Rotator cuff treatment?

[SweetErika]

I strongly suspect I have a rotator cuff tear in my right (dominant) shoulder from a fall in mid-June. I've had x-rays (still need to get the results, but I'm guessing they're clean) and will make an appointment with a shoulder ortho tomorrow. I've been taping, icing, NSAID-ing, resting it as much as possible, and treating with topical pain relievers and anti-inflammatory preparations for the past 2 months. In early July, I had cortisone injections on that same shoulder for swimmer's shoulder. Honestly, I thought the pain after the fall was simply from aggravating that condition, but when the shots alleviated the inflammation from swimming, it became clear that there was a separate, acute injury from my fall.

Anyway, I suspect many here have had rotator cuff tears, and perhaps even surgery to treat them. Any tips on dealing with the pain and making daily tasks easier? Ideas on how tough the recovery is if the doc recommends the surgical route?

 

[KrazyWhiteBoy]

Unfortunately I have extensive experience with this injury. For every day relief prior to surgery, keep the elbow of the injured arm close to the body, kind of tucked into your side. It protects the shoulder and avoids that stabbing pain. After surgery they will tell you to do this to protect the repair. Recovery is minimum six months for an active person. Find a doctor that specializes in sports injuries, the Dr. that did my was the team doc for the Nashville Predators his partner for the TN Titans. They will be very aggressive with physical therapy. You can't rush a shoulder repair. To put it into perspective, the year before my shoulder I tore my hamstring away from my pelvis, same Doctor released me back to full duty after 12 weeks. Shoulder was six months. My shoulder was a mess, but because you are dealing with small muscles you have to be more careful. Remember the exercises you do during rehab and incorporate them into future workout routine. Something I neglected to do and am now doing. I believe the continued use of the exercise does many things: 1. Protects from future injury. 2. Keeps the scar tissue pliable and reduce future discomfort. That second one is what I am dealing with. I have started incorporating shoulder isolation exercises into a regular routine and am experiencing less discomfort in both shoulders.

 

[KrazyWhiteBoy]

This is a very common injury, more common than most people think. My Doctor said that about 85% of the bodies donated for medical study have rotator cuff tears. The majority of people just learn to adapt their lives around the injury, and he said, most people are not active enough for the injury to affect their daily life.

 

[JAMESBJOHNSON]

I fell tearing my rotator cuff, it hurt so bad I cried, and I had head injuries in Vietnam!

What I did was eat ALLEVE for 9 months and force myself to repair the injury by lifting heavy weights above my head for 9 months. That was 8 years ago. No operations, no MD. Unless youre a glutton for pain I don't recommend my way. But it worked.

 

[KrazyWhiteBoy]

I fell tearing my rotator cuff, it hurt so bad I cried, and I had head injuries in Vietnam!

What I did was eat ALLEVE for 9 months and force myself to repair the injury by lifting heavy weights above my head for 9 months. That was 8 years ago. No operations, no MD. Unless youre a glutton for pain I don't recommend my way. But it worked.

Good point! Something I forgot, because mine was a complete tear. If the tear is less than 50% surgery is the last option. Rehab and strengthening the shoulder muscles are the first choice.

 

[Lord Pmann]

What I did was eat ALLEVE for 9 months and force myself to repair the injury by lifting heavy weights above my head for 9 months. That was 8 years ago. No operations, no MD. Unless youre a glutton for pain I don't recommend my way. But it worked.

Not this. Not this at all.

I have some problems with my rotator due to sports. There isn't a whole lot you can do with it if it is past a certain point. I'm not saying strengthening it is wrong. But I am saying "endure the pain and lift heavy shit while eating Advil" is NOT the way.

 

[All_4_Love]

Not this. Not this at all.

I have some problems with my rotator due to sports. There isn't a whole lot you can do with it if it is past a certain point. I'm not saying strengthening it is wrong. But I am saying "endure the pain and lift heavy shit while eating Advil" is NOT the way.

The idea is to strengthen the muscles surrounding the joint, thus taking some of the wear and tear off of the cartilage and ligaments, i.e. the rotator cuff.

Usually, physical therapy is prescribed for this. I think he did it the caveman way.

 

[LadyVer]

I had rotator cuff surgery done a few years back by a sports specialist. Mine originated from the aging process. The pain became so unbearable, it took me half an hour to dress myself. It was hard to sleep, and I would wake up because of pain. Fortunately, I had health insurance at the time. I couldn't take a lot of NSAIDs either.

The surgeon removed a badly inflamed bursa and debrided the joint. I think he attached something to something else, but I can't remember what.

The recovery period was hard, especially the first few weeks. But the physical therapy really helped a lot. I still do some of the exercises. I thought I was going to have to have surgery on my other shoulder because I was having some pain in that one, not as intense, but it went away, thank God. There's a slight scar that's barely noticeable as the surgery was arthroscopic.

 

[KrazyWhiteBoy]

The idea is to strengthen the muscles surrounding the joint, thus taking some of the wear and tear off of the cartilage and ligaments, i.e. the rotator cuff.

Usually, physical therapy is prescribed for this. I think he did it the caveman way.

Exactly!! This is why I strongly recommend an orthopedist that specializes in sports injuries. Look up the Doctors that the local professional sports teams use. They usually have physical therapists incorporated into their office.

 

[GiggLeGasm]

ok.. just to shed an ounce of hope..

perhaps you just have sick scapula syndrome. It's not uncommon in swimmers, pitchers, etc
I'll keep my legs crossed and hope for the best for you!

 

[JAMESBJOHNSON]

Not this. Not this at all.

I have some problems with my rotator due to sports. There isn't a whole lot you can do with it if it is past a certain point. I'm not saying strengthening it is wrong. But I am saying "endure the pain and lift heavy shit while eating Advil" is NOT the way.

Any port in a storm. It was 9 rough months.

 

[SweetErika]

Ok, I got an appointment for next week with one of the area's best shoulder docs. Yes, he's worked with a ton of athletes and was even a doc for the SEALS, so I should be in good hands.

I've found keeping my arm close to my body definitely helps, and there's no way I'm going to just deal with the pain and hope it heals eventually any longer. My son is 60lbs and an impulsive ball of energy who can easily make any existing injury far worse with one jump or pull. Plus, I haven't been able to get back in the pool even recreationally with almost no use of my right arm without making my shoulder worse, and that's a major problem considering I need that type of exercise to feel better overall.

Thanks for the thoughts on what to expect regarding recovery time and surgery. I was hoping to hear it'd be far easier and quicker than my knee surgeries, but it doesn't sound like that's really the case.

 

[KrazyWhiteBoy]

Like my hamstring injury, my ACL was also much easier than the shoulder. There is just no way to protect the shoulder once your arm moves away from the body. ACL was easiest because of the brace I could wear. Hamstring was one of out of the three on back of leg, yes the other two were torn, but still functioning.

You can start strengthening exercises prior to surgery, I did, per Doctors orders. Sounds like you'll be in good hands. Try to go to the therapist he works with most. They will be familiar with each other's preferred methods of rehab.

 

[All_4_Love]

Ok, I got an appointment for next week with one of the area's best shoulder docs. Yes, he's worked with a ton of athletes and was even a doc for the SEALS, so I should be in good hands.

I've found keeping my arm close to my body definitely helps, and there's no way I'm going to just deal with the pain and hope it heals eventually any longer. My son is 60lbs and an impulsive ball of energy who can easily make any existing injury far worse with one jump or pull. Plus, I haven't been able to get back in the pool even recreationally with almost no use of my right arm without making my shoulder worse, and that's a major problem considering I need that type of exercise to feel better overall.

Thanks for the thoughts on what to expect regarding recovery time and surgery. I was hoping to hear it'd be far easier and quicker than my knee surgeries, but it doesn't sound like that's really the case.

If it's to the point that you aren't able to extend your arm out from your body, I would definitely say you probably have a serious rotator cuff tear.

The surgery will, hopefully, be a closed arthroscopic procedure, fairly simple to the surgeon, as they do these all day every day with their eyes practically closed. The first few days, the postop pain will be significant, but easily treated with opiate medication. Then, after the first week, you should start feeling much better.

They will usually tell you 4-6 weeks recuperating time. You will definitely need help with your precious, 60-pound ball of energy.

Good luck, lady. Hope all is well soon.

 

[gregor2001us]

I had rotator cuff surgery two years ago. Small tear, doctor put in a screw and sutures.

Physical therapy was well worth it. I highly recommend that. I tend to have body parts tighten up (guarded is what the physical therapist calls it) so much of the therapy was slowly getting my range of motion back. But form what they said, that is not the case with everyone, so you may be different.

I was not at full motion and strength for over 6 months. But it was worth going through all that, my shoulder is fine now.

Best wishes

 

[SweetErika]

Ugh. The doctor's office called and had to reschedule me for a week from Friday due to an emergency surgery tomorrow afternoon. I don't think I can wait that long, since I only feel a minor temporary improvement with a lot of rest, gentle stretching and home care. As soon as I start moving my arm the wrong ways (which is, well, most ways! ) or moving even light objects, it flares up to 'pretty fucking hard to tolerate'. I'm going to call another ortho/sports medicine practice that has a bunch of award-winning shoulder docs tomorrow to see if they can squeeze me in this week or early next week.

 

[KrazyWhiteBoy]

If the Doctor can't see you ask for an appointment with his/her physical therapist. The therapist can then give your Doctor an idea of what he/she thinks. Most therapists attached to a sports orthopedist are almost Doctors themselves, at least the senior person. I know the senior guy at my Doctors had almost the entire alphabet after his name, signifying all his degrees.

Good luck!!

 

[SweetErika]

I finally saw the doc after my appointment was rescheduled, and it IS my AC joint that's injured. He did some additional xrays and an ultrasound that revealed I also still have shoulder impingement, which is why I was initially thinking if was my rotator cuff.

He didn't see any major tears, did a cortisone injection in the AC joint, told me to go easy on it, and come back in if it's still hurting after the cortisone kicks in sometime this week. I'm hoping the steroid and continued rest+home care help enough to allow me to get some motion back and start rehabbing it, but time will tell.

I may use a sling for when it stops hurting constantly and I get tempted to start doing housework and such with it; I'm guessing re-aggravating the injury with even light daily activities (hell, driving with my arm in the wrong positions hurts!) because it's my dominant arm is one of the main issues at play here.

Thank you for your insights; while I'm hoping the cure started today, if I happen to need surgery in the future, I'll be far better informed from your contributions!

 

[KrazyWhiteBoy]

No MRI? I'm confused. Muscle/soft tissue tears are usually diagnosed with an MRI. All of my muscle and tendon tears were thought to be strains/sprains until an MRI showed the true nature of the injury. My right knee was operated on twice because the first Dr thought it was a meniscus tear based on x-ray and ultrasound. When he got in there he found no ACL left. He was very embarrassed, he doesn't do ACL's. Had similar stories with my hamstring and shoulder, minus the extra surgery.

If your pain persists, get a second opinion or insist on a MRI.

Best of luck!!

 

[KrazyWhiteBoy]

What does your gut tell you is wrong with your shoulder? I ask because I knew immediately with my three major injuries, that they were serious. I gather from your post that you were a competitive swimmer. If I am correct then you know your body better than most Dr's. Go with your gut until the Dr proves your gut wrong.

 

[All_4_Love]

Best wishes to you, lady.

I know how frustrating it is to go through things like this. I really, really hope you have lots of success with the cortisone shot. Time and immobility are your best weapons now. Take good care of you.

 

[All_4_Love]

What does your gut tell you is wrong with your shoulder? I ask because I knew immediately with my three major injuries, that they were serious. I gather from your post that you were a competitive swimmer. If I am correct then you know your body better than most Dr's. Go with your gut until the Dr proves your gut wrong.

With all due respect, this is not necessarily the case.

Insurance carriers are making it nearly impossible for doctors to treat patients. They seem to think they know better than the doctors what is medically necessary.

It's not common for a doctor to order an MRI until he has followed protocol and used other treatment methods to no avail. The MRI is usually something that takes place right before a recommendation for surgery is made.

 

[Cathleen]

I hope things go well for you, Erika. I had a minor rotator injury years back and it took a very long time for it to resolve.

 

[KrazyWhiteBoy]

With all due respect, this is not necessarily the case.

Insurance carriers are making it nearly impossible for doctors to treat patients. They seem to think they know better than the doctors what is medically necessary.

It's not common for a doctor to order an MRI until he has followed protocol and used other treatment methods to no avail. The MRI is usually something that takes place right before a recommendation for surgery is made.

Believe me, I understand the insurance game. Two of my surgeries were workers comp so I know the hoops you have to jump through, all too well. My point is that, as a patient, you have the right to question the diagnosis.

I had a hamstring avulsion, the ER Dr said is was a strain or minor tear. The workers comp Dr said the same. Meanwhile I had this ball of muscle just above the back of my knee that shouldn't be there. Three weeks after the injury I finally had surgery, the day after I saw the specialist. He cleared a spot in his schedule because of the severity of my injury and the length of time it had gone unrepaired.

I KNEW it wasn't a strain or minor tear and continually pressed for an MRI. If I had let the work comp Dr do their thing, I would still be hamstrung. Similar situation with my shoulder, work comp. Pushed for an MRI, complete tear, 3 cm retracted. Again, I knew my body. Too many years of sports, hard physical labor, enduring minor injuries to not KNOW.

 

[All_4_Love]

Believe me, I understand the insurance game. Two of my surgeries were workers comp so I know the hoops you have to jump through, all too well. My point is that, as a patient, you have the right to question the diagnosis.

I had a hamstring avulsion, the ER Dr said is was a strain or minor tear. The workers comp Dr said the same. Meanwhile I had this ball of muscle just above the back of my knee that shouldn't be there. Three weeks after the injury I finally had surgery, the day after I saw the specialist. He cleared a spot in his schedule because of the severity of my injury and the length of time it had gone unrepaired.

I KNEW it wasn't a strain or minor tear and continually pressed for an MRI. If I had let the work comp Dr do their thing, I would still be hamstrung. Similar situation with my shoulder, work comp. Pushed for an MRI, complete tear, 3 cm retracted. Again, I knew my body. Too many years of sports, hard physical labor, enduring minor injuries to not KNOW.

I was just thinking, what are you? A professional football player? For goodness sake, you've put your body through hell! lol

Workers' comp, eh? No wonder! That's the biggest nightmare of them all. Those insurance adjusters love to play doctor at the patient's expense. Workers' comp is a joke.

Shoot, who am I kidding? Our whole entire healthcare system is a joke.

Ah well, here's to hoping you're past all of that KWB, although I know your body will never truly be the same again.