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gbogh
Jun 4, 2008, 6:34 PM
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i originally wrote about this injury here 6 wks ago. the mri suggested calcific tendonitis with no surgery required. see the following thread:
http://www.rockclimbing.com/cgi-bin/forum/gforum.cgi?post=1892439;sb=post_latest_reply;so=ASC;forum_view=forum_view_collapsed;;page=unread#unread
i now sit here typing one handed a day after surgery where my doctor repaired "a substantial tear that couldn't be left alone" among some calcium as well. i can tell you that shoulder surgery is no fun at all. they did a nerve block which basically rendered my left arm lifeless, that is until 3 or so last night at which time it let me know i had had surgery. so the oxycodone is working but limitedly as it does wonders on my stomach :(
what pisses me off more than the fact that i did this to myself is that the first doc (seen around the end of feb) basically didn't listen to me and threw me out his office as a simple bursitis injury though i insisted it was more than that. so i have included a pic of the actual tear....hopefully i will be ready to go in 6 months or so......
[inline cuff tear001.jpg]
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cuff tear001.jpg
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gbogh
Jun 15, 2008, 2:43 PM
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so it has now been nearly two weeks since surgery and i am about 2 days into PT. the prelim diagnosis is that i won't be running for 3 months (too much shock / arm movement), biking out for a while also due to potential for injury if i fall and the arm movement required if i climb hills, and no weight training for 6 months. now the one thing after my first visit the PT person said is that i seem to have a good start to my range of motion, potentially b/c i had a fair amount of strength/fitness in my shoulder prior to surgery. it still hurts a lot to move it but i am seeing improvements each day now. most of the exercises now are based on stretching the area to gain range of motion and trying to get the swelling to finally go down completely.
the tear turned out to be a partial tear though he said that much longer and i would have torn it completely off the bone. basically it was pretty bad. he also shaved a small part of the bone down to create a bit more space in the joint and cleaned out scar tissue and any small calcific build up....it was pretty messy around the injury i guess.
so my summer and fall are pretty much out for any sports but if i stick to the program PT doc says i should be no worse off than i was before the injury......so for now, i just sit back read about climbing and work on hand strengthening exercises to keep the tendons/muscles engaged while i am injured....
John
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rockvoyager
Jun 16, 2008, 5:50 AM
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John
Man can I sympathize. It's been 10 weeks and I'm still in a sling. Mine was a 1 inch long full thickness tear that happened in Thailand. Didn't hear any pops or even feel much pain. Just felt funny and couldn't pull a move that I did the day before in teva's. Told the guy I was climbing with that I needed to take a break for the day but would meet him the next morning. Knew I was in trouble when I woke up and could barely move my arm.
I was in PT four days after surgery. Spent the next 2 months getting back about 85 percent of my range of motion. Doc says 2/3 more weeks of the hated sling and he will put me on an iron diet. Have to start with 1 pound weights but should progress quickly. He expects full recovery in 9 to 12 months, I expect 6 to 8. We'll see......
Anyone contemplating this surgery should make sure to get a sports surgeon who's done about a gazillion of these things. Makes it much more likely you will get back to 100%.
We more seasoned climbers (read old) tend to develop bone spurs that a-braid the supra spanada yadda yadda tendon. Once the abrasion starts the tendon is more apt to tear. I NEVER want to go through this again. No more hanging straight arm from my hang board. No more climbing without stretching. No more dis-respect for my 59 year old shoulders.
Good luck with your recovery. Sounds like you have things in hand. Remember, there will be ups and downs. During one PT session you will feel great and think you've rounded a corner, but the next will be pure torture and you will feel like you went backwards. It can be a bit disheartening. Eventually it's all good and you can see the light.
Brad
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hosh
Jun 16, 2008, 5:56 AM
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I just got my shoulder "fixed" in February. I finished PT successfully, and have climbed since. I didn't tear any muscle tissue (Not a rotator cuff injury) but I did tear 50% of the cartilage in my shoulder. The surgeon who did the procedure (Dr. Kalfayun, sp?) in Seattle did a GREAT job. I was out and about by the next day, though I was in a sling and couldn't move my arm for at least 6 weeks after. The PT wasn't bad at all, I was lucky in that my therapist was married to a climber so she knew what I wanted out of the procedure. So the best of luck to you both, I wish you a speedy recovery!
hosh.
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gbogh
Jun 16, 2008, 11:08 AM
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Yeah my tear was similar...i did hear a bad sound and the shoulder went somewhat numb. woke up next day very sore but able to move and weight it so i figured it may not be much. after trying to do exercises or climb though, i knew something was wrong. it wasn't a full thickness yet but as i mentioned, it was well on its way. PT over the weekend felt as you said good and bad. It appears having had strong shoulders before surgery and a high tolerance for pain will play an important role as to how long it takes to recover. i don't wear the sling much now except when it really gets sore and at night. i can't sleep well though still as i used to sleep on this shoulder and obviously now i can't. anyway, i realize it is a long road and rushing it can only be worse so i am following what my PT says to do and will hope for the best.
john
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onceahardman
Jun 16, 2008, 5:47 PM
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Hi John...
I'm glad to hear it's coming along. Focus on the process-how the range of motion is improving week by week, and how the strength is improving. Try not to focus on how disabled you still are, how you can't climb yet, etc.
Regarding sleeping-some people do well sleeping semi-recumbent in a recliner, or perhaps propped up on a bunch of pillows or cushions.
It's important to do the exercises, even (especially) when you don't feel like it, when it feels stiff and sore.
Also, for all of us aging climbers...Loss of blood flow to the rotator cuff complex tends to occur with age. Not a bad idea to do the strengthening exercises on the non-surgical side as well. Exercise is probably the best way to improve blood flow to any muscle group.
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scotchie
Jun 25, 2008, 8:02 PM
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Hi John,
Thanks so much for keeping us posted! I have been dealing with shoulder bursitis for a year now, and I may be going through subacromonial decompression surgery soon. Still waiting for the MRI results, to see if I also have a tear. It's reassuring to hear from someone who is going through a similar issue, to see what I might expect. Good luck to you!
Scott
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gbogh
Jun 25, 2008, 9:14 PM
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Scott,
I would read up on symptoms of a tear and see if they fit you. My MRI showed no tear and only some "calcific tendonitis"....my doctor basically went into my shoulder ignoring any previous diagnosis and said he went in to look at the whole joint before repairing anything...that is when he found the tear...he said it was only a mater of time before it went full thickness tear...basically my advice is, you know your body/shoulder and you need to find a doctor that trusts you.
as for the PT well i am 5 visits in and have been told i am WAY ahead of schedule. the hardest part about this is the pain from really stretching the scar tissue and muscle. the more you can deal with the pain, the faster your road to recovery. i am not able to move my arm above my head yet or even above shoulder level yet, but i do notice significant gains. i am able to place my hand on my lower back now without help from my other hand which took the longest. PT is a bitch but as long as you stick with the home exercises, you can move forward faster. i will write back again in a few weeks to let people know how things are progressing. thanks for the support from folks...
John
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scotchie
Jun 25, 2008, 11:08 PM
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John,
Thanks for the tip. I will bring this up on my next visit. The handout from the doctor's office makes it seem like they will look for tears and other problems during the surgery. But it would really suck to have to get surgery twice because something was missed the first time.
Did they go in and look with an arthroscope?
Scott
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gbogh
Jun 26, 2008, 12:20 AM
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Scott,
So the doc (third one i went to) had me do one month of PT first to see if i improved. this would help with my insurance accepting the surgery. when that PT was done and i hadn't improved he went in the shoulder. he went in through two cuts (arthroscope) to look at the whole shoulder to see what was wrong. after looking over everything, he then made a third cut to go in for repair work...all cuts were only one stitch cuts. he was very thorough though and looked over the whole thing...hope this helps scott...
John
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gbogh
Jul 7, 2008, 12:35 AM
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4 weeks from surgery and almost 3 weeks of PT now and I almost have full range of motion PASSIVELY. however trying to get the range of motion without help is still pretty troubling. The muscles just aren't strong enough yet. I have started the stretch band exercises now and have had significant gains in the stretching except for one type that is....the external rotation i believe it's called...elbows at 90 and trying to rotate my hand backwards....that stretch has been my nemesis. small gains in that one but ive been told that seems to be the hardest for many. at any rate, my follow up with the doc is this friday so we shall see what his advice is and how i am doing...more at that time....til then...
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ladyrockstar
Jul 7, 2008, 1:19 AM
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Sounds really familiar to me. I tore my rotator cuff five yers ago. I went to several surgeons who looked at the MRI and said it couldn't be fixed. The piece was totally retracted, and was that way for almost six months. I finally went to a surgeon who works with the GB Packers. He agreed, but wanted to scope it and take a look, so I let him.
He came out of the operating room all excited. He kept saying, "I fixed the whole thing!" He sent me home in a sling and told me it would be almost a year before I'd have much use of it. I hate slings, so took it off when I got home. I used the arm, but quit if it hurt at all, but only used the sling when I took my dog for her daily walk, just to keep it from hurting during that time.
When I went to the PT for the first time, I waved my arm over my head and asked what he thought I needed. He said to just go home, because I didn't need any PT. I think it was because I didn't keep it in the sling, so it didn't get atrophied from disuse.
Six weeks after the surgery, I had to fly out to California to drive a car home for my mom (a gift from my sister). I couldn't imagine California without Yosemite, so I went there on the way home. I was alone, so no roped climbing, but I did a lot of bouldering. When I got back to Wisconsin, I had another appointment with the doc, so brought along pictures of me bouldering. He was surprised, but agreed that it was most likely because of the lack of a sling for the first few weeks.
I don't think it's right for everyone, but it worked for me.
(This post was edited by ladyrockstar on Jul 7, 2008, 2:03 AM)
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gbogh
Jul 11, 2008, 4:27 PM
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first doc visit after 1 month of surgery (3.5 weeks of PT)....range of motion is excellent...pleasently surprised....however tendon is still somewhat week so running outside or biking is a definite no-no as the arm motion from running could cause the healing tendon to tear again. biking isn't a problem except for the potential of falling. can't take a fall right now. so he said two more months and i should be ready to run at least...anyway, keeping up with PT at home and dealing with pain during stretching is oh so important :) im keeping up with grip strength exercises and am probably start working on bicep curls and tri extensions for now....fun stuff !!!
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scotchie
Jul 21, 2008, 9:50 PM
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gbogh wrote: Scott, I would read up on symptoms of a tear and see if they fit you. My MRI showed no tear and only some "calcific tendonitis"....my doctor basically went into my shoulder ignoring any previous diagnosis and said he went in to look at the whole joint before repairing anything...that is when he found the tear...he said it was only a mater of time before it went full thickness tear...basically my advice is, you know your body/shoulder and you need to find a doctor that trusts you.
Well the MRI showed a type 2 SLAP (cartilage) tear. During the procedure he checked for everything (which is SOP), but that just confirmed that the MRI was right in my case. It looks like the operating procedure and anatomy are different for SLAP vs RC tears, but the recovery process is just about identical. Different patients progress at very different rates, but I seem to be pretty lucky so far wrt pain. It hasn't been bad. Still just 3 days post-op. First post-op visit is next Monday. Will find out then when I can start PT and how long I have to wear the sling for. I know it will be at least 2 weeks in the sling, and probably more like 4. I only needed 1 anchor, which I think is pretty minor as far as SLAP tears go. Hopefully that means I will recover quickly.
Good luck on the rest of your recovery!
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hikerdd
Jul 31, 2008, 9:00 PM
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My rotator tear was repaired and I am climbing stronger than ever! My Dr also rock climbed and he was most concerned about me seeing the best PT that he knew.
He wanted me to get back as much as posible, the PT really worked me hard and I did all the exercises, even the little ones that didn't feel like I was doing anything! I also set up my own pulley exercise over a cupboard door at home. It took 5 months before he released me to climb "easy" again...
It was really weird, not trusting to layback, etc...but I finally had the trust in my head to get back in full climbing shape!
My Doc cleaned up 2 bone spurs and repaired the partial tear!
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gbogh
Jul 31, 2008, 9:30 PM
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Hikerdd,
Sounds like a similar injury to mine. Today was my 15th visit to the PT and she says my progress is way way ahead of schedule. basically i do most of the stretches at home but now since i have been given clearance to do some gym work, i do my stregth stuff there. though i still use the stretch band at home as well. strength is coming along well and the i am nearing full rotation (though still not smoothly). I let the PT really work my shoulder to i can't take the pain anymore. twice a week is working well though i would do more if my insurance allowed it. basically the worse i feel after PT the better my shoulder seems to get. keeping up with the stretching on the days between and doing the strength training is really paying off. i am out for about 1 month more before being given the go ahead for running and i am hoping he will give me the go ahead to start lifting more weight as well.
thanks for the reply as it is good to hear that if i keep up with what i am told, my recovery can be complete to where i was before!!!
more a bit later...
John
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rockvoyager
Aug 1, 2008, 9:16 PM
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Hi all
An update on my surgery. I now have full range of motion and am ratcheting up the exercise. Every other day I do a one hour series of excercises that include. curls with 10 pound weights, 300 sit ups, 5 sets of 8 pullups, hang boarding, jogging and a stretchy rubber thing. Tonight everything increases a notch or two except the situps.
I can't seem to do normal push ups without pain. So, for right now I do 5 sets of 10 from my knees.
It's all about gaining strength for my first climbing day in the third week of August. Yipppeeeeee
Good luck on your recovery.
Brad
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gbogh
Aug 17, 2008, 2:39 PM
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rockvoyager,
sounds awesome!!! i have run out of PT from insurance so i may do a few more on my own bill. my range of motion is not quite 100% but that is to be expected (i guess) considering i am only 10 weeks out from surgery. i have been lifting in the gym with weights doing the same type of exercises as one did with the stretch band. i have been told by my PT that i can start trying to do push ups on my knees but that i may not be able to go all the way down yet due to there still being some impingement. i have been resting my feet on a exercise ball while holding the up position of the push up and then lifting one arm at a time to the front or to the side. helps to build the stabilizing muscles of the shoulder. i see the doc in 10 days (or 11 weeks after surgery) and hopefully will be given the go ahead to run and maybe start dips/pull ups....maybe even hangboard...we shall see. i still don't have the full use of the shoulder but i have been told repeatedly that my strength and mobility at this stage of the game are way ahead of schedule and i am doing well. with nothing to compare to i just accept it as motivation to keep up with the exercises i have been given and don't stop stretching.... i can't tell you how excited i am at the thought of being able to jog again and even start lifting etc. i feel like a waste right now and sooooo out of shape but am happy with how things are going i guess. wish all with injuries the best to recovery and those in PT listen to your PT .... do the exercises and stretch stretch stretch!!! until next update....
John
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timd
Aug 27, 2008, 10:14 AM
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I am feeling for you all. At this moment I sit here typing with one hand because my other arm is in this goddamn supersling. I am six weeks out from a total left shoulder rebuild. I blew mine out last March on some late season ice. Only six more months of recovery and I might get to climb again.
Tim
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gbogh
Aug 27, 2008, 10:42 AM
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Tim,
What all did you have done? Sounds like a SLAP injury as well as a rotator cuff tear??? Wish you the best with your recovery!!!
John
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timd
Aug 28, 2008, 4:17 AM
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John,
I actually tore the whole shoulder joint apart. They had to shorten then reattach the muscles to my shoulder and yes they also did a flap repair. Right now I am around 20% mobility but I hope for the best. I do hope your recovery is going well also.
Tim
(This post was edited by timd on Aug 28, 2008, 4:20 AM)
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gbogh
Aug 28, 2008, 8:49 PM
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So just got back from my 3month visit to the Doc. Word is that i am way ahead of schedule on mobility and he was very happy with my progress. still have some mobility issues so i am to do PT now once a week and continue the stretching at home as well.
he did say that short of going in to the shoulder again, he can't say for sure how well the rotator cuff is actually healing and that they typically aren't fully healed for 5-6 months. so that being said, he doesn't want me to do any push ups yet or any heavy lifting....i can begin using the rowing machine on light resistance as long as my form remains good. i can also start to run lightly but no sprinting...
he said that i go back in two months and around that time he will give me the go to start doing any sport i want but to ease back into them ...so hopefully i will be climbing again starting around Dec!!!! i'd rather take the conservative approach to be safe then rush into anything and just hurt it again when i am finished!!!
so i guess i am pleased to be able to get outside running again and glad to see my mobility is right on or ahead of schedule and i will just follow what he said and continue stretching/ stretch band lifting for the next few months then hopefully i can get back into everything!!!
until next time!!!!
john
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tharlow
Aug 28, 2008, 8:56 PM
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John,
good to hear things are going well. Haven't read all of your posts, so forgive me if this is redundant. From personal experience, make sure you have done the work to strengthen and retrain coordination and proprioception of the shoulder blade muscles. Important with any shouder injury, but more so if you want to return safely to climbing.
regards, T
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gbogh
Aug 28, 2008, 9:54 PM
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If i completely understand what you are saying about the shoulder blades then yes this has recently become a large part of my stretching and strengthening. as i lift my arm up to near fully extension, my limitation is in part coming from my shoulder blade actually, for lack of a better description, rotating out of alignment and not allowing full rotation in the shoulder joint. my PT has me laying on one of those foam rollers to effectively "block" my shoulder blade into place and then raising my arm up bent at the elbow, and pulling on the elbow with my other hand behind my head as much as i can to get the shoulder joint and the shoulder blade to move somewhat independently of each other.
also when i do stretches now and weight training she has me really focus on pinching my shoulder blades together in the back to get the middle of my back strong and working together...
thanks for the advice, good to hear that i am being told correct things to do!!!
john
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timd
Aug 30, 2008, 3:30 PM
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Glad things are going good for John, keep up the good work
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