What a week! Up and down then up and then down... Coming to the conclusion that I'm going to at some point have to take the best part of a year off climbing/training is a pretty tough realisation. Going to explore all alternatives but from the sounds of it I'm just delaying the inveitible... There's a specialist called Val Jones in Sheff that was a great help and if she had any availability I'd be seeing her but she's fully booked up and doesn't know when she'll have space... Trying to stay positive but it's tough...
I’ve been thinking quite a bit about this one DD. I’ve sat on both sides of the desk and it's a difficult decision. TL/DR: go straight to the last sentence.
The crux is whether your current non-ideal anatomy will lead, in the long term, to arthritis and more pain and dysfunction. Your surgeon thinks so. You’ve had some expert physiotherapy opinion that it isn’t as clear-cut as that. There is probably a degree of “s/he would say that wouldn’t s/he” in both camps. Any chance of a second surgical opinion?
Personal experience: I had a right shoulder SLAP lesion, possibly less severe than yours, “tidied up” twenty years ago. Famous surgeon, consulted for Arsenal at the time. It took about a year before I felt like I was properly over the surgery. It didn’t help me in the short and medium term (at 5 years it felt much the same as before injury) but I didn't do as much rehab. as I could have done. In the long term that shoulder is now my stronger one but I can't be sure if this was due to the surgery. I’ve taken conditioning much more seriously over the last 10 years especially after dislocating my left (not the SLAP one) shoulder 4 years ago. I think the conditioning made the biggest difference.
Professional opinion: the recent deterioration in your shoulder after getting this bad news is a good example of how pain and dysfunction is not simply down to the state of the joints, ligaments and tendons. Your shoulder hasn’t changed but your mood and anxiety probably have and you may even be doing less with that shoulder. What is the evidence that long-term lack of repair will give you arthritis? There are no very long-term studies (10+ years) that I’m aware of that track folk with unoperated SLAP lesions so any answer is going to be a bit speculative. The medium term (2-5 years) outcomes for non-surgical management are pretty good.
There is also
this study, a rare example of a blinded clinical trial for surgery. Small numbers (n=118) so possibly underpowered and at risk of a false negative result and outcomes at two years only so far. Their conclusions are striking: “Neither labral repair nor biceps tenodesis had any significant clinical benefit over sham surgery for patients with SLAP II lesions in the population studied”.
What would I do if I was in your shoes? Hammer the conditioning and wait and see.