“It gives me a little peace of mind to go get (the surgery),” Hall told the Chronicle. “Seeing the MRI and seeing what I’ve been dealing with the last couple of years, it kind of puts me at ease to go get it fixed. That way I can get back out there (as) the player that I used to be and be healthy (and) go out there with two labrums.”

The labrum is located in the ball-and-socket joint of the shoulder. Since the shoulder socket is very shallow, a cuff of cartilage called the labrum allows the arm bone to move within the shoulder socket, giving it more stability and range of motion. The labrum, however, is susceptible to injury. Most labrum tears do not require surgery, but patients with persistent symptoms after trying other treatments unsuccessfully may need surgery to correct the problem.

Shoulder surgery often requires the use of pain pumps for post-operative pain management. The pain pump is implanted into the shoulder joint during surgery and delivers a steady amount of medication to the wound site.

A recent study published in The American Journal of Sports Medicine identified post operative pain pumps, or intra-articular pain pumps, as a likely cause of Postarthroscopic Glenohumeral Chondrolysis, a debilitating condition in which the cartilage in the shoulder joint breaks down, causing the bones in the shoulder to rub together. The condition can cause chronic pain and can limit mobility. Additional surgeries may be required.

The Astros will void Hall’s minor-league contract, as he will be out at least four months for surgery as opposed to just one month if he had tried rehab without surgery.

SOURCE: Pain Pumps › Astros Toby Hall opts for shoulder surgery to correct torn labrum

A torn labrum flap is an injury to the part of shoulder joint. Having the surgery could likely end the season for Francis. Though he is a month behind on his throwing program, he says he will continue to pitch and hope that he can work past the shoulder discomfort.

Perhaps one reason Francis hopes to avoid surgery is that shoulder surgery often requires a pain pump for post-operative pain management. The pump is implanted into the shoulder joint during surgery and delivers a steady amount of medication to the surgery wound site. This is often a preferred alternative to narcotics and pain-killers, which can have negative side effects.

However, post-operative pain pumps recently have been associated with a painful condition known as Post-arthoscopic Glenohumeral Chondrolysis , or PAGCL, in which the cartilage in the shoulder joint break down, causing the bones to rub against each other. The damage can occur rapidly. PAGCL is believed to be irreversible and may require extensive surgeries.

The symptoms of PAGCL can begin to develop as early as two months after surgery up to a year following the procedure. Symptoms of PAGCL include decreased mobility and range of motion; constant pain both at rest and in motion; shoulder stiffness and/or weakness; and popping, clicking, grinding noise in the shoulder. Those who experience symptoms are encouraged to contact their physicans.

SOURCE: Pain Pumps › Shoulder surgery decision weighs on Rockies’ Jeff Francis