rotator cuff surgery necessary? please help - Shoulder / Rotator Cuff Problems Message Board

Citycyclegal · 08-01-2009, 02:09 PM

I'm a 65, fit, active woman. Last Jan. I felt shoulder pain, when working with personal trainer. Thought it was tendinitis, rested, iced, etc. for a month. Went to ortho, sent me to PT for 10 weeks, finally got an MRI that indicated a small tear. He said live with the discomfort, or get surgery, but wasn't specific about the MRI other than that. At first I had trouble putting 1/2 gallon of milk in frig with R arm, bowls on shelf, but that has improved. My shoulder does ache, can have sharp pain down right arm to elbow depending on what I'm doing. I have not done any heavy lifting, ie. putting bike or kayak on racks, moving furniture, etc. so my activities have been very compromised. It has improved after PT but there is general discomfort, and my activities have been low key, no furniture refinishing, painting of walls etc. I have a 2nd opinion the middle of Sept. with a top shoulder doctor. I'll be better informed as to what decision to make then hopefully. I've read many posts about how tough the rehab is. I want to stay active and continue doing things so wonder how my quality of life will be with/without the surgery as I age. I also live alone, have a dog, and am wondering if I can manage post surgery on my own re: passive exercises that can be done with another person or with the useful arm. I'm not concerned about the day to day things, as I have done a lot of caregiving, and know how to adapt, etc. but want to be sure I can handle the home PT on my own. Any experiences you can share would be wonderful, thanks so much! * email address removed by hb-mod, moderator *

feelbad · 08-02-2009, 06:57 AM

were there any other significant findings that showed up in that MRI besides one small tear? was this in that very top tendon(supraspinatus)? thats just the most commonly torn one of all of them. this is what i did have a smaller tear in at one time but just did not know that for many years til it completely snapped on me. not every rotator surgery or the post op rehab is the same by any means. it all comes down to how bad the damage actually is and what needs to be fixed actually. the thing here is, once that tear occurs at all, if you stay as active as it sounds like you are, it WILL tear completely on you at some point along the way. it just progresses if it is not repaired when it is much smaller?

considering the fact that you are just very active and want to continue to be so? i would actually go get that tear fixed while it is still small and not wait til it completely snaps and the pain and loss of ROM are much more impactful. not to mention how simple it would be now vs later to just get it done. if i had had the MRI BEFORE that morning my supra snapped and actually saw what was going on, i would have gotten it sewen back up then. i had some pretty extensive damage in mine when i had my repairs done and the pain and rehab were much more painful and PT was also mandatory and lengthy. it would not be that way for what you only have going on right now.

at this point, if this is the only issue that needs to be fixed, it would be a pretty quick type of procedure that just involves more of an arthroscopic approach. if it completely tears on you at some point, trust me, it is much much more involved and painful at that point. this is of course my own opinion having gone thru more extensive repairs. but right now, its not too big of a deal, later, it would more than likely be. i would just get it done and over and get back to your life without the pain and losses you are feeling right now. simply catching a small tear now will keep it from progressing into the type of mess i had to deal with.

i wish you luck with this city. please keep me posted. FB

jennybyc · 08-02-2009, 06:28 PM

I've had both shoulders operated on although only had a rotator cuff repair along with it. Osteoarthritis can cause a lot of pain and difficulty with movement from OA in the acromioclavicular joint...the joint on top of the shoulder area where the collar bone and shoulder blade come together and often the pain comes from there, not the rotator cuff. the surgery to fix it is very simple in that they cut off about 1/2 inch of the end of the collar bone. this is done by scope. While in there, they can fix a torn rotator cuff. There are 4 tendons that make up the rotator cuff and as Marcia said, the most commonly torn is the supraspinatus. This can also be fixed through a scope so that all you end up with is 4-5 1/2 inch incisions. Day surgery. My surgeon does nothing but shoulders so it was fast and easy. He used both a nerve block and a light general and I needed no pain meds after surgery.

Rehab has changed drastically in the past few years and if your surgeon is up on the latest techniques, you'll know by his approach to rehab. They used to have you in PT the same week working the arm. No more. Now, it's rest the arm and let it heal for at least 3 months before even starting strengthening. You may have PT to keep the range of motion going so the exercises are all passive but no lifting or doing cords or anything else for 3 months to let the tendons heal. A rehab that begins too fast is the #1 cause of a re-tear. So let that guide you in choosing a doc.

I get a quarterly report from a major orthopedic hospital and their last issue just had all the new recommendations(no stress for 3 months) and why(healing) that I went through 5 years ago. And it went very well. Not much pain, and strength is better than before. And I had the AC joint excision along with it.

Any questions, please ask. I can't believe that people are still going through these huge open shoulder surgeries where a scope can do just about anything in the right hands. and then the people I saw in rehab pushing these newly attached tendons!!!! Met 1 guy who re-tore the same tendon 8 times and kept going back to the same doc who blamed the patient instead of his technique. Poor guy! Best to know in advance what is now the best procedure before you end up being butchered.

gentle hugs...............Jenny

jenj770 · 08-04-2009, 05:35 AM

Couldn't agree more about starting rehab too soon. I had arthroscopic rotator cuff surgery in March and started PT shortly thereafter. The PT guy kept subtly admonishing me for not pushing through the pain more. When my surgeon saw I was regressing rather than progressing he stopped all PT, which helped. But it is now 5 months post surgery and I still have a problem with that arm "catching" on certain movement. I recently tried light weights, which my surgeon suggested, but that only exacerbated the problem. The surgery was partially successful as I couldn't use that arm at all prior to it, but I do wonder if I'll ever move into fuller recovery.

Jen

feelbad · 08-04-2009, 08:14 AM

i would imagine considering that long of a wait before even starting hands on would create a much higher incidence of the basic frozen shoulder wouldn't it? i know with mine, i used that CPM machine which ONLY moves that joint without involving any of the tendons or muscle for about two and a half weeks? it was not til about a month post op that i went thru the standard hands on and that was very subtle at the beginning and just progressed upon MY timetable and not an actual set standard type of thing? that really is the key here, whatever you had done and YOUR actual healing course considered too. i had my myofascial therepist doing my rehab and he was also helping by slipping in my usual myo release therepy too,that helped tons with the muscle tendon tightening crap.everything went really smooth with my shoulder. i am back to full ROM on that side too now and have been for quite some time.

while i do agree there HAS to be that down time with the key excecises to keep that joint moving(the pendulum stuff?) i just cannot fathom why three full months would be considered just based upon how quickly that shoulder joint can freeze up without movement for that long. once that joint starts to encapsulate and build those nasty adhesions, well its a tough one to rehab from. what occurs within that joint jenny? thats just such a very long time with no movement ya know? it seems like that wait could actually 'create" more problems than it would solve, to me anyways. i just remember vividly when i had reached that degree mark my surgeon had set for me and that chair got picked up? after that, i really started to feel everything tighten back up(with more pain back again too) and some ROM i had gained i just could not 'do" anymore til i was in the hands on.

i do think the way my surgeon did my post op course really went rather well considering. i never went 'backwards" at all, only kept progressing. it really IS interesting how certain surgeons will do things. my ortho is one of the best here in MN. tho he did my two knee surgeries, his main specialty which i did not actually know til my rotator tore is shoulders. i am lucky to even have this particular ortho who actually understands RSD and chronic pain too. i AM blessed there just with that since most are unfortunetly for us, truely clueless on both things.

that three month thing tho, this is the first i have even heard about that long of a wait before even beginning to rehab that stuff. how much actual joint excercises does this reqire while that healing takes place? i would think that THAT part would have to be almost mandatory with that? interesting. FB