Rotator Cuff Surgery

[The70RT]

Some here have heard that I had an accident at work and dislocated my shoulder Jan 8th, now the MRI results are back....rotator cuff tear  I can't believe it takes 6 months to heal....really?? I feel alot better since the injury and can move my arm over my head and move it almost anyhow I need to but still have some pain. I just don't see how a partial tear can keep me down for 6 months. I guess I could opt out of surgery since my doctor said it was up to me  (Feb 20th) but if it gets worse It could be a stupid mistake. I am probably officially screwed now since I was pretty much a shoe-in for my bosses job when he retires before too long. The big raise was gonna get me back on track from the last few years of barely making it. I did do a search on here and some had it done and are still on here.....some vanished and haven't been back to talk about it on here so not knowing what to expect.  I know I am really in the dumps right now and don't know how many more curve balls I can defend off....  ..... Thanks for listening 

[Dans 68]

You're welcome.    And by the way, venting is very therapeutic. 

Dan

[FlatbackFanatic]

I work with a guy that had that done in December, about 2 weeks ago he had the sling off, the Dr. told him no lifting, but at least he can use it a little , he can drive etc.
He is still off of work. He said its feeling better. His was a real bad tear. So I guess on how bad the tear is will determine how long you'll be off work. Hope everything works out.

[green69rt]

My wife had a similar surgery and it took about 6 months for "full" recovery.   No pain after a week or so, but a long time to get full range of motion and full strength back.    We ended up hiring a gym trainer that specialized in old-people problems to get the last little bit back.    The therapist that the doctor recommended, got her to about 80% then said "that's as good as it's going to get!"   We thought that was pretty piss poor so went the trainer route.

[Mike DC]

   
I messed up my RC two months ago.  No range-of-motion problems(?) but a lot of joint/muscle pain.  Been keeping that arm totally out of service for heavy work ever since.  It's gotten a lot better, hardly hurts at all anymore.  But I'm still not gonna put it under any load for at least another month, maybe two.  


I read that MRIs can detect RC tears, but finding a tear doesn't always correlate very well with how much it hurts or how badly it needs surgery.  Just going strictly by the word of the MRI might send you into surgery for something that would have recovered on its own in some cases.  I came away from some reading with the feeling that RCs aren't a difficult thing to diagnose, but it seems to be difficult to know the best way to treat it sometimes.  

[68X426]

My brother had this surgery, and it was 6 months to full recovery.  Says he felt 60% good by one month, then lots of physical therapy to get to 100%.

[The70RT]

The doctor said it was up to me if I wanted to get it done or not but what do I know about it. He said if it was him he would have it done if that's any consolation. The nurse was saying that they won't know exactly the condition of the tear till they get in there. I just hope I don't have a doctor thinking since he's in there fix something that don't really need fixed. I can move my shoulder ok but with some pain that's why 6 months sounds out of place but I guess from what you guys are saying it is that way. It is what it is I guess......thanks guys.

[Dino]

Did they mention which muscle has the tear?  I had one in my supraspinatus but it was small enough that it could be treated with PT. 

[The70RT]

I'm sure he did Dino, I really can't remember now because I was so frustrated. He said he was doing a swivel lock procedure, just don't like the idea of anchors being screwed in my shoulder. I was hoping to have a speedy recovery but I guess it's unheard of.

[Dino]

I have seen the swivel lock and other anchors when the supraspinatus tendon is released from the bone.  If the tendon is off the bone then it cannot heal so they have to compress it down.  If this is the case there are very few options I'm afraid.  The supraspinatus is the muscle on top of your shoulder that originates at the top of your shoulder blade, close to the spine and inserts on the humeral head, your upper arm bone.  This muscle is mostly responsible for lifting your arm away from your side.  It also helps with other lifting motions but that's its main one.  Is this where you have the most pain?   

The problem here is not just the one muscle but now you have three others pulling the head of the humerus while one of four is not and that can cause a whole host of issues later on.  You need an antagonist for your agonist.  Look up muscle pictures, or better yet drawings, of the rotator cuff so you can see how the muscle fibers run.  By looking at those you can imagine how they contract as they go in the direction of the fibers.  There are four muscles at work here:  the supraspinatus on top which abducts the arm, the teres minor that adducts the arm (brings it back to the body) and this also rotates your arm out.  The subscapularis you cannot see or feel but it rotates the arm back in and then there's the infraspinatus which also rotates the arm out.  They all compliment each other and keep the humerus snug in the glenoid cavity of the scapula. 

With any case like this, get a second opinion.  A good surgeon will agree with that plan. 

[Ram07]

Wish I could offer some help, but got nothin'...but, why would it affect a potential promotion at work? If you don't mind me asking?

Feel better soon.

although I would get the second opinion, and if the 2nd Dr. agrees...well...would have the operation...

[tsmithae]

I agree, a second opinion is best. I would say have it done,  It may take a while to get back to 100% but you should be able to return to a relatively normal life within a month or 2.  My stepdad got his rotator cuff repaired and never has issues with it anymore.   

[The70RT]

Wow thanks Dino, right now most of my pain is when I sleep and is pretty much on top towards the outer end of my shoulder. I can move it pretty much where ever I want. When I dislocated my shoulder it went up against my ribcage. At first I couldn't raise my arm but now I can. I also had numbness on top of my forearm which has mostly subsided. That's why I was thinking I may not need surgery. As far as the job thing goes if my boss leaves before I get back I could see myself not getting the job. No light duty, I have to be able to lift and carry 50-75lbs and push or pull like 250-300lbs. I have been there since 1993 and have a good relationship with the higher up so maybe I am just being pessimistic like I always am. I am having a second opinion, I just went to the Dr. and signed a release form so a copy of my medical records can be faxed to a different place. I also had to go to the hospital to get a CD of my MRI and x rays and dropped them off to them this morning. They are gonna get me in before the 20th so that will at least ease my mind somewhat.

[Dino]

Wow thanks Dino, right now most of my pain is when I sleep and is pretty much on top towards the outer end of my shoulder. I can move it pretty much where ever I want. When I dislocated my shoulder it went up against my ribcage. At first I couldn't raise my arm but now I can. I also had numbness on top of my forearm which has mostly subsided. That's why I was thinking I may not need surgery. As far as the job thing goes if my boss leaves before I get back I could see myself not getting the job. No light duty, I have to be able to lift and carry 50-75lbs and push or pull like 250-300lbs. I have been there since 1993 and have a good relationship with the higher up so maybe I am just being pessimistic like I always am. I am having a second opinion, I just went to the Dr. and signed a release form so a copy of my medical records can be faxed to a different place. I also had to go to the hospital to get a CD of my MRI and x rays and dropped them off to them this morning. They are gonna get me in before the 20th so that will at least ease my mind somewhat.

That's pretty much what I figured.  When the tendon got pulled of the humerus, the antagonist pulls the shoulder toward the ribs.  Your other muscles will take over some of the action needed so you're usually better off awake than asleep when control goes out the window. 

That said, you have to have that muscle at the very least holding the humerus in place, even if the muscle itself is not fully function, it has to play the role of fixator. 

You may have no other recourse than the surgery but do get that second opinion.  The good news is that they can do it arthroscopically so no major open surgery and the recovery rate is pretty good.

You will need physical therapy and you will need to slowly get everything back in shape, there is no rushing these things.  Best you can do is have a whole nutritional and balanced diet and have plenty exercise.

The numbness would be of concern if it did not fade.  In all likelihood you got some minor nerve damage when this happened and nerves do take their sweet time to heal.  However when there is improvement this usually takes care of itself.

Go easy on the pain relievers, you only have one liver.

[The70RT]

Wow thanks Dino, right now most of my pain is when I sleep and is pretty much on top towards the outer end of my shoulder. I can move it pretty much where ever I want. When I dislocated my shoulder it went up against my ribcage. At first I couldn't raise my arm but now I can. I also had numbness on top of my forearm which has mostly subsided. That's why I was thinking I may not need surgery. As far as the job thing goes if my boss leaves before I get back I could see myself not getting the job. No light duty, I have to be able to lift and carry 50-75lbs and push or pull like 250-300lbs. I have been there since 1993 and have a good relationship with the higher up so maybe I am just being pessimistic like I always am. I am having a second opinion, I just went to the Dr. and signed a release form so a copy of my medical records can be faxed to a different place. I also had to go to the hospital to get a CD of my MRI and x rays and dropped them off to them this morning. They are gonna get me in before the 20th so that will at least ease my mind somewhat.

That's pretty much what I figured.  When the tendon got pulled of the humerus, the antagonist pulls the shoulder toward the ribs.  Your other muscles will take over some of the action needed so you're usually better off awake than asleep when control goes out the window. 

That said, you have to have that muscle at the very least holding the humerus in place, even if the muscle itself is not fully function, it has to play the role of fixator. 

You may have no other recourse than the surgery but do get that second opinion.  The good news is that they can do it arthroscopically so no major open surgery and the recovery rate is pretty good.

You will need physical therapy and you will need to slowly get everything back in shape, there is no rushing these things.  Best you can do is have a whole nutritional and balanced diet and have plenty exercise.

The numbness would be of concern if it did not fade.  In all likelihood you got some minor nerve damage when this happened and nerves do take their sweet time to heal.  However when there is improvement this usually takes care of itself.

Go easy on the pain relievers, you only have one liver.

Thanks, I had a two weeks supply of meds I got on Jan 8th and still have some. I know about the liver thing since I was tiring to find out why my liver enzymes were elevated awhile back. I cant take any Tylenol or Advil type meds. Was doing some blood work on that then caught the H1N1 over Christmas then this happened. I hardly ever drink or take any meds so not sure what's up with that. I never take any meds because I never had any other issues. I kinda put that on the back burner since everything else is going on.

[Dino]

Wow thanks Dino, right now most of my pain is when I sleep and is pretty much on top towards the outer end of my shoulder. I can move it pretty much where ever I want. When I dislocated my shoulder it went up against my ribcage. At first I couldn't raise my arm but now I can. I also had numbness on top of my forearm which has mostly subsided. That's why I was thinking I may not need surgery. As far as the job thing goes if my boss leaves before I get back I could see myself not getting the job. No light duty, I have to be able to lift and carry 50-75lbs and push or pull like 250-300lbs. I have been there since 1993 and have a good relationship with the higher up so maybe I am just being pessimistic like I always am. I am having a second opinion, I just went to the Dr. and signed a release form so a copy of my medical records can be faxed to a different place. I also had to go to the hospital to get a CD of my MRI and x rays and dropped them off to them this morning. They are gonna get me in before the 20th so that will at least ease my mind somewhat.

That's pretty much what I figured.  When the tendon got pulled of the humerus, the antagonist pulls the shoulder toward the ribs.  Your other muscles will take over some of the action needed so you're usually better off awake than asleep when control goes out the window. 

That said, you have to have that muscle at the very least holding the humerus in place, even if the muscle itself is not fully function, it has to play the role of fixator. 

You may have no other recourse than the surgery but do get that second opinion.  The good news is that they can do it arthroscopically so no major open surgery and the recovery rate is pretty good.

You will need physical therapy and you will need to slowly get everything back in shape, there is no rushing these things.  Best you can do is have a whole nutritional and balanced diet and have plenty exercise.

The numbness would be of concern if it did not fade.  In all likelihood you got some minor nerve damage when this happened and nerves do take their sweet time to heal.  However when there is improvement this usually takes care of itself.

Go easy on the pain relievers, you only have one liver.

Thanks, I had a two weeks supply of meds I got on Jan 8th and still have some. I know about the liver thing since I was tiring to find out why my liver enzymes were elevated awhile back. I cant take any Tylenol or Advil type meds. Was doing some blood work on that then caught the H1N1 over Christmas then this happened. I hardly ever drink or take any meds so not sure what's up with that. I never take any meds because I never had any other issues. I kinda put that on the back burner since everything else is going on.

I've seen many not make it from H1N1 and it's mutations.  Scary stuff man!

You are absolutely correct in setting these priorities but if you have an allergy towards acetaminophen then it should be checked closely when you can.  Do you know of any aspirin or aleve, or ibuprofen intolerances?  Those have different active ingredients and may be an alternative.

In any case, it's not that uncommon and frankly, if you can take e few antibiotics when you really need them then at you least you won't be one of those people who goes into liver failure.

As a means of natural pain killers, nothing beats good nutrition and exercise.  A physical therapist can bridge the worst part by adding deep tissue relief with heat, radiation or whatever technique they use.  Feels priceless.  I did all of the above when I had a tear and I was able to recover 100%.

All the best to you, don't let it get you down and keep rehabbing that shoulder.  As a general rule we tell people that go into a variety of surgeries that most rehab takes one year.  You will however be as good as new as early as 2-3 months.  The people that recover in a week are not the norm.

Lastly, if you are 'almost' there you will be at a higher risk of re-injury as the confidence usually comes back faster than the full healing so be aware of that and tell yourself to not push your luck.

Also feel free to pm me if you have questions or concerns as well.

[The70RT]

Thanks again Dino, 2-3 months sounds good. I was reading up and some were saying 6 hopefully not the case for me. As I was saying my doctor acted surprised with all my mobility so soon so hopefully I'm one of the faster healers. I eat lots of fruits and veggies and am trying to stay healthy. I walked 3-7 miles a day when I was at work before all this. I am staying away from acetaminophen.

[Dino]

Thanks again Dino, 2-3 months sounds good. I was reading up and some were saying 6 hopefully not the case for me. As I was saying my doctor acted surprised with all my mobility so soon so hopefully I'm one of the faster healers. I eat lots of fruits and veggies and am trying to stay healthy. I walked 3-7 miles a day when I was at work before all this. I am staying away from acetaminophen.

You'll be just fine.      

[The70RT]

Seen a different doctor, he says MRI doesn't show anything that warrants surgery. He says since I have regained strength and mobility, physical therapy will tell the tale. Keeping my fingers crossed 

[tsmithae]

 

Here's hoping!

[Dino]

Seen a different doctor, he says MRI doesn't show anything that warrants surgery. He says since I have regained strength and mobility, physical therapy will tell the tale. Keeping my fingers crossed  

I was hoping for this.  

Seeing as you are progressing already, you will have the option to take several weeks of physical therapy in one go or split it up to have some left on your insurance for the summer and fall.  I find that once you are near full capacity, it is good to have PT left to take, as most of us usually get a little setback because we were not yet fully healed and due to low or no pain we push ourselves beyond the muscle's capability.  

Don't forget, this muscle is an abducter: it helps to move your arm away from your body.  It has often been said that the supraspinatus is responsible for the initial abduction, but there are studies that refute that claim.  Regardless, your deltoid will be working a little harder for a while and you may experience some discomfort at the origin.  This is normal and will resolve itself over time.  I want you to know this so you don't freak out and think the tear is back because the origin of the pain will be real close to it and may be hard to distinguish.  

Some change may last, scar tissue will form and it's a throw of the dice on how well that will resolve.  I can still get the occasional twitch or sharp pain, but it's nothing you can't handle.

Now go and get pampered by PT!  

[The70RT]

Thanks again Dirk 

[Silver R/T]

I don't trust docs, especially family docs-they're not very smart when it comes to anything other than diagnosing a flu/ear infection (something real simple)
My doc diagnosed me with stomach ulcer, after getting colonoscopy/endoscopy done there was NO ulcer to be found. I came back to him and he told me how come I'm not taking medicine he prescribed (for an ulcer).
To make story short I'm seeing a specialist about this and no longer will go back to that family doc.
In your case I would see a specialist and get some opinions. Doctors might be real pushy to talk you into surgery as it's extra thousands of dollars for them-this is how they make that huge paycheck, with your money.

[PlainfieldCharger]

I have seen the swivel lock and other anchors when the supraspinatus tendon is released from the bone.  If the tendon is off the bone then it cannot heal so they have to compress it down.  If this is the case there are very few options I'm afraid.  The supraspinatus is the muscle on top of your shoulder that originates at the top of your shoulder blade, close to the spine and inserts on the humeral head, your upper arm bone.  This muscle is mostly responsible for lifting your arm away from your side.  It also helps with other lifting motions but that's its main one.  Is this where you have the most pain?   

The problem here is not just the one muscle but now you have three others pulling the head of the humerus while one of four is not and that can cause a whole host of issues later on.  You need an antagonist for your agonist.  Look up muscle pictures, or better yet drawings, of the rotator cuff so you can see how the muscle fibers run.  By looking at those you can imagine how they contract as they go in the direction of the fibers.  There are four muscles at work here:  the supraspinatus on top which abducts the arm, the teres minor that adducts the arm (brings it back to the body) and this also rotates your arm out.  The subscapularis you cannot see or feel but it rotates the arm back in and then there's the infraspinatus which also rotates the arm out.  They all compliment each other and keep the humerus snug in the glenoid cavity of the scapula. 

With any case like this, get a second opinion.  A good surgeon will agree with that plan. 

I see a screen name change to "Doctor Dino" 

[The70RT]

I don't trust docs, especially family docs-they're not very smart when it comes to anything other than diagnosing a flu/ear infection (something real simple)
My doc diagnosed me with stomach ulcer, after getting colonoscopy/endoscopy done there was NO ulcer to be found. I came back to him and he told me how come I'm not taking medicine he prescribed (for an ulcer).
To make story short I'm seeing a specialist about this and no longer will go back to that family doc.
In your case I would see a specialist and get some opinions. Doctors might be real pushy to talk you into surgery as it's extra thousands of dollars for them-this is how they make that huge paycheck, with your money.

The doctors I seen were orthopedic doctors/surgeons.