Results 1 to 22 of 22
  1. #1
    Join Date
    Jan 2007
    Location
    CT
    Posts
    1,405

    Second time Rotator Cuff

    Just got the phone call from my bro that he tore up his shoulder again. Last time it was Labrum, Rotator Cuff, and Biceps tendon. This time, I haven't had a chance to get all the details, but I'm guessing its at least labrum and rotator cuff again since he mentioned 6 weeks in a sling and 6 months recovery. Anyone do this twice? His ROM was extremely shitty after the first one, and his strength suffered as well. Last night at the gym he managed to crank out 55 pullups (10-9-8-7-6-5-4-3-2-1), but he can't lift things overhead.

    Will his Strength and ROM decrease after this one? Is that dependent on the surgery and PT? Not sure if he's scheduled anything yet or if he's gonna try to wait until later in the summer so that he can do his recovery during "shoulder season."

    Fuck, totally bumming right now as we were signed up to be teammates in an Ultimate league this summer and I'm rebuilding his mountain bike right now, so I was looking forward to hanging out with him this summer, and now he'll probably be cooped up in the house.

    What can I expect to see as far as his PT goes? I'm actually starting PT school in a few weeks, but the first semester is all Anatomy and Phys again, no Musculoskeletal diagnoses and treatment for a few semesters (at least according to the schedule).
    It's not tragic to die doing what you love.
    http://www.savemagicvermont.com/
    http://www.flickr.com/pearljam09/
    http://pearljam09.blogspot.com/
    Hats made by me! use Coupon Code MAGGOT for 15% off. Pro deals available, just ask.

  2. #2
    Join Date
    Mar 2008
    Posts
    230
    Sorry to hear about your brother. Rotator cuff surgery is a tough recovery once, let alone twice. The surgery is technically more difficult the second time around, and his surgeon will have a very specific recovery path in mind, so I would adhere to that carefully. The outcome is generally dependent on 1) repair healing, and 2) avoiding stiffness in the shoulder. Obviously, those two things are somewhat at odds with each other - hence, it's a balance between immobilizing the shoulder long enough to heal to the point that some motion is doable without ruining the repair, but not so long that it's entirely healed but then the shoulder's too stiff to move. Therefore, initially there is usually no real PT for range of motion, and after a period of time (dictated by your surgeon) there is a subsequent focus on passive range of motion. Active range of motion comes last so that the rotator cuff doesn't actually fire (and therefore stress the repair) until the repair is healed enough to withstand it.

    Best of luck to your brother...
    Originally Posted by jm2e:
    To be a JONG is no curse in these unfortunate times. 'Tis better that than to be alone.

  3. #3
    Join Date
    Jan 2007
    Location
    CT
    Posts
    1,405
    Update:

    It is just the rotator cuff. It is apparently a portion near the top of the shoulder that is most affected, so any hard strike to the underside of his arm causing hyperextension is basically the end of it. He's going out to frisbee tonight to see how it goes. He's going armed with KTape and a brace, so we'll see what happens. He's not a huge skier, so I think he's going to try to live up the summer biking and playing disc and then get the repair done in August, as long as he can't cause any irreparable damage in the meantime (still waiting to hear back from the surgeon on that).

    Will they hook him up with a CPM this time? They didn't last time, but I've heard good things about them. I think he has to be immobilized for a few weeks following the repair, but not sure on that.
    It's not tragic to die doing what you love.
    http://www.savemagicvermont.com/
    http://www.flickr.com/pearljam09/
    http://pearljam09.blogspot.com/
    Hats made by me! use Coupon Code MAGGOT for 15% off. Pro deals available, just ask.

  4. #4
    Join Date
    Mar 2004
    Location
    West Coast of the East Coast
    Posts
    5,499
    Tell him not to lay out, and he should be fine. I tweaked mine on both shoulders skiing and snowboarding. Never had it fixed, but the ability to lift stuff overhead returned. At the time of injury, I couldn't hold my arm out sideways, more than about 6 inches off my body.
    http://adaps.smugmug.com/photos/315388427_jdSb8-Th.jpg

  5. #5
    Join Date
    Mar 2008
    Posts
    230
    Quote Originally Posted by warthog View Post
    Tell him not to lay out, and he should be fine. I tweaked mine on both shoulders skiing and snowboarding. Never had it fixed, but the ability to lift stuff overhead returned. At the time of injury, I couldn't hold my arm out sideways, more than about 6 inches off my body.
    Would have a conversation with the surgeon. The problem with rotator cuff tears is that they tend to get bigger with time, but hard to predict which ones will become symptomatic. In turn, when they do become symptomatic, the muscle involved in the tear can by that time become atrophied/scarred enough to make it irreparable. For this reason many surgeons err towards fixing them in a young person like your brother (thankfully, they are rare in young people except in some traumatic situations). The hardest part is deciding what to do with someone like you, Warthog, where there was presumptively a full-thickness tear but the patient became asymptomatic - you can always make a person with painless and full range of motion worse. That's why developing a relationship with a surgeon and having a honest discussion about risks and benefits is key (there's no automatically right answer).
    Originally Posted by jm2e:
    To be a JONG is no curse in these unfortunate times. 'Tis better that than to be alone.

  6. #6
    Join Date
    Sep 2001
    Location
    Before
    Posts
    12,669
    Shoulder woes:
    Sometime last year, slowly, my shoulder became messed up. It had gotten to the point that I couldn't lift my left arm horizontal to the ground and pole plants were ungodly jarring and painful. I don't remember doing anything or any sudden onset, but holy fuck is it painful.

    A long time ago I took a header crash into some slush where I jammed my arm deep in and got hung up kind of dangling over my shoulder. Had to get pulled out and almost passed out from the pain, but it went away and that was like 20+ years ago.

    Been in for MRI & X-ray and eventually a cortisone shot to the shoulder but not much of a diagnosis in terms of finding a ripped rotator cuff or any lig/tendon damage. Some of the images indicated a thinning of the rotator cuff, but no visible damage other than that.
    Some inflammation of some pad on the upper right of my left shoulder blade. That's where I got the shot. This was with a good orthoped surgeon office and they couldn't find any reason to charge me more money.

    Been trying to strengthen the shoulder with some upper body workouts (normally completely ignored in lieu of quad/leg workouts and stamina training.

    But the damn thing is still really painful: can't lie on my left side and certain moves with my left arm send bolts of hot pain all over my left arm. Had a bad one yesterday mtnbiking.

    OK, yeah, been just trying to man it up and get over it, but this one isn't going away. I'm so slammed timewise I haven't been able to get to any PT people since they all work weekdays and I'm so slammed with work and family I haven't found time to go.

    So, any of you magnions out there have any wisdom to share regarding therapy for this shit?

    Getting old blows in a lot of ways.
    Merde De Glace On the Freak When Ski

  7. #7
    Join Date
    May 2002
    Location
    Tahorado
    Posts
    23,879
    Quote Originally Posted by warthog View Post
    Tell him not to lay out, and he should be fine. I tweaked mine on both shoulders skiing and snowboarding. Never had it fixed, but the ability to lift stuff overhead returned. At the time of injury, I couldn't hold my arm out sideways, more than about 6 inches off my body.
    Same with me, did bicep tendon, too, but not all the way. Like Buster, pole plants and screams of pain went together. It's been almost five years now. Stem cells gave it a jump start and the last prp I had from Patches and his wonderful wife worked wonders on it. The bicep tendon scared/hurt me the most but now I lift pairs of skis into the press in aluminum cassettes supinated that, combined, weigh 30, 40 or more pounds without trouble/pain. I see so many old dudes my age with the braces on and I don't envy them at all, knowing they prolly have a year of hell ahead. Tell your bro to at least get some prp, maybe 3-5 rounds. You, too, Buster.
    We don't make the snow. We just make it more enjoyable.


    Git Your FKNA On!

    You Like?

    fkna.com

  8. #8
    Join Date
    Sep 2001
    Location
    Before
    Posts
    12,669
    yes, well I'm slow, but what's prp?
    LBJ took the IRT up to 4thStreet usa...
    Merde De Glace On the Freak When Ski

  9. #9
    Join Date
    May 2002
    Location
    Tahorado
    Posts
    23,879
    Platelet Rich Plasma

    They take your blood, spin it in a centrifuge to get the very best healing part of it, then inject it into the area of injury for enhanced healing. It's been magical for my knee and shoulder. I got the injections every 3 months as a booster for my stem cell injections. Within 24-48 hours, the difference has been extremely noticeable. As I posted in my last update in my stem cell thread, Mrs. Patches, el doctora fabulosa, asked me where it hurt, I pointed to the spot and she put the needle right into my bicep tendon, which then fibrillated a bit uncontrollably. Even though she said the lack of blood supply in the tendon would not carry the prp throughout the tendon, it improved by light years in terms of the healing response. Patches might show up here and elaborate more. I'm sure Orthoski could give us the tech talk on it, too.
    We don't make the snow. We just make it more enjoyable.


    Git Your FKNA On!

    You Like?

    fkna.com

  10. #10
    Join Date
    Sep 2001
    Location
    Before
    Posts
    12,669
    Yikes. I was hoping for more PT oriented suggestions...I'm kinda pin averse and eschew doctors as a habit.
    Merde De Glace On the Freak When Ski

  11. #11
    Join Date
    Nov 2003
    Location
    none
    Posts
    3,696
    My wife was suffering from Frozen Shoulder.

    http://www.mayoclinic.com/health/fro...oulder/DS00416


    She went to PT about 10-15 times, gets massaged often, does ROM exercises everyday and it went away.

  12. #12
    Join Date
    Aug 2013
    Location
    groovy UV
    Posts
    1,190
    Yikes, never heard of this frozen shoulder.

    My right shoulder is going to need surgery for a torn labrum and possible rotator cuff rupture (haven't seen the MRI yet) but I've decided to put it off until next spring. The doc said I'll be in a sling for 2-3 weeks post surgery, then can expect PT for 3-4 months. If I was to get the surgery now it would put me in the clear for the ski season if everything went well. But the switch side is I'll be at school and way to busy to go for PT a couple times a week. Thinking right when I get back in May, but then it fucks up my whole summer.. plus risking more dislocations until then. The count is 7-8 in the last two years. Actually had a real bad one from an off balance pole plant this past season. Guess it's still better than anything to do with my knees.

    There's my soap box drama in a nut shell.

  13. #13
    Join Date
    May 2002
    Location
    Tahorado
    Posts
    23,879
    Read orthoski's post again.
    We don't make the snow. We just make it more enjoyable.


    Git Your FKNA On!

    You Like?

    fkna.com

  14. #14
    Join Date
    Mar 2009
    Location
    Aspen, Colorado
    Posts
    2,176
    I have pretty messed up shoulders. I had rotator cuff surgery last week on my left one after I hit an Aspen tree with my KTM's right handguard and all my weight and momentum pushed on my left arm. The Dr found pretty good evidence of prior dislocations, but I don't ever remember having one. The socket and humoral head were messed up with areas of no cartillage and weird growths in there. All said, I ended up with three operations being done at once. It makes me wish I had had something done earlier. I also had the platelette rich plasma treatment.

    Typing one handed with a slung shoulder is frustrating

  15. #15
    Join Date
    May 2002
    Location
    Tahorado
    Posts
    23,879
    I'm interested in the prp you had done, Jethro. Was it right after surgery or before?
    We don't make the snow. We just make it more enjoyable.


    Git Your FKNA On!

    You Like?

    fkna.com

  16. #16
    Join Date
    Mar 2009
    Location
    Aspen, Colorado
    Posts
    2,176
    I had the supraspinatus tendon re-attached, which is the most commonly damaged tendon of the four in the cuff. I think the surgeon injected the PRP between the bone and the freshly attached tendon. It might have been placed in that area also. I cannot recall exactly, but he might have said the PRP was a gel-like substance. I don't know if it was used with the micro fracture procedure

  17. #17
    Join Date
    Dec 2009
    Location
    The Mayonnaisium
    Posts
    2,052
    Quote Originally Posted by Jethro View Post
    I have pretty messed up shoulders. I had rotator cuff surgery last week on my left one after I hit an Aspen tree with my KTM's right handguard and all my weight and momentum pushed on my left arm. The Dr found pretty good evidence of prior dislocations, but I don't ever remember having one. The socket and humoral head were messed up with areas of no cartillage and weird growths in there. All said, I ended up with three operations being done at once. It makes me wish I had had something done earlier. I also had the platelette rich plasma treatment.

    Typing one handed with a slung shoulder is frustrating
    Quote Originally Posted by Jethro View Post
    I had the supraspinatus tendon re-attached, which is the most commonly damaged tendon of the four in the cuff. I think the surgeon injected the PRP between the bone and the freshly attached tendon. It might have been placed in that area also. I cannot recall exactly, but he might have said the PRP was a gel-like substance. I don't know if it was used with the micro fracture procedure
    Were you symptomatic prior to hitting the tree? Seems like most people I talk with and most articles I read on rotator cuff injuries mention pain in the front and top of the shoulder accompanied by problems pressing overhead or lifting the arm to the side. One of my shoulders isn't 100% and I'm pretty sure there is some chondral defect or loose debris floating around, but the only place I have pain is on the lower rear portion of the shoulder, not far above the rear of the armpit. And, even then the pain is not an issue unless I'm doing pull ups or pull downs (which I've stopped doing for now). Bench press and overhead press are not an issue, though they could be magnifying the damage without my knowing.

  18. #18
    Join Date
    Mar 2009
    Location
    Aspen, Colorado
    Posts
    2,176
    Quote Originally Posted by Mazderati View Post
    Were you symptomatic prior to hitting the tree? Seems like most people I talk with and most articles I read on rotator cuff injuries mention pain in the front and top of the shoulder accompanied by problems pressing overhead or lifting the arm to the side. One of my shoulders isn't 100% and I'm pretty sure there is some chondral defect or loose debris floating around, but the only place I have pain is on the lower rear portion of the shoulder, not far above the rear of the armpit. And, even then the pain is not an issue unless I'm doing pull ups or pull downs (which I've stopped doing for now). Bench press and overhead press are not an issue, though they could be magnifying the damage without my knowing.
    I definitely was symptomatic before the wreck. I have had several accidents skiing and mtn biking which would leave me with a barely functioning shoulder for a few weeks. As the pain went down, I would gain more motion, but even after years plus with no accidents I'd be weak in overhead and front lifts. Standing rows, incline bench, military and bench all sucked. So did the dip motion. I am strong in pull ups and lat pull downs.

    One of the rotator cuff muscles and tendons comes off the lower shoulder blade and connects to the humoral head at the back of the arm pit. Perhaps you injured this one?



    i

  19. #19
    Join Date
    Dec 2009
    Location
    The Mayonnaisium
    Posts
    2,052
    That's what I'm thinking; the teres minor or infraspinatous. Strained my rhomboid a few months ago and, even with PT, that side of my back/shoulder isn't quite the same. I'm guessing the rotator cuff muscles were strained when trying to compensate for a sore/weak rhomboid.

    You eluded to corrective surgery sooner rather than later, and that definitely sounds like the way to go if given an option. Good luck with rehab and recovery. And masturbation.

  20. #20
    Join Date
    Mar 2009
    Location
    Aspen, Colorado
    Posts
    2,176
    Quote Originally Posted by Mazderati View Post
    That's what I'm thinking; the teres minor or infraspinatous. Strained my rhomboid a few months ago and, even with PT, that side of my back/shoulder isn't quite the same. I'm guessing the rotator cuff muscles were strained when trying to compensate for a sore/weak rhomboid.

    You eluded to corrective surgery sooner rather than later, and that definitely sounds like the way to go if given an option. Good luck with rehab and recovery. And masturbation.
    For me, surgery earlier was not going to happen given how long the rehab is. I was just really stubborn about it, and once I had it done a lot of old injuries were addressed. I would have been better off with an earlier surgery

  21. #21
    Join Date
    Dec 2009
    Location
    The Mayonnaisium
    Posts
    2,052
    Jethro - Saw you mention a long recovery in another thread. How's the shoulder doing?

  22. #22
    Join Date
    Mar 2009
    Location
    Aspen, Colorado
    Posts
    2,176
    The shoulder is doing pretty well, but the stiffness and pain stretching were an eye opener. I saw the Doc yesterday for a checkup and he said no band therapy yet, which was disappointing. The PT had me doing some resistance with bands and I had no discomfort, and I was psyched to be working on strength. Doc say no to that. Strength training will happen after I get a fuller range of motion. I have been using it way more than the doc or pt know about. They limit me to about a pound of weight on that side, and I have gingerly shoveled my walk and I can carry my 20lb son. Dressing him is another matter though.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •