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Anyone here have surgery for a torn rotator cuff?

va_deb

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Mr. CommunityDeb, who loves nothing more than being outside and doing things like skiing, golfing, and biking, got confirmation following a recent MRI that he will need surgery and 6 months of rehab. Needless to say, he's not a happy camper.

After the follow-up to review the MRI he went to his primary care doc to talk about a different issue, and show him the scans and discuss what the surgeon said. He was hoping that his GP might tell him that maybe it isn't as bad and he can wait. His GP actually thinks he should do the surgery sooner rather than later. Not what he was hoping to hear.

He wants to get in an entire ski season for a host of reasons -- especially since it is likely his last season before he makes a major, intense limited free time type of career change.

Any voices of experience out there? If you had surgery this time of year, how long did it take before you were cleared to ski?

If you put off the surgery to fit in one more ski season, what did you do to help ease the pain? And did you ski more conservatively than usual? (Please lie about that last part even if you didn't.) Although he prefers blacks and double blacks, last season he said wanted to spend a little more time with me on the blues -- but this isn't what either of us had in mind.

Thanks in advance for any insights, wisdom and encouragement!
 

ScotsSkier

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Yes, I had rotator cuff surgery 8 years ago. I had the op in June and I was skiing (and racing) at the start of the season in mid november. Iirc I was still doing physio then as well. The physio was hard work to get full ROM back. When they did the cuff repair they also found a couple of detached tendons they had to repair as well. They actually caused me more pain than the RC. But, don't put it off. Shoulder repairs can be tricky,you don't want to make it worse by waiting
 

Jenny

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Don't know if this is relevant, but DH had a partially torn bicep tendon and had surgery in October and was skiing in January. The tendon wasn't repaired, but cut the rest of the way and then embedded into a hole in the bone for a new attachment point. He also had some arthritis removed from the end of his collar bone (I think) at that same time.
 

Ron

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Had partial cuff repair and a full open. What I can tell you is to seek out the most experienced surgeon for this. Shoulders are very touchy in that they are really a floating joint so the repair has to be done precisely. Where are you located?
 

Lorenzzo

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I've had significant issues with a rotator cuff. I agree if surgery is the correct approach, the sooner the better. That said, with many or even most rc tears surgery may not bet the best option. How extensively are the fibers torn? To what extent is bursitis involved at this point? I assume microsurgery would be performed, is that correct? Why is surgery being recommended? How versed is the GP with diagnosis and treatment in this area? I'm not sure I'd consider his opinion to be validation.

I agree with @Ron , there are many OP-s involved in diagnosing and performing surgery for this but not all that many I would trust, maybe fewer than 1 in 5. Some surgeries combined with rehab can be magical, others make the condition no better than plain rehab and many times worse. Your husband might consider beginning with a really top physical therapist with significant experience in this area and consulting with them. Even if they can't provide a valid opinion on what's going on and what approach might be best they may know which OP-s can be trusted. Another approach would be referrals from college or even hs trainers. This is one area where surgery is often recommended but in fact is ill-advised.
 

Andy Mink

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Paging @Andy Mink to the white courtesy phone.
Ahhh, my favorite subject! I have now had both shoulders done, one about 5 years ago and one about 12 weeks ago. Same doctor, but the first one had more damage with no trauma, just worn out. I also had the bicep tendon "released". I did PT (paid torture) for months on that one. Honestly, it was a new scale of pain. The first 6 weeks are the therapist moving your arm, working on ROM. Did something ever hurt so much that you giggle instead of cry? You are in a sling and not supposed to move it at all. The reason is because the repair is very delicate. It's just a couple of threads holding the tendon to the bone with a mattress stitch. If you move it too soon, the tendon can pull out before it reattaches to the bone. Second 6 weeks is light stretching, getting back more of the ROM. After that is the strengthening process. It was over a year before I stopped thinking about doing anything with that arm. The shoulder, however, is now great with full ROM and no pain save an occasional twinge.

The shoulder I just had done was bothering me some before I put the exclamation point on it by crashing skiing. I thought it was going to be a ton of damage but it wasn't as bad as the first one, though there was some calcification in there that had to be removed too. Honestly, the second one was a breeze except for the annoyance of a sling for 6 weeks. It was almost painless which made it hard to be a good patient. Where it did hurt was driving long distances. Just hanging there on the wheel with very little holding the joint in place it would get achy. I had full, or close, ROM within a week or so, so much so that I only went to PT 3 or 4 times in the first 11 weeks. It is doing great now with very little pain and I have started the strengthening part of the process. I've been antelope hunting and that did make it a bit sore but nothing bad.

As for when to get it done, there is never a good time. Make an appointment and do it. Get that first 12 weeks out of the way before the good part of ski season. Talk to your doc and therapist about your activities and what you can and can't do and if you HAVE to go 6 months for rehab before doing stuff. You will definitely have to go 12 weeks, but once you're strengthening you can do a lot more. They'll probably tell you to not ski but they may say it's ok after X time. Follow their directions. Get of the loopy pills as soon as possible. That stuff will mess you up! If it's your dominant hand, prepare to become ambidextrous. For everything. (The bathroom parts might be the biggest challenge of the whole thing!)

Good luck!
 
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va_deb

va_deb

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Had partial cuff repair and a full open. What I can tell you is to seek out the most experienced surgeon for this. Shoulders are very touchy in that they are really a floating joint so the repair has to be done precisely. Where are you located?

Great point. You want someone who does this type of surgery all the time. We're in Northern Virginia, outside DC.
 
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va_deb

va_deb

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@Lorenzzo @Andy Mink and everyone -- thanks for all the helpful insights. He is going to try PT. Will ask about some of the other things you mentioned a well. Valuable info, as always.

Hope y'all are healing up nicely!
 

Ron

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not sure if you are open to travel but steadman has some excellent surgeons as does Andrews institute and cleveland clinic. i know there are some top-notch surgeons in the pack city area as well.
 

jmills115

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I had my right shoulder done (full tear in rotator cuff) in January of 2013. My surgeon (Andrew Cooper in SLC) and PT were both worried as I was so far ahead of schedule in my recovery they were sure I was going to injure it from using it too soon. At 6 weeks I felt like I could do almost everything as my range of motion was where they expected it to be at 12 weeks but I listened to them and took it easy. I believe it was at 3 months I was cleared to get back to regular life.
As good as I felt at three months I also remembered the hell of the first 2 weeks and would not want to go through it again by pushing it too hard too soon and don't think I would have been comfortable on the mountain anytime before 5 months
I started swinging a golf club at around 4 months but usually don't crash as hard on the course as I could on a mountain.
Prior to surgery I had another doctor try to push me to PRP while trying to rehab it at PT. Luckily my PT was convinced I had a tear and sent me to Cooper who told me the only way to be pain free was with surgery.
 
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jmills115

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not sure if you are open to travel but steadman has some excellent surgeons as does Andrews institute and cleveland clinic. i know there are some top-notch surgeons in the pack city area as well.
Eric Heiden is in PC. My doc, Andrew Cooper is at Salt Lake regional and has treated many olympians and old fat bald guys like me.
 
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Andy Mink

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If anyone needs shoulder work in the Reno area, I'd highly recommend Tom Fyda. According to my PT, he is bad for business as his repairs just keep getting better and better with less initial PT.
 

John Webb

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@Lorenzzo @Andy Mink and everyone -- thanks for all the helpful insights. He is going to try PT. Will ask about some of the other things you mentioned a well. Valuable info, as always.

Hope y'all are healing up nicely!
Pick a good PT clinic. My better half Trish had RC surgery 8 years ago. She went to this supposedly great sports clinic in Silver Spring MD for several PT visits
and thought the PT person did not know what she was doing. Trish consulted with the surgeon who totally agreed. He said No, No, No, get out of there, I'm not going to let them wreck my surgery. She visited the PT wing in the surgeons office and got a 60 yr old gal looking like grandma. Grandma turned out to be the best, only did shoulders and healing went perfectly. Others we knew in the Fagowees ski club did not do PT(pain & Torture) and years later their shoulders still are not well.
 

John Webb

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My right shoulder is off and on a bit sore with a slightly lower ROM from a fall 20 years ago at Snowbird. So far it's not bothered me enough to see a doctor
or get PT. Stays about the same. Of course, this is not advice.
 

L&AirC

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I know you said this is for you husband so I wrote it more to him than to you only for the ease of writing it.

I had my right shoulder done in 2010. I was scheduled to have a different surgery on the shoulder (SAD) to shave some bone and remove the bursa sac. MRI showed the RTC was intact. 30 minute surgery and a week in a sling. A month prior to the surgery I feel and caused a 90% tear of the same shoulder. That turned the surgery to 3.5 hours and 6 weeks in a sling. PT (not to mention sleeping if you can't sleep on your back) can be difficult and painful. Both are also crucial to a full recovery which takes (providing you are over 40 and not a WC athlete) about 18 months.

Often the claim is 9 months but that is to get you back within normal limits. I took me 18 months to not feel pain when I did certain things. I had other issues than just the RC to deal with as a previous injury that I never addressed and babied for over a decade and is what caused all the degeneration and the need for the SAD surgery to start with. Maybe the right answer is to split the difference and say a year. What they tell you the rehab is for duration is usually how long the insurance says it should take. Well after the PT ends you find yourself still doing it on your own because the ROM will be within normal limits but not the same as the other side and not as strong as the other side. You'll notice the difference and if you stick with it on your own, you can get it right. I also had the challenge of not getting it back to how it was prior to surgery, but getting it to how it should have been anyway.

I would point out that though I tore the RC a month prior to surgery, and it made things worse, I was still skiing and setting gates. The staff agreed I shouldn't carry a gate bag so the HS kids did that. I couldn't pole plant on that side either. I did ski more conservatively and probably shouldn't have been skiing at all, but I'm an idiot and addicted to this sport and have had already been dealing with the pain in my shoulder for longer than a decade so though it hurt more, it was something I was used to. I couldn't hold a coffee cup in my right hand without it shaking. When it came to strength moves, was using my left arm. Same with reaching for things. I couldn't reach for the alarm in the morning without supporting my right arm with my left one. In retrospect, all I did was make the surgeon's job harder. Since they didn't do a second MRI, it might be that my shoulder was only 60% torn and all my skiing brought it to 90%. Who knows?

When I had mine done, a friend from work shortly after had his done. Lots of commiserating about the process. I found out a couple months ago he was going in to have the other shoulder done and he would be back to work in less than a week. I had been out several weeks as was he the first time. He also said he'd be at PT the next day and all other sorts of unbelievable claims.

It ends up there is a new procedure that for the life of me I can't remember the name, lapsomethingoranother. The key is that this summer he was already golfing when in the traditional procedure, he would still be in a sling! It was something like a month after the surgery. I'll find out the name and post it here. He spoke so highly about it that it almost made me want to tear my other one (no not really) and he's doing fine with no complaints.

Like has been mentioned, you need to have a surgeon that is good at the procedure so if there isn't a surgeon in your area that can do the lapthing, then either travel or go for the traditional one. The shoulder is way too important to your life to get a hack job. You also discover how connected your legs are to your shoulder. It's eye opening. Remember; if you get out of balance, the hands move. The first time I stumbled (two days after surgery), both hands shot forward to break my fall and the pain was so intense, I had to go sit down for a bit. I didn't fall, just miss-stepped going upstairs and the natural reaction is to throw your hands forward. Took my breath away. I still hold the hand rail on stairs because of that.

If it is going to be the traditional one, you need to prepare ahead of time. Get a comfy recliner to sleep in. Trust me, you can't get comfortable in a bed and drugs aside, it was the best sleep I had in years. I still sleep in one now and again and it is the only time I sleep through the night without waking up for something (I also have a bad back and wife with the reflexes of a ninja when it she hears snoring).

Some of the things I did was to get an electric razor and electric toothbrush. I'm no DaVinci and found out the hard way from a previous injury when I couldn't use my right hand for a couple weeks, how right handed I was. I almost lost an eye trying to brush my teeth! No way was I taking a razor to my neck with my left hand!!

I also finally bought an adult car (automatic transmission) and gave the Wrangler (manual) to my son. Shifting had become impossible for me anyway and shifting left handed is quite tricky on American vehicles.

I would recommend putting your arm in a sling for the day and see what the interruptions for you are and address them ahead of time. Taking a shower and getting dressed all become quite the chore and help is much appreciated. Simple things like unscrewing a shampoo cap have to be thought out.

And though I thought it was funny my wife did not when from the bathroom I yelled "I'm done!"

Hope all goes well,
Ken
 

Varmintmist

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As for when to get it done, there is never a good time. Make an appointment and do it. Get that first 12 weeks out of the way before the good part of ski season. Talk to your doc and therapist about your activities and what you can and can't do and if you HAVE to go 6 months for rehab before doing stuff. You will definitely have to go 12 weeks, but once you're strengthening you can do a lot more. They'll probably tell you to not ski but they may say it's ok after X time. Follow their directions. Get of the loopy pills as soon as possible. That stuff will mess you up! If it's your dominant hand, prepare to become ambidextrous. For everything. (The bathroom parts might be the biggest challenge of the whole thing!)

Good luck!
I snapped my upper arm and while it was the right humerus, it wasnt particularly funny. I was in a brace and a sling for 12 weeks, then the rehab started which is the same as rotator cuff rehab because the shoulder locks up in the same manner. The rehab hurts. It hurts a lot. Suck it up and go for it you will get out faster.
I came home and with the kids around lamented that I had to learn to wipe lefty. They laughed, then I said if I cant we will find out who really wants to be in the will.
 

L&AirC

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Deb,
I talked to my fried on the correct name. He said he doesn't remember it having a special name but was referred to as a Rotator Cuff Repair With a Patch. They do the same repair as previous, but add a patch to it. I guess it reinforces it and is why he was out of a sling in 3 days. Also I had exaggerated on his return to golfing. It was three months after the surgery and not one. Still an amazing feet.

He added that he has golfed all summer and though was concerned going into it, has had no issues and here it is 8 months later and has nothing but positive things to say about the process.

The patch can be from different things; cadaver etc. His is Bovine :eek:

Ken
 

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