surrounding tissues. This stress is far more than his shoulder experiences during a normal power forehand shot. We see McMahon then grab his throwing arm with his off hand. He bends over and gently pulls on it. This is again very common with an anterior dislocation. Putting the arm in that position gives the shoulder the best possible opportunity to return to normal. You can even hear him say in the video, “Ow my arm!”
There are a couple different injures that can happen when you sublux your shoulder like McMahon did. The first is a labral tear. This is fairly common with anterior dislocations. What makes the labrum so important in the shoulder, is the stability it adds to a very unstable joint. This instability allows us to have such a large range of motion allowing us to do all sorts of activities. The labrum helps to deepen the shoulder joint giving more stability without sacrificing much range of motion. The problem with a labrum tear is the loss of stability and loss of strength/power. One of the heads of the bicep muscle attaches directly to the labrum. With the tear in the labrum the muscle doesn’t generate as much power and can make the tear worse. McMahon mentioned in his update video that he believes he has a labrum tear.
Using my years of experience, I would bet that he has the type of tear called a SLAP tear. A SLAP tear stands for Superior Labrum Anterior Posterior. What the heck does that mean? It means the top of the labrum is torn from the front to the back. How far is unclear and the only way to truly know is with an MRA or arthroscopic surgery. I did not mispronounce it an MRA or MRI-A is an MRI Arthrogram. Basically, they inject the joint, the shoulder in this case, with a special dye that help identify the tear
In the video, McMahon talks about stem cell therapy. This is also known as platelet rich plasma or PRP. In the most basic sense, they take some of you blood, spin it really, really fast, this causes the blood to separate in to different layers. One of those layers is the platelets in your plasma, these can in the right conditions aid in the healing process. I want to emphasis that this is the explain it like I’m version. In reality it’s a lot more complicated and also way outside the scope of the video. As he said in the video, PRP has the least risk, with the most upside, and shortest recovery. This is true, sort of; let me explain.
Doing my own research on the US National Library of Medicine & National Institutes of Health I found that when I search with the terms ‘PRP’ and ‘SLAP’ I find 65 articles published in the last 5 years. Articles older than that mostly talk about “the possibilities” and that “there needs to be more research.” Of those 65 articles 20 were about the rotator cuff, I’ll get back to that in a second, 10 weren’t even related to PRP, 1 was about a sports hernia, 2 were about the labrum or SLAP tears, and 2 were about veterinary medicine. Quick chat about the rotator cuff. Yes, that is in the shoulder but its very different from the labrum. The rotator cuff is a group of 4 muscles that help stabilize the shoulder. The labrum is cartilage. They serve two separate but complimentary functions but they don’t react to treatment and healing the same way.
Of all the articles I found 2 articles helpful. The first is an article by Schneider et al. titled Platelet-rich plasma and the shoulder: clinical indications and outcomes. The article basically says that the literature is inconclusive but there isn’t a downside other than wasted time. They suggest more double-blind studies are conducted. The second is a study by Sivaraman Arumugan et al. titled Platelet-Rich Plasma Injections in Sports. The conclusion they came to is that PRP is a good adjunct to other treatments.
I did find one case study that the patient through the International Journal of Exercise Science that showed a positive outcome for a person who had a labrum tear in their left shoulder. They only had PRP and rehab; after 12 weeks they report that the patient is almost complete symptom free and returned to normal activity. Unfortunately, this is a recreational basketball player and not a professional athlete. In the abstract they didn’t mention which hand was dominant. Given that most people are right-handed we can assume that this individual is right-handed. And case studies aren’t the best evidence. They show that something can work but a larger study needs to be conducted to reduce the likelihood of random chance.
I also did a google search and found several clinics that offer PRP injections. The also offer some testimonials but I couldn’t find how the success rate of the PRP treatments in general let alone for a labrum tear.
I know your eyes are glazing over and you didn’t totally understand everything you just read. And that ok. Feel free to drop a comment below and I’ll do my best to answer your questions. If I was Eagle McMahons athletic trainer and given the information I could find, I would advise against this as the sole treatment. I do not have access to all the research out there and I would strongly advise him to talk it over with his Orthopedic Surgeon. If he needs a recommendation, I can recommend one that is one of the top surgeons in the country and has some amazing outcomes and quick recovery times.
So how did we get here? That is the question of the day. Eagle McMahon sustained this injury right before the Disc Golf Pro Tour Championship. His Instagram post is dated October 14th, 2021 so I will use that as a starting point for my time line. he states in his post, “I plan to work with disc golf strong for the rehab process and also seek other professional care if I don’t see improvements in the coming weeks once I get home to Colorado.” In my mind I’m seeing red flags from this statement. The course of treatment that is highly recommended is to see a physician. Why you ask? Well, if an orthopedic physician or other sports medicine professional got hands on with his shoulder, they’d be able to tell with reasonable certainty whether or not he tore his labrum. Most likely they’d have ordered an MRI in November and McMahon would have the full picture. He’d have the opportunity to make the most informed decision. Instead, he just did rehab for the last five months.
Normally what the insurance company want is to have their customers try rehab for about 4 weeks. At this time if things aren’t better then they go for surgery. Depending on how bad things are with the tear that process can be shortened. One thing to note doing rehab before surgery is a great idea. The strong you are going into surgery the better outcome and faster recovery. If he had surgery in December, it would be completely plausible to see Eagle McMahon fully healthy at the Champions Cup. Instead, this is the second injury that has the appearance of mismanagement. Who is the first you ask? Well, that’s none other than Discmania teammate, Simon Lizotte.
I want to emphasize that I want Eagle McMahon to come back as quickly and safely as possible. I hope we get to the him back at 100% by the 2023 season at the latest. I hope you found this information useful. Let me know in the comments below if you have any questions. Or you can hit me up on Twitter or Instagram @JoesDiscGolf.