rotator cuff surgery necessary? please help

I just had shoulder surgery on 04/15/10 They said I had a small tear in rotator cuff along with bone spur on my collar bone, by then I had adhesive capulitis (frozen shoulder). But when they did the surgery the bone spur was rubbing the rotator cuff and it was worn but not torn. They removed the bone spur and broke up the frozen shoulder. I wore a sling from Thursday, day of surgery until the following Tuesday, and could not drive during that time. After removing sling, I was stiff and sore. The more I move my arm the less it hurt and the more I could move it. Started Therapy on Wed. the day after removing sling. I was doing great. Was getting more movement with each exercise, that you can do on your own with no help. The pain was nothing compared to what I went to before surgery, with the adhesive capulitis. But then I went back to the Therapist on Fri told her how good I felt and was doing, for whatever reason she pressed down hard on my shoulder and pulled her hand across my shoulder so hard it felt like she was ripping my incissions apart, twice I had to tell her to stop and told her it felt like she was pulling my shoulder incissions apart. My shoulder hurts all the time now. I have lost movement because of the pain.My surgen just blew me off as being a winer and won't check for any damage. I am now looking for a new surgen and therapist. Don't be afraid of the surgery be afraid of who is treating you and what they can do to you. Don't be afraid to ask what they are going to do and why, and how much pain to expect. If I hadn't trusted this therapist and asked questions first, maybe she wouldn't have injured my shoulder and I would be a lot further along.
 
Good luck with your surgery. I live alone, but my sister stayed with me the first couple of days, which was helpful. Be sure to read some of the other posts regarding getting ready for coming home with the use of one arm. Having clothes that you can get into easily is helpful. If you have any questions be sure to ask. I found being informed was essential for the surgery and afterwards. Let us know how things go!
 
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
 
sounds like a good plan city,and DO let us know what the plan is. good luck.

jenny, you just described pretty much what my therepist did, but the strengthening did not start til after about six weeks and it was very slow,and at my comfort level too with no "pushing thru" crap. i do believe i did the pullys tho before anything else? the joint excercises are really really crucial. my only problem with this as having to use my knees/hips to just do the swinging stuff and even the little circles too? i have RSD in my right knee so this stuff just sent THAT over the top big time. so doing the shoulder swings sucked for me but i did do them only with my knee braced. that helped some. i do agree that not doing ANYTHING at all is what would be the biggest problem. they kind of did this with my sisters knee injury where they had her completely immobilized and using crutches for like ever and it really messed up her knee permanently. this was wayy back in the early 90s? its still screwed up today now. with my knee surgeries i was up on that thing the very next morning weight bearing and getting PT, subtle but doing it. that joint is much easier to rehab since it really only moves in one direction, up and down. things were VERY different with that shoulder tho. marcia
 
i had 3 on my left shoulder 4 years ago and i am doing fine alot has to do with the doctor you use the frist doc did it twice did not fix it the last one fixed it
 
no problem, glad i could help someone else thru my experience,it IS the very best teacher ya know, lol. just what other damage needs repair in there? there just usually turns out to be alot more than just the 'one' thing, or the bigger thing that prompts you to even get that needed MRI. just kind of the way the wear and tear occurs in that rotator cuff area. i really am glad you are going on with the surgery. trust me, you WILL be very glad you did this too.

one really great thing that helped me to speed up recovery and also reduce some pain post op? ask your ortho if he can(or he may already do this for all patients?) use what is called the CPM chair to use in your home post op? they actually deliver this to your home then pick it up when you reach a particular level of degrees? what this 'chair' actually does, along with the very specific types of excercises they will also recommend to you, is allowing that joint ONLY to move up and down over and over but it will not allow ANY real stress or actual movement of the tendons, muscles or ligaments, just that very crucial acro joint itself? you just sit in this a few times a day and strap your arm to this arm thingy on it and IT very very slowly moves it for you. this did kind of put me a bit ahead in the moving of that shoulder quicker and actually readuced some of the intensities of the pain, and the best thing this does is help in NOT ending up with a frozen shoulder type of situation that just can occur anytime we are immobilzed with that sling for a long period of time? it was paid by my ins co since it is something that the ortho ordered too? i think i did have to only pay a rather small co pay on it, but man was it ever worth what it just did for my shoulder.

if they also offer one of those really cool compression and icing devices for you, take that sucker in a heartbeat. you just bring that with you on the day of surgery along with the mandatory sling you have to get too, and when you wake up in recovery, that icing device will be on you along with that sling. ICE will be your very best freind there for a while. it really was a lifesaver for me in the hosp and when i got home too.

if you have any other questions for us that we can answer, don't hesitate to ask, K? just exactly what did your ortho tell you needed to be fixed? that you remember? FB
 
I am 58 and injured my shoulder 2/10. At first the pain was pretty bad, now is minimal and managable. My (4/15/10) MRI shows no visible supraspintus tendon between the humeral head and the acromion. Is rotator cuff necesary?
 
I had rotator cuff surgery a few years ago (age 40) and I'm extremely happy I did it. I didn't have a ton of pain prior to surgery, but the little things just kept adding up and annoying me, so I took the plunge. My only regret was waiting so long. I also had a tear in my labrum, so I'm sure that figured in my pain a bit.

I started therapy about a week after the surgery and followed their plan. I was fine with it. After two weeks I was doing just about everything, in fact it was hard for me not to push myself because it felt so good. Within three months I was back in the gym doing brazilian jiu jitsu.

For me, it was worth it. I tried the PT first, and had some shots, but they didn't give me anywhere near the relief the surgery did. Good luck
 
My thanks to all of you. I got my tear on March 11, 09. Had a heck of a time with the area clinics where I live. Finally went to larger town to a Bone and Joint doctor. They took MRI, said it was big tear, and he wanted me to meet a surgeon. I said I needed time to think about it. I had read on the Mayo Clinic site that they do repair themselves...so then on May 18 I fell. Of course I fell into the front of my computer chair and hit the arm of the chair with my right shoulder....the bad one! I just sat there and cried. Was going to PT and had to go that afternoon. Could not finish PT. Went back to dr and met surgeon, very nice and am still on the thinking mode. Going to be 70 next month, have had open heart, herina, gall bladder, stint, etc. All in the past 4 years. Just do not want anymore! Truthfully the arm does seem to be getting better. I also live alone and have a small dog. Can't do everything I used to do, but slowly making it work.
Sandy
 
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
 
Thank you for your response, I thank you for the advice of asking questions of both my surgeon and p.t. I will take your advice.
I wish you the best in looking for both a new surgeon & P.T.
 
in a word, YES. our rotator cuff area IS the entire upper shoulder area that has all the tendons, ligaments and muscles that actually allow ANY real movement. this also includes the highly mobile acro joint too. without it, our arms would kind just hang there? if you want to be able to actually move your arm in certain ways and have things interconnected, you NEED to have that supra reattached properly again. all they do is sew it back together. but you really DO need to get that very top tendon there reattached, seriously.

that top tendon which is the one i happened to also snap right in half just does the majority of work, so it is the most commonly torn. i can tell you right now, if that very top tendon is NOT actually attatched properly thru damage, the tendon directly underneath THAT particular one WILL also suffer without that needed repair(and it will also effect ligaments and muscle accordingly). my tendon right below the one that was slowly tearing over years but i did not know it(then it finally worked all the way thru and simply out of the blue just snapped completely), actually started to tear too since that one starts to try and compensate for the top one not doing ITS job kinda thing? it simply trys to take on that load which it cannot actually do as far as performing the supras real ROMS so it will start to suffer for it too? so you very easily CAN end up with huge amounts of real ongoing damage(and muscle loss) if things starting right at the very top are not in good shape. it would work its way down all the tendons(and the ligaments and muscles too) eventually? the "domino effect"? thats just how things are within that rotator cuff area. it just works and works and works in 'doing' for us like all day everyday so depending upon what you do, it can simply wear out on us. my supra snapped on me at only age 47? when i had my MRI i was really stunned at the real level of wear and tear types of damage(fraying, bone spurs IN the acro joint too) and all the tears and of course that snapped supra which i did NOT expect at all. my whole shoulder was a mess i did not even know about.

honestly? i would seriously get that one problem area in that supra fixed or IT WILL start impacting other structures as they try and compensate for what is not working properly over time. that will create a much bigger and more in depth type of needed repairs as time goes by and you will simply start to lose more and more ROMS and the abilitys to simply 'do' certain things anymore at all. its just the highly progressive way the damage will go without that very top good "anchor tendon" being attached and holding things together again. believe me, doing this now vs waiting means a much less invasive repair surgery vs what will be even over the next couple years if you wait on this. the recovery would also be much longer, more painful and require much more extensive rehab/PT that just would be needed to get all that damaged/repaired stuff back into sinc again and usable. just because your pain has gone down and become more manageable at this point does NOT mean when other structures start becomming impacted that it wont come back on you or in an even more profound way than it was before as newer and much deeper damage creates new pain?

have you actually had that very needed consult/eval of the arm/shoulder by a good orthosurgeon yet, just to find out what HIS impression actually is about what may be needed here if you chose a surgical repair? just getting that needed opinion does not mean you are suddenly locked into any type of surgery. you just seriously DO need to get the expert opinion and eval on how much real ROM is also being impacted/lost right now too. just getting this done and overwith now will save you alot more damage, hassle, and pain later on, trust me on that one. what is a much simpler repair now will just progress over time and become a much bigger in depth deal for you.

i do hope for your own sake you at least seek out a good ortho opinion from an ortho that actually specializes in shoulders? they all kind of have their own specialtys, so you DO need that type that does shoulders like on a daily basis for the best possible surgical outcome and opinion too. let me know what you find out. good luck with this, FB
 
I am having second TKR May 26. First one done June, 2009. One of the consequences of the knee PT was both torn rotator cuRAB. Had MRI in March to diagnose shoulder/arm pain. Ortho said we have to do TKR first then repair rotator cuRAB since he thinks if we do rotators first the PT for TKR will cause them to tear again. I can't imagine how I will be able to do adequate job on knee PT with 2 painful arms? Has anyone had this?
 
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