OT Rotator cuff tear

[wc1934]

MRI shows a small tear in my rotator cuff. I am fine riding and all daytime activities - Night time is a different story - that's when I feel the pain, and as a result don't get much sleep. Doc suggested surgery - I declined - opted for PT (which consisted of pulling/stretching bands). Did that for about a month and quit as I did not see much of an improvement.
Any thoughts, suggestions or advice.
Thanks

[chuckroast]

I had a small tear from a crash. Same problem as you, I was ok during the day but it hurt at night. Ortho told me I wasn't a good candidate for surgery so my GP prescribed an anti-inflammatory (Meloxicam). I took it before going to bed for about a year and a half. Worked great, no pain.

I finally stopped taking them because I wanted to see if I still needed them. Turns out I didn't. Whatever I had, must have healed or at least stabilized.

[scooter]

A common complaint of cyclists that have fallen, extending an arm to brace their fall, is shoulder pain from a tear in one of the four rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis) - usually the supraspinatus. Dr. Loren Fishman, M.D. did a study that concluded that a yoga pose or a variant called the triangular forearm support (TFS) can improve shoulder function by recruiting the subscapularis to do more of the work. The TFS maneuver is based on the yoga camel pose or headstand but you don't have to employ the actual yoga pose to get the benefit of this technique. You can simply hold the pose against a wall for 1 minute and then raise your injured shoulder rapidly. The subscapularis muscle is recruited for the injured superspinadis. It's a simple technique that has worked for many people. Google it for more info http://www.nytimes.com/2011/08/02/health/02brody.html?_r=0. I think there is a You Tube demonstration on the web http://www.youtube.com/watch?v=2-LlDPteGR4, also.

[Ken Robb]

I've had shoulder impingement in both shoulders. On the first shoulder PT didn't work but surgery did a great job.

Second shoulder PT didn't work at first. I struggled along for a while because surgery is a BIG DEAL with lengthy/uncomfortable PT afterward. I didn't want to live with the pain so I went back to PT and this time it worked great.

I'd say you should try all reasonable options.

[leooooo]

Try getting another MRI or something. Second opinion.
I opted for surgery even though MRI showed a small tear.
After going in, surgeon found out it was completed ripped off. Had a type 4 tear.

[kurto]

I had shoulder surgery in June to repair some labrum tears, a tear of the biceps tendon and impingement. I had previously tried PT and all other non-surgical routes. I wish I would have had te surgery sooner. I was off the bike for only five weeks. It hurt coming back, but now four months post-op I'm totally pain free and hitting the gym hard. Basically, if you have a good surgeon and your tear can be fixed arthroscopically, the rehab isn't all that bad. If you want any more info, let me know. Otherwise, I'll just go ahead and shut up.

[wc1934]

Great replies - keep them coming as I am open to all suggestions, comments and advice.
Thanks.

[Keith A]

Not exactly the same problem, but had the same symptoms as you. Daytime was fine for the most part, but I did have some limitation in motion. But trying to sleep at night was miserable and there wasn't any position that I could sleep comfortably.

I had a bone spur that was tearing into the soft tissue in my shoulder. The OS said I could try PT or surgery. I opted for the surgery and then followed up with PT. My recovery is much faster than with the rotator cuff tear, but I am SO glad I did the surgery. It has been great to sleep with no pain...and there is no more pain when paddling my surfboard!

[mgm777]

I've had shoulder impingement in both shoulders. On the first shoulder PT didn't work but surgery did a great job.

Second shoulder PT didn't work at first. I struggled along for a while because surgery is a BIG DEAL with lengthy/uncomfortable PT afterward. I didn't want to live with the pain so I went back to PT and this time it worked great.

I'd say you should try all reasonable options.

What Ken said above. Shoulder surgery sucks.

[Peter584]

I had surgery for a torn labrum from a bike wreck. I had the surgery in Jan. and wrecked again on it as soon as I was back on my bike in march. I really thought it was torn again and remained in pain for a few more months. Now it seems fine and I'm mostly pain free. The recovery was not fun, considering the months of uncertainty. If you have it, I would wait until you feel really strong until you put yourself in a situation where you may damage it again.

[bigreen505]

Ask your PT if you are a good candidate for dry needling. Rotator cuff surgery sucks, but it works. Ask some PTs who they recommend as surgeons. They know whose patients recover faster.

[Keith A]

As with any type of surgery, getting the right surgeon is key. I sought out input from a local surfer forum as surfer's tend to have shoulder problems. In my case, there was one OS that almost everyone recommended and I went with him and was very happy with the results.

[Frankwurst]

The worst part of the surgerey for me was having my right arm in that big a$$ sling for a month 24/7. The whole process was a long drawn out affair but after dealing with the torn rotator cuff for the better part of spring and all summer I finally had it done and I'd do it again given the same situation.
It's no fun but it sure beats living with a bad shoulder day and night.:beer:

[Plum Hill]

Have had three surgeries (two right, one left) and surgeons refuse to do fourth (left), all do to work-related issues. As one surgeon stated, when the pain gets bad enough you'll do something about it.

Results are a crapshoot since all patients and all tears are different. The recommendation for my surgeon came from an insurance case worker; she gave me her opinion of the two best surgeons in the St. Louis area. My PT also had high praises for the man.
I originally saw a doctor known as The Guru of Shoulders, a well-respected person in the field. Personality wise, I thought he was cold, so I went elsewhere. I have friends that have had great luck and not-so-great luck with this man, so that's the basis for my 'results' comments.

My recomendations: MRI with contrast (the only way to get an accurate picture) or, as an alternative, ultrasound (less invasive, cheaper, but few places are really talented at giving and reading) and Celebrex for an anti-inflammatory (only issue is that extended use masks other things that go wrong).

Surgery has come quit a way since my first in 2002, where I was in a sling for six weeks. Three days after my last in 2010 I was passively exercising the shoulder with an apparatus similar to ones used for knee relacement surgery. This was the worse tear but the quickest recovery.

Sorry for being long winded. PM if you'd like further info.

[merlinmurph]

I'm headed for rotator cuff surgery in two days. I've dinged my right shoulder a few times, skiing and mt. biking, but my mt bike crash last March really did a number on it. It hurt, and I had issues trying to sleep. I did 10-12 weeks of PT where it got a lot better, but improvement stopped and I still had limitations.
Went back to the doctor, had an MRI in Sept, and two docs said the damage was worse that they had thought, mostly to the supraspinatus. Searched around for a surgeon (even asked here @ Paceline) and found a guy that's good - Dr. Alan Curtis - and that my insurance will pay for. While he's at it, he's going to take care of a bone spur he saw in the MRI.
So, unless I chicken out in the next two days, I'll be out of action for awhile. I already wrote off most of the ski season and didn't get a season pass (first time in ~30 years). Right now, trying to figure out what to do this winter....

Anyways, get all the info you can about your shoulder, and at least two opinions about your choices. Everybody is different, every injury is different.

Enjoy your ride,
Murph

[MattTuck]

Sadly, your baseball career is probably over :(


Seriously, if regular 'western' medicine isn't working, it may be worth a few sessions with an accupuncturist or reiki massage. Both can promote healing.