OT - Shoulder surgery

[Chris]

I'm 46 and I have some shoulder impingement issues in my right shoulder. MRI shows a variety of minor problems, possible tears of the rotator cuff and some spurring as well as tendonosis. I had an injection about four months ago and it worked well for awhile. I can't throw overhanded or play tennis with my daughters who are avid tennis players very well. Sleeping on the shoulder, which is my primary sleeping position, is problematic and I wake up through the night with pain. I'm definitely going to tolerate it through the cycling season. I've been doing all the theraband exercises and a hanging protocol, but nothing is making much of a difference. Has anyone gone through surgery with a resolution of their symptoms? I'm concerned about the surgery "fixing" what's wrong but still having the discomfort afterwards anyway. The doc said part of the surgery would include shaving down some of the bone. That seems a little drastic.

[93legendti]

I would make sure to get a second and third opinion. When my mother was 75, she had "rotator cuff surgery". Only problem was when the doctor got in there he made a mistake and found out that she didn't have a torn rotator cuff and he stated that the surgery shouldn't have been performed. I can't remember now what she had ( bursitis? Arthritis?) but it didn't need surgery and has been controlled by medicine.

[joosttx]

Originally Posted by 93legendti

I would make sure to get a second and third opinion. When my mother was 75, she had "rotator cuff surgery". Only problem was when the doctor got in there he made a mistake and found out that she didn't have a torn rotator cuff and he stated that the surgery shouldn't have been performed. I can't remember now what she had ( bursitis? Arthritis?) but it didn't need surgery and has been controlled by medicine.

Agreed. I had shoulder surgery about 5 years ago. My shoulder has never been the same.

[Chris]

Originally Posted by joosttx

Agreed. I had shoulder surgery about 5 years ago. My shoulder has never been the same.

These are my concerns. Can you elaborate?

[eippo1]

I have issues with the over side of the shoulder necessitating the Bankart repair. Have had it done twice and is still unstable -- although I need to get back on the lifting horse.

No surgery will actually ever "fix" a shoulder, but it might help you get to where you can manage pretty well. There's just too much going on with that joint that any repairs will only be a patch.

[joosttx]

Originally Posted by Chris

These are my concerns. Can you elaborate?

Basicaly, a nickel size peice of cartilage dislodged from my socket. I had spurrs too. They cleaned it up and microfractured it.

I lost a lot of muscle that has never come back. My left should is noticably smaller than my right.

It took a long time like two years before I could sleep with waking up in pain from rolling over on it.

I still cannot naturally lift my shoulder in the air. I cannot bench press, do push ups, or lift heavy stuff with my left arm.

With all that I am glad I did it bc prior to the surgery I was in a lot of pain . but it will never be normal again.

[Bentley]

Originally Posted by eippo1

I have issues with the over side of the shoulder necessitating the Bankart repair. Have had it done twice and is still unstable -- although I need to get back on the lifting horse.

No surgery will actually ever "fix" a shoulder, but it might help you get to where you can manage pretty well. There's just too much going on with that joint that any repairs will only be a patch.

Agree with above completely. I have had multiple knee surgeries and I have a slight tear in my Rotator Cuff, gonna do everything short of surgery. My Orthopedic Sugeon told me it's about reducing pain and gaining mobility, definitely not a fix, in the classic sense.

[.RJ]

I had a torn labrum & some bone spurs from a car accident - I had lots of PT to get it strong and be able to live with it for a time, about 7-8 months - and when I couldnt sleep well I scheduled the surgery. The road to recovery was LONG. You will often wonder why the f&#$@! did I do this? But I recovered to near 100% and I'm glad I did it. Keeping up with the post-surgery PT is key. I was able to ride the trainer after about 6 weeks, and riding out doors 4-6 weeks after that.

[GregL]

I had the exact same symptoms and diagnosis as the OP. I lived with it for nearly ten years, as a variety of family commitments made me hesitant to be "useless" for the first six weeks of the recovery period. Last fall, the time was finally right to have the surgery. My surgeon is a very good friend as well as a team mate on my cycling team. Based on year's of trust and personal experience, I knew he wouldn't let me down. My trust was 100% rewarded!

Last October, I had a decompression, debridement, and rotator cuff repair. My doc shaved down the offending bones, removed bone spurs, and sewed up a 2cm tear in my supraspinatus. The surgery was a piece of cake. I arrived at the surgery center at 8AM and was home by 1PM. Had lunch, took a nap, and then went for a long walk with my wife and our dog. Back to work in two days, back in the gym (recumbent bike, leg weights) by day 3. Between the gym and fall hikes, it was fairly easy to keep base fitness. I was in PT by week two. At the (nearly) five month mark, I have about 90% of nominal strength and range of motion back. I'm confident that in the next few months, I will be at 100%. Best of all, my right shoulder is 100% pain free for the first time in ten years! I plan to have the left shoulder done this fall.

My takeaways:

- Find the best surgeon you can. My friend/doc is a knee and shoulder specialist who I have known for 20 years. He is revered here in CNY for his talent and his knowledge of athletes. My recovery has been exactly as he predicted.

- Work your posterior off in PT. Shoulder rehab is both challenging and frustrating. You have to build into it slowly to ensure that you don't re-injure the connective tissue in the joint. At the same time, it is very painful. I never screamed out in pain, but on many occasions my eyes involuntarily teared up as the therapist stretched the joint.

- Plan to sleep in a recliner for the first six weeks post-surgery. It was the only way to be even remotely comfortable. You will be wearing a large brace (see photo), so a bed really isn't an option. I also found that placing pillows strategically around my arm helped a lot. I also found comfort by placing an ice pack on my shoulder at bed time. The cooling sensation was a big help in getting to sleep.

Good luck! If you decide on the surgery route, I hope yours is as successful as mine!

Greg

[LouDeeter]

My wife has a condition called Avascular Necrosis which causes the ends of her long bones to die. It was a rare side effect from the use of a common steroid used in cancer treatments to buffer the effects of the drugs. Her shoulder was gradually grinding down. Her doctor for the shoulder and another for her hip both told her to have surgery only when she could no longer live with the pain or impingement to her daily life. Their advice was no surgery if you can get by without it. She had her left shoulder replaced with a titanium device. She has yet to have her hip replaced. While "shopping" for a surgeon, her question to the doctors was, "If your wife were having this surgery, who besides you would you recommend?". After a consensus pointed toward a single individual, in Jacksonville, FL, she read up on him, then had her initial appointment. One question she asked him, "How many shoulder replacements have you done?". When he said he does almost 150 per year, that was enough for her! He also designed the implant that was used.

[Seramount]

wow, lot of shoulder injuries out there...

I'm wrestling with a Grade 3 separation (damage to AC, CC, rotator cuff, bursal sac) that occurred 6 months ago.

the surgeon I'm seeing is apparently THE guy for shoulders around these parts. he says I'm exactly on the cusp of needing a surgical repair, so am diligently doing PT to rehab the joint and not go under the knife.

he's going to review my situation in 90 days and we'll decide if I'm satisfied with the progress at that point. if there's pain or mobility issues, he's recommending arthroscopic surgery to clean up the rotator cuff tear.

altho it's an outpatient procedure, will still require 6 weeks in a sling and 6 more months of PT.

going to have to be in a lot of discomfort to opt for that...

[guido]

I am an ex marathon flatwater kayak racer. For those unfamiliar, the normal race stroke on an kayak with a wing paddle is really tough on shoulders. I have fought rotator cuff impingement issues for years and had to quit racing and eventually all paddling long before my interest was expended. Orthos wanted to do surgery to shave the acromion etc. but I never found a majority of folks who had the surgery report success so i eventually hung up my paddle. But even stopping altogether the shoulders still continued to be troublesome. Riding got real painful last year. I wasn't happy at all. Then I was recommended this little book by my chiropractor:
https://www.amazon.com/gp/product/15...?ie=UTF8&psc=1

I got a set of lifting hooks as recommended and started doing sets of the hangs daily. In about a week I was feeling real improvement. In a month I had no discomfort and went into maintenance mode (a couple of sets every 2 weeks). If I start to feel any increase of discomfort (roof raking anyone?) I do a couple more sets a week and any trace of pain goes away.

Would I go back to paddling? No. Is my riding or normal life activities 100% improved? Absolutely.

It is worth a try. It will not make it worse and it may well give you back your shoulder.

[jimcav]

Originally Posted by guido

Then I was recommended this little book by my chiropractor:
https://www.amazon.com/gp/product/15...?ie=UTF8&psc=1

I got a set of lifting hooks as recommended and started doing sets of the hangs daily. In about a week I was feeling real improvement. In a month I had no discomfort and went into maintenance mode (a couple of sets every 2 weeks). If I start to feel any increase of discomfort (roof raking anyone?) I do a couple more sets a week and any trace of pain goes away.

I have SLAP tears and cuff muscle tears in both shoulders. I was told to have surgery on both a few years ago, but I was in the navy and over 15 yrs ago I had a friend who got shoulder arthroscopy as he was getting out of the navy:and he died on the table (their fault)--so certainly the ability to CHOOSE the best surgeon would be key. I tried PT for months (6-7) and steroid injections but what got me functional (can't throw or do a pull up without pain, but i can ride) was dry needling to the muscles in the rotator cuff and scapula as they were all guarded and tight and that kept me impinging! the dry needling worked dramatically in 2-3 sessions I was functional
good luck to the OP

[shovelhd]

I agree with the good advice here. Avoid surgery if you can, get multiple opinions, choose the best shoulder surgeon you can find, and do your PT like a second job. I had a grade three separation with multiple tears and avoided surgery. I'm mostly pain free. What grade is your injury?

[DG24]

I've had both my shoulders done as I approached, and just after, 50. My experience in diagnosis and recovery was similar to GregL.

I would say I'm at 90% for both shoulders give or take 5%, given the day or activity. I still sometimes feel a little numbness or soreness stretched out on the bike toward the end of a ride. Probably should have worked the therapy a little more diligently, although I did until I was on my own.

In my experience, the first 4 months (when actively in physical therapy) get you to 60-75%. I let time and normal activities do the rest. It really took me about a good year to recover.

The first few weeks of post-op are no fun. At least they weren't for me. Started therapy three days after surgery. Had a little bit of a frozen shoulder already after the first surgery and a little nerve issue at the elbow (from being in the sling) after the second. It can really wake you up quick when they start to move that shoulder/arm around again. The sensation is no joke.

Regardless, I scheduled my surgeries on Friday and was back at work by Tuesday both times (Monday was the first therapy appointments). Only took pain meds the first night. Slept in a chair the first weekend.

Had both surgeries in winter. January.

Prior to going under the knife, I build a fork stand out of 2x4's (with a Thule truck fork mount) for my rollers. I think I rode the first Saturday both times.

I was out of the slings after four weeks each time (fairly standard for my procedures). It's too hard to ride outdoors with one arm, so don't bother trying (I did once...kind of a dumb move).

For showering and riding on the rollers, I found a good use for old tubes. I cut a few down to length and knotted them for a sling. Keeps your daily brace from getting wet or sweaty. Additionally, I used a junior rubberized football (that my dog had found on a local playground) and tucked it between my arm and my body to keep my arm at the correct angle. Worked well for putting over jackets as well (tough to put a jacket - or anything - on over a full brace and a lot quicker that setting one up on the exterior of your coat).

Everyone is a little different with regards to the extent of the damage and subsequent surgery, so your experience may be different (i.e. be better). The initial therapy is almost as important as the surgery. So work it like you would your training.

Good luck.

Dave