OT - Shoulder surgery

[DG24]

"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."

I don't know if I teared up...but I had a call a ten second time out on a number of occasions. It's almost indescribable. But it passes quickly.

[Frankwurst]

Had rotator cuff and arthritis surgery several years back on my right shoulder. After the loooong period of PT it was and still is like new. Left shoulder is mucked up now and I've been in PT for 8 weeks now and it's almost there. It'll probably never be back to 100% but it wasn't 100% long before I started PT. Dr. said he'd prefer going the PT route vs the surgery route. We'll see what he has to say next week. Good luck with yours.

[Plum Hill]

Had complete tears repaired in both shoulders in 2002, one arthroscopic and one open surgery.
By the end of 2009, had the same in both shoulders again. Assume work related, as surgeon was proud his original repair hadn't failed. Original surgeon and second choice would not repair the previous open surgery side, which got me a disability retirement. That side still haunts me at times.
Six months down time on first two; much less on third.
My injuries were so painful it hurt to reach across a table or to put my elbow on the door of the service van, let alone do other things the job required. Even working directly in front of me 9Arms down and elbows bent) was painful.

On MRI, unless it's an MRI with contrast, don't believe it. The contrast shows a lot that a plain Jane MRI doesn't. Like a 2+ cm tear.
Another good diagnostic tool is ultrasound. Few places offer it; fewer doctors can read the results.
CPM machine is worth it's weight in gold for rehab. I had one by day two after the last fix. Made recovery very fast. If you spend weeks with your shoulder immobilized, it's pretty much useless when you start PT. (Also had CPM machine for TKR.)

[Ken Robb]

Several times in my life I got sprains and had doctors tell me I was lucky to have joints that were tighter than average or the sprains would have been worse. When I got to be 65 my left shoulder was giving me increasing pain. I told my orthopedist it felt like I was being stabbed from inside my shoulder. X-rays and MRIs showed I WAS being stabbed by bone spurs in the joint.

I tried PT. It was painful and not helping as quickly as I expected so I had surgery which involved disconnecting my deltoid to make room for power rasps/grinders to smooth things up. The post-surgery PT was no more fun than the pre-surgery PT but I had no option but keeping at it if I wanted a good result and in the end that's what I had.

Then I had the big Ducati crash which shattered my clavicle and scapula on the same side that had been repaired. 9 hours of surgery over two days and 5 weeks in thee hospital followed by on-going PT at home for a few months and I have a pretty good shoulder full of titanium plates and screws to match my Hampsten.

Then I got impingement symptoms in my other shoulder. This time I worked harder/longer at PT and the symptoms went away. MY surgeons and PT practitioners agree that I should not try to get back to the level of strength that I had before I developed the impingement syndromes because exerting a lot of pressure above chest level could cause a recurrence of impingement in the "good" shoulder that was not surgically repaired and there are several tender places in the smashed side that give twinges when I make some moves.

For me, avoiding excruciating pain and preserving range of motion is more important than being able to push as much weight around a gym as I used to do.

So, my final analyses: I think the surgically repaired shoulder would have been good as new after surgery PT though the process wasn't fun. Too bad I broke it up.

The shoulder that only got PT feels normal as long as I don't try to exercise it too strenuously. I'm 74 years old so I think I'm in the best condition compromise that makes sense for me. If I was 30 years old I would probably be willing to go through the pain/expense that MIGHT give me more athletic ability.

[mgm777]

Originally Posted by 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.

Chris -- I had many of the same symptoms you are experiencing now, back in 2009. I was 45 at the time. After several office visits and an MRI, my doctor ascertained that surgery was my best option. I had a shredded labrum and pitted humeral head. The surgery was initially intended to be a simple arthroscopy procedure, but once in, my Doc saw that the damage was more extensive than he expected. As a result, the procedure morphed into a partial joint replacement, complete with metal parts. Recovery was long. During my post-surgery PT, my shoulder froze up, likely because I didn't push hard enough during PT -- hard to know how hard to push -- hard enough to prevent scar tissue from forming, but not so hard as to undue the surgical fix. I had to go under anesthesia a second time so my Doc could rotate my arm within the shoulder joint, and break-up the scar tissue. The result was increased ROM. Now, my shoulder strength & flexibility(including ROM) is about 85% of normal. I figure that is as good as it is going to get, ever. Most importantly, I can once again sleep at night without waking up in the middle of the night to sharp shoulder pain. I can sleep on my side, again. Like others have said, I recommend you exhaust all non-surgical therapy modalities first. Then, if you do have the surgical procedure done, ensure you perform your post-surgical PT properly. Good luck.

[paredown]

Another sufferer here. Separated my right shoulder in a severe bike crash in my 20s, re-injured it about 10 years in another endo--docs thought it was all new damage since my right shoulder had 'healed' about 1" lower than my left (had to get suit jackets to match .

Flash forward a couple more years, and lots of physical stuff working on our house, including hanging drywall by myself, and the shoulder pretty much locked up.

Found the local orthopedist--a sports medicine guy--and he could see all the usual including small spurs etc, but really, really believes that surgery is last resort. He shares office space with a physio group.

Six session with the physio, interspersed with doing range of motion exercises on my own--and then continuing to do more exercises on my own. It is not 100%--but she actually managed to get it back into a more natural position (no longer lower on right). I have the occasional twinge and the occasional position where I feel like I have a loss of power, but it is pretty good.

Surgery is the last resort, IMO.

(Now I have to go back for tendonitis in my forearms...)

[GregL]

Sample size of one here, but today's data point: rode at lunch hour with some of my fast co-workers. Race training tempo ride in the wind, down in the drops for a good chunk of the time. Right (repaired) shoulder: zero pain, feels like new. Left (not yet repaired) shoulder: sore and stiff. If you get to the point of surgery, get it done well and work as hard as you can in rehab. At age 52, I figured that continuous shoulder pain was the new normal. Now I am looking forward to fixing the second shoulder and being pain-free.

Greg

[Corso]

Another Bankart repair here. But that was back in 1985---i’m sure things are different now. I had 5 dislocations-so time for surgery. I didn’t have a choice.

I was told if I played tennis, golf, bowling, basically anything that involved a throwing motion, I had a 1 in 10 chance of having it come out again.

So, I got into cycling! Years of mountain bike racing, crashes, road events, etc etc, and dirt bike riding, It’s never come out. I broke a collarbone in a cycling crash, but my shoulder was fine.

BUT…it’s never felt as strong as before the operation. maybe it’s in my head, but I’ve never thrown a “fastball” again.

[seanile]

^similar. Dislocated my left one 4 times, tore the labrum and bruised the head of the humerus on the fourth. Surgery was a meh result, functions though.
Right shoulder just recently came out a 4th time. Tore that labrum during the third dislocation 3yrs ago (happened two weeks after tearing my left labrum). Never got it repaired because that's my dominant shoulder so it was a little more stable. But now I have an appointment on the 21st to see how much more damage has been done during this fourth dislocation given that the labrum was already torn.
Root of my issue is hereditarily loose ligaments...which at least means i wont tear my rotator cuff and the ball slides volbtarily back into the socket.
Im 27 now, expecting to probably need a shoulder replacement by 40..

[merlinmurph]

Originally Posted by GregL

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.

Exactly what I would say. I dinged my right shoulder a number of times and the final blow was a mt bike crash.

I spent a lot of time researching surgeons. Ask around a lot. I didn't like the first surgeon I talked to, and did a lot of research. I think I got my surgeon's name from someone here, and I liked him a lot - did as good a job as could be done.

PT sucks. It hurts - a lot. Too bad. The progress is encouraging, though. Find a good PT place.

Honestly, the pain wasn't really bad. I had some percosets for a few days, but I gave them up. The worst part was trying to sleep because you can't get comfortable. I ended up sitting in a chair listening to podcasts every night. I probably went back to work too soon, and ended up being exhausted because of lack of sleep. Plan to take a week off.

Again, find a good surgeon.

Any questions, send a PM.
Good luck,
Murph

[Britishbane]

If it were my shoulder I'd try everything, and I mean everything, before going under the knife. For some reading if you're inclined: https://www.researchgate.net/profile...e/publications

In the meantime, sleep on the UNAFFECTED shoulder, but prop a pillow under the painful arm so you're not sleeping with the painful shoulder in an adducted position. This will put the shoulder in a more neutral, happy position.

[BobO]

Originally Posted by eippo1

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.

I'm going to disagree, mostly. There are certainly going to be costs to having surgery.

I had massive instability in my left shoulder as the result of a high school wrestling injury. It reached a point where I could not lift more that ten pounds without it popping out of joint. I had a surgical repair done when I was 18 that was only partially successful. By the time I was 37 the instability was worse than ever and I lived in constant pain. I visited a very talented surgeon who found that I most likely had a minor defect in the joint from birth that allowed the instability to progress rapidly. He performed a Modified Bristow procedure. That was ten years ago, the joint is still stronger than it ever was, and I live free from any shoulder pain that had dominated much of my life. There are positive outcomes to be had from surgical repairs of shoulders. Personally, I think the quality of the doctor is key. I chose the surgeon that the Arizona Cardinals and Diamonbacks use. I figure they've got quite a bit riding on their Ortho.

[weisan]

I am dealing with a labrum tear on my left shoulder currently.

Not sure what causes it

At first, went to see a Orthopedic specialist and took some X-ray, he didn't see anything wrong, suggested either give me a cortisone shot and then start on PT to strengthen that joint or go for a MRI to see what else is missing.

I turned down the shot and decided to schedule for a MRI, which I later canceled, thinking it's not going to show anything, just a waste of money, probably a mistake.

Looked around and found a PT close to my home, he helped me with my range of motion. We had three seasons and I realized it's not going to be a quick fix. So discussed with my PT and asked if I could continue working on my own at home for the time being. He agreed.

So I am doing a bunch of exercises to strengthen and stabilize that joint, also improve range of motion. So far, I can see daily improvement in those areas with the exception of the pain and the discomfort. It doesn't seem to help.
The pain is affecting my sleep. I tried to lean on the other side.

What else can I do to help with the pain and discomfort?

I have taken ibuprofen and used ice packs.

Not considering surgery at the moment.

Btw, nobody told me it's a labrum tear, not the specialist nor the PT. I found that out myself by noting all usual indicators that point to it:

Pain when doing overhead activities.
Grinding, popping, "sticking" in the shoulder socket.
Pain at night.
Decreased range of motion in the shoulder.
Loss of shoulder strength.

[.RJ]

Originally Posted by weisan

What else can I do to help with the pain and discomfort?

Go get the MRI and figure out whats going on - This *will not* heal itself and you are just guessing.

The one in my left shoulder required surgery - PT made it tolerable until it wasnt, so, we worked at it until it was time, then called for the knife - but having it stronger made the recovery easier I believe. If it does require surgery, no amount of PT will resolve it. The surgery sucks so I would not have it done unless absolutely necessary, but if it is, you wont be able to function otherwise.

My right side after a mountain bike yardstale just required PT and the same shoulder guy said it was 50/50, so I got lucky.

[reuben]

Originally Posted by .RJ

Go get the MRI and figure out whats going on - This *will not* heal itself and you are just guessing.

What he said. Get the MRI. It *might* heal itself, but right now you're just guessing, and more accurate data/diagnosis will speed the recovery.