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cosmokramer
Sep 23, 2004, 7:49 PM
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Hello people, it is with great misfortune that I have to ask these questions, but I am looking for responses from people who have actually gone through surgery for a damaged rotator cuff. I've searched the forums and I don't think a thread like this is available, I may be wrong and I apologize in advance if I've unnecessarily started another one.
2 years ago, I was playing flag football (STUPID) and I dove on an outstretched arm trying to grab someone's flag. The next day I couldn't towel my hair or put my arm through a shirt sleeve without tears welling up. I had obviously damaged my rotator cuff. It was excrutiating for about 3 months and I went and saw a phyical therapist. He performed "tests" on me, seeing which shoulder motions hurt and in what position. The extent of which I was able to perform on these tests led the PT to conclude that I DID NOT have a serious injury, and he gave me some rehab exercises to do, and I followed his plan exactly. 3 months later and 6 months in total, I was pain free, doing dumbell shoulder exercises in the gym, and I was about to discover the awesome sport of rock climbing. I never did see an M.D.
I have been climbing (entirely pain-free) for almost a year now and lead 5.10d, and 21 days ago I was monkeying around in a climbing gym (which I don't even like doing) like a total idiot playing a game of roof Add-On, and the next morning my shoulder was and has been killing me. If the first time I hurt it was a 10, this time it is only a 3, but it still has me on the sidelines, and 21 days later barely feels like it has healed.
I am going to see a doc, but the chances he pulls rock are slim to none. I want feedback from my fellow climbers.
********QUESTIONS********
(1) How bad was your pain/condition when you decided to have surgery?
(2) How much rehab time/efforts did it take to get back on the wall at 100%?
(3) If you could go back, would you have the surgery again, or would you opt for a more physical-therapy intensive alternative?
Thank you for taking the time to read this, I look forward to hearing your advice, and as many details as you can spare will be greatly appreciated.
CK
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send513
Sep 23, 2004, 7:58 PM
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1) DON"T DO SURGERY till you work through PT again, as well as look into other options. Surgery should be a LAST resort! Once you cut, its never the same. I don't care what anyone says.
2) The FIRST time I hurt my rotator cuff it took about 4 weeks of complete rest (along with ice and NSAIDS) to feel better. I was 25 at the time. I didn't do any PT and it was fine for 5 years. The SECOND time I hurt it, its been 10 weeks and I am still not back on the rock. I did go to the ortho and he confirmed it was rotator cuff impingement. Tears happen as well, but do you know for sure you tore it? I am currently doing PT and its starting to help. I did NOT do any sort of cortisone injection because I didn't want to be tempted to get back into climbing too soon, and I didn't want to potentially damage the area further.
3) I would do pt again before I even began to think about surgery. Especially if it was just an overuse injury and not separated, or torn.
You're lucky, the first time I damaged my shoulder it was a 3, this time it was a 10. I couldn't change, shower, shift, type, etc... Its a LOT better, but I still have a ways to go.
If you are only a 3 this time, PT is totally the way to go. You will also learn how to strenghten the shoulder so you don't hurt yourself again. (I bet the problem you were doing had a lot of gastons in it...).
You want to find an ortho that understands you are active and want to remain active. Surgery will put you out for MUCH longer than just rest and PT.
I hope it gets better. I am looking forward to a time where mine no longer hurts (that will happen when the rotator muscles ARE strong enough to hold the joint in place and NOT allow the joint to creep into the shoulder bursa creating a pressure point.)
best of luck
KK
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taino
Sep 23, 2004, 8:02 PM
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In reply to: ********QUESTIONS******** (1) How bad was your pain/condition when you decided to have surgery? (2) How much rehab time/efforts did it take to get back on the wall at 100%? (3) If you could go back, would you have the surgery again, or would you opt for a more physical-therapy intensive alternative? Thank you for taking the time to read this, I look forward to hearing your advice, and as many details as you can spare will be greatly appreciated. CK
I damaged my rotator cuff in a nasty bicycle accident. I didn't have insurance, and was unable to even get it looked at, much less have surgery. It was six months before I could lift my arm out to the side of my body and over my head; another three months before it was healed to the point of no pain. As far as rehab... *shrug* "If it hurts when you do that - then don't do that." Suffice to say that I was very careful, but still did much of what I normally did.
As I didn't have surgery in the first place - just the equivalent of intense PT - I don't know. I would have liked to have had it looked at.
T
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cosmokramer
Sep 26, 2004, 8:07 PM
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Thank you very much for your replies. Good luck to those who are injured, and may your recovery be a speedy one!
CK
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gasdr
Sep 26, 2004, 8:52 PM
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Not to frighten you off surgery but, it is one of the more painful surgeries to recover from. If you do have surgery ask if the surgeon can do it arthroscopically (through small incisions with a small camera), if he would place a pain pump in your incision/joint for post-operative pain control and ask if your anesthesiologist would perform a interscalene block for postoperative pain. All of these will help in the immediate post-op period. Now, most likely your surgeon will not want you to actively move your shoulder for 6 weeks then you will be able to at least use it and perform more aggressive PT. But, I agree with previous posts, I don't think your shoulder will ever be 100% especially for climbing which uses your shoulders ALOT. And, I agree with putting it off and retrying PT unless absolutely necessary. Best of luck! I know how bummed you must be with cooler rock comming soon.
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cosmokramer
Sep 28, 2004, 7:21 PM
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In reply to: (I bet the problem you were doing had a lot of gastons in it...).
Can someone please tell me what this means? Are gastons side-pull moves or what?
Rehab is going well, I hope those of you who are injured are experiencing recovery too. I am border-line depressed at the moment! Someone mentioned "cooler rock" and the frustration of not being able to go out and climb. This couldn't be more true! I live in San Antonio TX, and all summer I have been climbing in 100+ degree weather with high humidity and mosquitos everywhere, AND LOVING EVERY MINUTE OF IT. I was ONE FRIGGIN' move away from completing my first ever 5.11 climb, but it looks like I will be starting over in a sense. My calluses have sloughed off and been replaced by soft and supple baby skin, which should be fun breaking in again. For 6 months I have been looking forward to the cooler rock, but can't enjoy it yet because of the bum shoulder. My wife (who is a 4th year medical student and also my climbing partner) and I are fortunate enough in our last year of school to not have to work. We have ALL DAY together with only school work to tend to. We live 2 miles from an 80 foot limestone wall called Medicine Wall, which is on private property but is bolted and a lot of fun, a 3 hour drive from Enchanted Rock granite slabs, and a 2 hour drive from Reimer's ranch, a limestone paradise with hundreds of sport routes. AAAARHGHGHGHGH!!!!!!!!!!!!
I am able to do all kinds of overhead motions (which someone with a "bad" rotator cuff injury would not be able to do), external and internal rotations, and front and lateral raises, all with a 10 pound dumbell (which is totally humbling...I usually do dumbell raises with 45 pounders, and military presses with 65's). In the 365 degrees of motion in the shoulder, there are about 15-20 degrees in there that are hurting, so I guess shoulder surgery is really not necessary, even though I still feel hobbled.
THANK YOU SO MUCH TO THOSE WHO RESPONDED, ya'll have no idea how much it means to me that climbers I'll unfortunately probably never meet took the time to read and respond.
Enjoy your fall and winter, wherever you are, and stay safe AND TAKE PROACTIVE STEPS TO KEEPING YOUR ROTATOR CUFFS HEALTHY...you just don't know how crucial this area of your body is until you have sat for a month in pain unable to pull rock.
Peace, love, and good rock,
CK
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rckclimr
Sep 29, 2004, 3:21 AM
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I agree with all of the above, especially to avoid surgery if possible.
However, if surgery is necesary, you'll be happy to know that a near full recovery is possible. I had a complete tear that was unable to be repaired orthoscopically, and needed conventional surgury. I was told a full year of therepy would follow. but i think I was back to 90+% within 6mo. ( I did the P.T. that was prescibed, then some) It's been over 18mo. since my surgery and I would say that I'm nearly pain free (some night pain, little things now and agaian). Although I don't climb as hard as I used to, I think that has more to do with being 40 y/o than surgery. :wink:
I hope all goes well for you, Take it slow
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noshoesnoshirt
Sep 29, 2004, 3:46 AM
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In reply to: In reply to: (I bet the problem you were doing had a lot of gastons in it...). Can someone please tell me what this means? Are gastons side-pull moves or what? ... Peace, love, and good rock, CK
While you're sitting at the computer, take your right hand, place it on the left side of the monitor, and attempt to pull the monitor to the right. This is the basic position of a gaston - side pulling so that your body will move away from your hand instead of towards it.
Oh yeah, I blew my rotator cuff for like the 5th or 6th time a month ago. I can finally lift my hand over my head, but very slowly.
Don't drink (to excess) and boulder.
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cosmokramer
Sep 29, 2004, 1:30 PM
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Noshoesnoshirt -- GEEZ-LOUIZE...5th or 6th time??? Could you please tell me what motions you think caused each rotator cuff blow out? Were you bouldering roof routes at a rock gym? That's how I hurt myself, and I have vowed to never climb in a rock gym again, although that might be a little unrealistic and illogical.
A question for anyone who wants to take a stab at it -- Are gaston pull-moves a concern for someone with a recovered rotator cuff injury? After reading the grab-the-monitor-and-pull description above, I realized that this is one of my favorite and most-used moves! Am I likely to reinjure myself after I heal with this particular move?
Thanks in advance,
CK
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edge
Sep 29, 2004, 2:29 PM
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In reply to: A question for anyone who wants to take a stab at it -- Are gaston pull-moves a concern for someone with a recovered rotator cuff injury? After reading the grab-the-monitor-and-pull description above, I realized that this is one of my favorite and most-used moves! Am I likely to reinjure myself after I heal with this particular move? Thanks in advance, CK
Yes, if the antogonist muscles are not up to par, then that can be a very big concern as it tends to push the shoulder joint forward and out, away from the pull muscles.
My daughter dislocated her shoulder 1 1/2 years ago doing a gaston move on an overhanging wall. Specifically, she stretched the labrum, which is the cartilage that encapsulates the socket side of the joint. The doctor prescribed PT, but I insisted that she see a sports specialist.
We ended up going to one of the premier orthopedic surgeons in the area, someone who was highly recommended by the physician father of one of her teammates. This surgeon said that she would never be at 100% with just PT, as the joint was damaged and PT would only compensate to a somewhat lesser degree. As my daughter competes, we went for the surgery, which has been the best course of action she could have taken.
The doctor had performed this same procedure on many pro football players. He used arthroscopic surgery to fold the labrum back on itself, staple it with dissolving stitches, then electrocuted the tissue that was preventing the shoulder from seating perfectly. Meg was in a splint for 6 weeks, PT afterwards for 3 more. Her first day back at the gym was with the doctor's blessing 2 1/2 months later, and she was able to climb 5.10s with some pain. Scars on her shoulder are three, 3/8" slits, now hard to detect; two in the back of the shoulder, one in front.
The first year after surgery she did have some occasional discomfort, but she is now 95% fully recovered (the Dr said two years to 100% was to be expected).
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cosmokramer
Oct 4, 2004, 4:00 PM
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Hello friends!
I HAVE GOOD NEWS TO REPORT: I pulled rock yesterday (I even dogged up a 5.11) and have only slight soreness in the shoulder!!!!! (I'm the guy that started this thread, the guy who sadly was unable to climb for 4 weeks straight)
I'm back, and thanks to your advice I saved surgery as an absolute last resort (didn't need it), focused on INTENSE physical therapy, and am back at 95% as we speak.
If anyone is interested in the 2 weeks of rehab exercises which were prescribed to me that I have done so far (which have become A PERMANENT part of my workout regimen), I will be glad to share them in detail here or in PM's.
Health, happiness, and healing,
CK
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healyje
Oct 4, 2004, 4:15 PM
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CosmoKramer,
Please do post whatever exercises you've been doing.
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mischief8
Oct 4, 2004, 4:40 PM
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I tore my rotator cuff while snowboarding and had pt almost a whole year before I had surgery. It just got worse and worse. So I had surgery and then another and another. Finally the third time the doctor got it right and I skipped the pt (which never worked for me not to say it will not work for you) Then I started climbing after third surgery and it hasn't hurt since. It was the best pt for me and now it is only sore from time to time because of the weather or after a long hard day of climbing. It is a hard and painful surgery to recover from because you really can't do much for the first six to eight weeks and your not suppose to resume full activity for six months. That is what my doctor said.
daniela
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barrel
Oct 4, 2004, 5:19 PM
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In reply to: CosmoKramer, Please do post whatever exercises you've been doing.
I'd be interested, too. Particularly in good stretches.
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cosmokramer
Oct 4, 2004, 10:24 PM
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Since I've had a few requests via PM's and here on this thread, let me get back to you guys in full detail, as I am up at school at the moment and need some time respond properly. I'll try and get you guys/gals tonight.
Cheers,
CK
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azbc
Oct 4, 2004, 11:38 PM
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When I had my shoulder injury several years ago (heroically putting up some heavy shelves at work!) I consulted an orthopedic surgeon for a full exam. This included x-rays and a MRI which revealed that I did not have a tear, but I did have and impingement where one of the shoulder muscles was swollen and inflamed where it passes between two of the bones at the shoulder. One of those bones was less than perfect in shape and was making the condition chronic. The ortho guy suggested PT and anti-nflammatories to reduce the swelling.
After several months of PT trying to get the swelling to go down it became obvious that I was a less than perfect patient. I finally consented to surgery only because I knew my own poor rehab habits were not going to do the job (and workers comp was going to pay for it!).
The surgery consisted of shaving off the bit of bone worsening the impingement and cleaning up the inflamation. It was a painful surgery to recover from and it took about one year to get back into climbing shape.
Today I am climbing harder than I did before the surgery due to better training habits and an awareness of what not to do so I do not hurt my shoulder. I apply ice and ytake ibuprofen if needed (I do the same for my elbow problems - geez I'm a mess!)
The only wierd thing that sometimes happens is in situations where I pull up to a hold and then lock off tight on it (my hand is up close to the shoulder) with my injured shoulder I get pain in the shoulder when releasing from the hold as I shift wieght onto the other hand.
So, what should you do? I would say get a full evaluation from an orthopedic surgeon or sports medicine doctor (not just a PT) to get a full understanding of the nature of your injury. Without this you are flying blind as to how to treat it. Is it a serious tear or a minor, but painful, impingement?
Do all you can to avoid surgery, but consider it an option depending on the nature of you injury and you ability to heal thyself (I sucked at it). Some surgeries are easier than others. Mine was relatively minor in what had to be done, but it still took time to recover from. More major surgeries would likely take longer to get over.
(1) How bad was your pain/condition when you decided to have surgery?
Bad enough to not want to climb on it, although I still did at a lower difficulty than what I was used to.
(2) How much rehab time/efforts did it take to get back on the wall at 100%?
About 1 1/2 to 2 years from injury to surgery to recovery.
(3) If you could go back, would you have the surgery again, or would you opt for a more physical-therapy intensive alternative?
In my case I would.
Good luck,
bc
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cosmokramer
Oct 5, 2004, 3:46 PM
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Hello friends,
Before I share my rehab regimen, please understand that I am in no way qualified as a health professional of any sort, but in fact am a poor college student without the luxury of medical insurance. The advice I have received has come from a family friend who is a PT and my wife, who is a fourth year medical student. Understand that these exercises may or may not help you, in fact, depending on the severity of your injury, they may hurt you. If you are not dealing with a bum shoulder, you probably will find this long-winded and boring, but if you have a minor, nagging shoulder injury, you know you are not seriously injured, and want to hear what is working for me, then read on. In doing these exercises, the rule of thumb I used was to do the exercises to the threshold of discomfort – if I felt even the slightest pain I backed off completely.
The first thing I did to start healing my shoulder was to go out and purchase a small 5 pound dumbbell, a small 10 pound dumbbell, and a chin up bar, the kind that you can install between a door way in your house or apartment. Buy the dumbbells as small as possible, because as you gain strength, you can start doing the exercises below with the 5 and 10-pounder in one hand at the same time, which also helps grip strength. I found the chin up bar to be GREAT for stretching the shoulder! I remember the first time I hung on it and let some of my body weight pull on the hurt shoulder…I just felt like it was pulling things apart (in a good and pain-free way) and giving them a break from being so compressed and tensed and cramped…but that was my own personal experience. I gently hang from the pull up bar for stretches after each set – grab it either overhand or underhand and SLOWLY walk past your hand, to the sides of your hands, GENTLY twist your body one way or the other while gripping the bar firmly, using care to not do anything too quickly which may fire on the injury. There are really an infinite number of ways to stretch your shoulder using the bar. I HIGHLY RECOMMEND THE CHIN UP BAR, or something you can hang from. Also, take Advil daily or preferably a prescription strength COX-2 inhibitor like Vioxx (which has worked wonders for me, but was unfortunately pulled from the market this week).
I found the healing really starting to take place as I got more intense with the exercises and started to deny the “I am hurt and will never climb again” attitude. If I was about to top out at 12 reps, I added another 5. If I was going to do 5 sets, I added another 2 sets. If I had done 4 workouts for the day, I added another workout. DON’T WORK OUT WITH PAIN. PAIN IS YOUR BODY TELLING YOU TO STOP. During the actual exercises, I was deeply focused with an intense scowl on my face (damn it, I WILL get back on the wall!) with each move I was doing, being careful not to aggravate my injury, and to also feel all of the other healthy parts of my shoulder working in concert to complete the motion. DO THE MOTIONS SLOWLY. I found that fast up and down motions caused pain for me. I’ve read and been told that the idea behind non-surgical shoulder therapy is to strengthen all of the muscles AROUND the rotator cuff, which helps to keep the bones and ligaments from migrating out of place which causes impingement and other problems.
The first 4 exercises are straight out of Training for Climbing by Horst. For copyright reasons, I won’t quote them verbatim here. I’m sure an internet search will give you what you need. IF THESE EXERCISES HURT YOU, DON’T DO THEM!
1. Dumbbell internal rotation (lying on your AFFECTED side)
2. Dumbbell external rotation (lying on your NON-AFFECTED side)
3. Bent over lateral arm raise (bent at the waist)
4. Bent over arm kickback (bent at the waist)
The rest of my rehab regimen comes from what I already know from 10 straight years of weight lifting. Go to any bodybuilding or fitness website and get a complete list of shoulder strengthening exercises. Do them CAREFULLY, SLOWLY, and with very little weight to start out. FORM IS THE MOST IMPORTANT FACTOR. If you have never lifted weights before, seek professional advice. DO NOT EXERCISE WITH PAIN.
5. Lateral raises
6. Military press
7. Front raises
I also do as many slow pull ups as possible...you can even do pull ups with both feet on the ground to lighten the load on your shoulder if you install your bar low enough, which is what I did. If I want the full pull up effect, I simply bend my knees so all of my weight is on the bar. You can do pullups with a forward or reverse grip, or with hands close or far apart. JUST DON'T DO ANYTHING THAT CAUSES PAIN, like I said earlier: find your threshold and work just under it.
So that’s what I have been doing…this took me from “I will never climb again” to “I just dogged up a 5.11c!” in 30 days – I hope you have the same luck that I did.
Health, happiness, and healing,
CK
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healyje
Oct 6, 2004, 4:48 AM
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CosmoKramer,
Thanks so much for all that info - that's a lot to share and I for one really appreciate it as I'm dealing with more or less the same thing and I can feel it starting to flare up...
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cosmokramer
Oct 6, 2004, 3:36 PM
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In reply to: CosmoKramer, Thanks so much for all that info - that's a lot to share and I for one really appreciate it as I'm dealing with more or less the same thing and I can feel it starting to flare up...
Healyje -- don't mention it...just TAKE IT EASY AND SLOW...it will get better if you play your cards right.
CK
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