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zoinnk
Oct 5, 2011, 4:48 PM
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I'm a 31 year old otherwise healthy male. I've had shoulder pain for ~1 month. Got an MRI arthogram that showed a partially torn subscapularis. Doctor said "slight" but I do not know the exact extent of the tear. I have pain-free range of motion except during the Hawkin's test and bear hug test.
The doctor sent me to PT w/o discussing my goals, but my physical therapist says that PT might not get me back to rock climbing.
I have a call in to my doctor to discuss but wanted to hear other people's opinions/experiences.
I'd rather get surgery and be 100%, even if it means long rehab, than be restricted and constantly worrying. I'm not a serious climber (5.9s and V3s before hurting my shoulder) but was planning on improving/doing it more regularly.
Any thoughts/comments?
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altelis
Oct 5, 2011, 11:37 PM
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Surgical outcomes are going to depend a lot on information that we (and it seems you) don't have, like where in the muscle/tendon the tear is, what direction it runs, etc.
Why exactly did your therapist say that PT may not "get you back into rock climbing"? Depending on what they meant by that, surgery may have the "same" outcome.
Is the doctor an orthopaedist? If not, you definitely need to see an orthopaedist. And if so, make sure they understand your goals as an active person. Not all people have the same goals, and its important your doctor understands them.
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zoinnk
Oct 6, 2011, 12:02 AM
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I've scheduled a 2nd opinion appointment for next week, so hopefully I can get that info.
The therapist just meant that PT will never get me back to 100%. I had asked her if I could get back to my regularly active life after completing PT. She said yes but then mentioned, in passing, not for rock climbing because I would need full ROM.
The doctor is an orthopaedist, and I was very clear to him about my activity level when he suspected a torn labrum (pre-MRI) -- crossfit, rock climbing, variety of sports. After the MRI, he sent me to PT w/o even really telling me I had a torn rotator cuff and what the options were.
(This post was edited by zoinnk on Oct 6, 2011, 12:05 AM)
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altelis
Oct 6, 2011, 12:07 AM
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Not getting back to 100% is pretty vague- 5%? 99%?
How limited do they suspect your ROM will be?
Does your PT really understand what is needed for climbing?
There are obviously many risks to surgery, including permanent decrease to ROM.
Obviously it seems your surgeon feels its safe to do PT, meaning there is most likely no/nominal risk at a trial of PT. If you aren't happy, and the things you aren't happy about are correctable surgically, that seems like the appropriate time to re-discuss surgical options. All that said, I would make sure that that game plan works given the unknown details of what your PT thinks and what your surgeon thinks...
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mcarroll
Oct 11, 2011, 4:37 PM
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Just remember that not all tears have to be put under the knife and stitched up. Do not be afraid to try rehab for a while before surgery. The surgery works, but the recovery is typically 6 months. You may want to take a look at www.rotatoreliever.com. Good new product for shoulder pain and even shoulder pain caused by rotator cuff tears. Good luck.
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zoinnk
Oct 11, 2011, 8:48 PM
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My main concern was that a literature search on subscapularis tears returned a lot of journal articles indicating that all subscapularis tears needed surgery, otherwise the tears will worsen. Further, the studies showed that repairs of the subscapularis wear much more successful when done within 6 months of the original injury, so time may be wasting...
I'm getting a second opinion tomorrow, so hopefully I'll know everything by then.
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zoinnk
Oct 12, 2011, 7:36 PM
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Second opinion said surgery is a no-brainer. Essentially, I have a genetic problem where my biceps tendon does not sit properly in the groove of the humerus. Because of that, my subscap is prone to tearing (80% chance that it'll happen in my other shoulder as well).
Surgery is needed to shave down the groove in the humerus and also repair the subscap. Will be combination arthroscopic and open surgery.
If this isn't repaired now, my subscap could tear completely at some point, and I'd only have a 3-4 week window for surgical repair once that happens.
(This post was edited by zoinnk on Oct 12, 2011, 7:37 PM)
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onceahardman
Oct 12, 2011, 10:54 PM
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Please stay in touch regarding your decision and rehabilitation, so that others may learn from your experience.
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healyje
Oct 13, 2011, 6:17 AM
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Where do you live? Try to find a shoulder doc who personally does sports, preferably climbing, but yoga, running, etc. will do.
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zoinnk
Oct 14, 2011, 2:50 AM
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I live in Minneapolis and am having the Twins' shoulder guy do my surgery.
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