Rotator cuff injuries- how likely is surgery?
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barefootboatnik
Posts: 134 Member
I've been off the site for the past few weeks, been struggling w/moderate pain in my right shoulder & the stress that goes along w/it (my job requires a good deal of heavy lifting, some of it overhead). I figured I had a rotator cuff tear (initially happened back in March of this year), and was trying to take it as easy as I could w/out calling too much attention to myself @ work.. couldn't really afford to have to take time off b/c of it.
Wednesday, I had a bit of an accident that seems to have made things exponentially worse. Management @ my apartment complex hired some contractors to replace the steps in the stairwells of my bldg.. I was going down the steps Wednesday, and one of them completely detached when I put my weight on it, sending me sliding down several steps on my rump. I threw my right hand back to catch myself (there's no handrail on this particular stretch of stairs), and as I slid, it stayed on the step I caught, bending the arm up and back. I could feel the popping in my shoulder, thought I was actually going to black out for a moment.
Doc ordered an MRI, had it done on Friday. Results show:
-a high-grade tear (greater than 50%) of the supraspinatus tendon just proximal to the footplate, involving the anterior
and central fibers
-a small articular sided tear of the anterior fibers at the footplate insertion of the supraspinatus
-a high-grade tear of the articular surface of the superior to central subscapularis tendon at the footplate involving
greater than 50% of tendon thickness
-tendinosis within the intra-articular portion of the biceps tendon
-moderate AC joint arthritis w/undersurface spurs
SO.. for those of you who have gone through something similar, or who might have a better understanding of this than I do.. I guess what I'm wondering is, is this as serious as it sounds? How likely is it that I'll be able to heal this w/just PT? I'm officially off the schedule at work for the foreseeable future, so I've got nothing but time to work on healing it.
Wednesday, I had a bit of an accident that seems to have made things exponentially worse. Management @ my apartment complex hired some contractors to replace the steps in the stairwells of my bldg.. I was going down the steps Wednesday, and one of them completely detached when I put my weight on it, sending me sliding down several steps on my rump. I threw my right hand back to catch myself (there's no handrail on this particular stretch of stairs), and as I slid, it stayed on the step I caught, bending the arm up and back. I could feel the popping in my shoulder, thought I was actually going to black out for a moment.
Doc ordered an MRI, had it done on Friday. Results show:
-a high-grade tear (greater than 50%) of the supraspinatus tendon just proximal to the footplate, involving the anterior
and central fibers
-a small articular sided tear of the anterior fibers at the footplate insertion of the supraspinatus
-a high-grade tear of the articular surface of the superior to central subscapularis tendon at the footplate involving
greater than 50% of tendon thickness
-tendinosis within the intra-articular portion of the biceps tendon
-moderate AC joint arthritis w/undersurface spurs
SO.. for those of you who have gone through something similar, or who might have a better understanding of this than I do.. I guess what I'm wondering is, is this as serious as it sounds? How likely is it that I'll be able to heal this w/just PT? I'm officially off the schedule at work for the foreseeable future, so I've got nothing but time to work on healing it.
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Replies
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What did your doctor say? I had/have a torn rotator, but didn't get an MRI so I have no idea how serious it was. It took about 18 months, including a couple months of PT, for the pain to go away, though I still have twinges if I move it wrong or put too much pressure on the shoulder by doing pushups or weights. When I found out what the problem was, I did some internet research because I was afraid of needing surgery and read that surgery is done in the serious cases, but was not likely to be necessary with the degree of pain that I was dealing with. Since you have a couple of 'high grade' tears, I think it likely that you will need surgery, but I'm not a doctor. He/she should have given you a much better idea of what you're facing.0
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I'm just going to assume you're looking at the interpretation without having talked to your doctor (easy enough to do depending on if you have the access automatically). That said. Don't ask us, ask your doctor. It's really that simple. None of us can give you an even moderately educated guess because we don't know you, we haven't seen the MRI, most of us are not practicing doctors (and even if we were, doing so would be unethical), and so on.0
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As has been said, ask the doctor. That being said I have had several shoulder operations, including rotator cuff. From my experience, the sudden jerking and momentary black out pain indicate this is nothing that is going to be fixed by PT.0
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Assume the worst then be happy if it’s not needed. You should be able to find out from doctor within a couple days.0
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Oh, there will be plenty of questions for the doc, that's for sure. These results were given to me by my GP; I've got an app't with an orthopedic surgeon next week. I was hoping I could get a little insight before then is all.0
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May want to read some stuff from Eric Cressey. Trainer who's a go to shoulder guy. Lots of free articles on his site. May help you frame questions for doctor.
https://ericcressey.com/1 -
My husband had several surgeries on his shoulder dating back to the 1960s; the first after he fell off a bridge in Germany while in the Army. Over the years his shoulder deteriorated even further, which led to more surgeries. Eventually the pain became so bad that he finally when to an orthopedic surgeon.
He ended up having a full reverse shoulder replacement (titanium) six months ago. He is now free of pain with full range of motion after surgery followed by about 12 weeks of PT. I guess he's a bionic man now. I wonder if he'll set off the alarms at airport security? We haven't tried it yet.
His surgeon did an amazing job. Equally important was his post-surgical care in the hospital and at home. The doctor made sure that he stayed in ICU post-op until his release after about 3 days. Once home the surgeon arranged for in-home visits from an RN for wound dressing, checking vitals, monitoring meds, and observation for infection. You will need help at home with wound dressing, bathing, and doctor follow up visits (no driving because your arm will be in a pillowed sling), etc.
He also immediately began passive physical therapy using a Kinex CPM device for six weeks followed by active physical therapy. The Kinex is a machine delivered by the company rep. who sets it up and teaches you and/or a family member how to operate it. It's basically a chair with an arm lift that increases range of motion in increments every other day, 3 hours per day (1 hour sessions), for six weeks until full range of motion in the shoulder is achieved. This is followed up with active physical therapy with a licensed physical therapist. We found a very good one close to our home.
Hope this offers some insight if you have to go the surgery route. It's a serious operation but worth the outcome.
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I've had rotator cuff surgery in both shoulders for different reasons.
Based on my experience, if there is a tendon or ligament tear in your shoulder, it will NOT heal on its own and surgery is the only option..
OP: You have THREE tears and I don't see why your doc would recommend anything but surgery to repair it.
You are looking at (at least) 1-2 months in a sling, 2-3 months of PT, 6 month to a, and year for full range of motion and strength to return.
Good luck!2 -
I agree with @sgt1372 and @Packerjohn
You have three high grade tears and PT is good but not a miracle that could fix them. I had surgery in both shoulder with less problems than yours.
See your orthopedic doctor and follow his lead. If you do need surgery, don't let it pass thinking that the problem will go away, or you may lose the full range of motion in your shoulder/arm even after surgery. The doctor can't perform miracles either. PT after surgery is very important and crucial to your complete rehabilitation. Take it seriously and deal with it. It will not be easy but very necessary.
What I am going to say is not going to make you happy but: be ready for some *kitten* pain. Good luck to you!!2 -
I have copied a link for you which may help and one point that is made is that shoulder surgery is avoided till all conservative treatments have been tried.
http://www.aidmyrotatorcuff.com/rotator-cuff/rotator-cuff-surgery-rehabilitation.php?ig1=p&ig2=g&ig3=c&ig4=SN&ig5=185294262657&ig6=rotators cuff tear&ig7=1t1&ig8=774045044&ig9=36100066450&gclid=Cj0KCQjwquTbBRCSARIsADzW88xoMPXeu9xEc5da5KxvT9ZUwtyXilZAlt1QVXXv8ZL6cA9HgYQH6OIaAm9oEALw_wcB
I had a rotator flare up. I woke up in excruciating pain one Thanksgiving morning. I had been cleaning and rearranging a large closet. My problem came from excessive use not caused but trauma, so I am different. In any case, I googled. Learned that most of the pain would be gone by morning and it was, but for the 20% of pain that was left I did a set of instructions for physical therapy till the pain was gone. I have never had the problem again, nor have I done that type of work again.
I hope you heal, Surgery for the shoulder causes scar tissue and that is why it is avoided so try to solve it without surgery.1 -
Ane, Keep us posted on this issue and I don't think you want to eat more. You can still be active.0
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I had a rotator flare up. I woke up in excruciating pain one Thanksgiving morning. I had been cleaning and rearranging a large closet. My problem came from excessive use not caused but trauma, so I am different. In any case, I googled. Learned that most of the pain would be gone by morning and it was, but for the 20% of pain that was left I did a set of instructions for physical therapy till the pain was gone. I have never had the problem again, nor have I done that type of work again.
If your shoulder pain went away just by doing this, you did NOT had a ligsment or tendon tesr. While you csn function (often w/o pain) with a minor tear, that's NOT the OP's situation.Surgery for the shoulder causes scar tissue and that is why it is avoided so try to solve it without surgery.
This is pure nonsense.
While lesser therapies shouldbe tried IF there is some reason they may work, there is NO therapy other than surgery that will fx a 3 way shoulder tear.
Also, surgury is NOT avoided for fear of scar tissue. Surgery is avoided because it is an invasive procedure which, like all surgeries, can lead to infection or other complications.
However, out of all the surgeries that I've ever had and there have been many, arthroscopic rotator cuff surgery is the least risky and, if I had any debilitating scar tissue from the 2 rotator cuff surgeries, I would not now have the full range of motion and strength fo do any lift or exercise, including OHPs and pullups.
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My husband had several surgeries on his shoulder dating back to the 1960s; the first after he fell off a bridge in Germany while in the Army. Over the years his shoulder deteriorated even further, which led to more surgeries. Eventually the pain became so bad that he finally when to an orthopedic surgeon.
He ended up having a full reverse shoulder replacement (titanium) six months ago. He is now free of pain with full range of motion after surgery followed by about 12 weeks of PT. I guess he's a bionic man now. I wonder if he'll set off the alarms at airport security? We haven't tried it yet.
His surgeon did an amazing job. Equally important was his post-surgical care in the hospital and at home. The doctor made sure that he stayed in ICU post-op until his release after about 3 days. Once home the surgeon arranged for in-home visits from an RN for wound dressing, checking vitals, monitoring meds, and observation for infection. You will need help at home with wound dressing, bathing, and doctor follow up visits (no driving because your arm will be in a pillowed sling), etc.
He also immediately began passive physical therapy using a Kinex CPM device for six weeks followed by active physical therapy. The Kinex is a machine delivered by the company rep. who sets it up and teaches you and/or a family member how to operate it. It's basically a chair with an arm lift that increases range of motion in increments every other day, 3 hours per day (1 hour sessions), for six weeks until full range of motion in the shoulder is achieved. This is followed up with active physical therapy with a licensed physical therapist. We found a very good one close to our home.
Hope this offers some insight if you have to go the surgery route. It's a serious operation but worth the outcome.
Are you in the US? I've never heard of anyone staying in ICU for 3 days following a shoulder operation. Did he have some high risk factor?0 -
I agree with @sgt1372 and @Packerjohn
You have three high grade tears and PT is good but not a miracle that could fix them. I had surgery in both shoulder with less problems than yours.
See your orthopedic doctor and follow his lead. If you do need surgery, don't let it pass thinking that the problem will go away, or you may lose the full range of motion in your shoulder/arm even after surgery. The doctor can't perform miracles either. PT after surgery is very important and crucial to your complete rehabilitation. Take it seriously and deal with it. It will not be easy but very necessary.
What I am going to say is not going to make you happy but: be ready for some *kitten* pain. Good luck to you!!
I'm going out on a limb, but the pain issue is a very personal one. I've had 6 shoulder operations (including rotator cuff) and pain was not a big deal. I believe I took maybe 3 doses of the prescription pain meds total over the 6 procedures. Several times, I got on my laptop and did a few things for work in the afternoon after an early morning procedure.
My wife had rotator cuff surgery and had a few more issues with pain. Personal thing.0 -
Packerjohn wrote: »My husband had several surgeries on his shoulder dating back to the 1960s; the first after he fell off a bridge in Germany while in the Army. Over the years his shoulder deteriorated even further, which led to more surgeries. Eventually the pain became so bad that he finally when to an orthopedic surgeon.
He ended up having a full reverse shoulder replacement (titanium) six months ago. He is now free of pain with full range of motion after surgery followed by about 12 weeks of PT. I guess he's a bionic man now. I wonder if he'll set off the alarms at airport security? We haven't tried it yet.
His surgeon did an amazing job. Equally important was his post-surgical care in the hospital and at home. The doctor made sure that he stayed in ICU post-op until his release after about 3 days. Once home the surgeon arranged for in-home visits from an RN for wound dressing, checking vitals, monitoring meds, and observation for infection. You will need help at home with wound dressing, bathing, and doctor follow up visits (no driving because your arm will be in a pillowed sling), etc.
He also immediately began passive physical therapy using a Kinex CPM device for six weeks followed by active physical therapy. The Kinex is a machine delivered by the company rep. who sets it up and teaches you and/or a family member how to operate it. It's basically a chair with an arm lift that increases range of motion in increments every other day, 3 hours per day (1 hour sessions), for six weeks until full range of motion in the shoulder is achieved. This is followed up with active physical therapy with a licensed physical therapist. We found a very good one close to our home.
Hope this offers some insight if you have to go the surgery route. It's a serious operation but worth the outcome.
Are you in the US? I've never heard of anyone staying in ICU for 3 days following a shoulder operation. Did he have some high risk factor?
Yes, we're in South Florida and he does have other health issues including age. Additionally, his shoulder was completely mangled from scar tissue and tears and that added hours to the surgery.0 -
Packerjohn wrote: »My husband had several surgeries on his shoulder dating back to the 1960s; the first after he fell off a bridge in Germany while in the Army. Over the years his shoulder deteriorated even further, which led to more surgeries. Eventually the pain became so bad that he finally when to an orthopedic surgeon.
He ended up having a full reverse shoulder replacement (titanium) six months ago. He is now free of pain with full range of motion after surgery followed by about 12 weeks of PT. I guess he's a bionic man now. I wonder if he'll set off the alarms at airport security? We haven't tried it yet.
His surgeon did an amazing job. Equally important was his post-surgical care in the hospital and at home. The doctor made sure that he stayed in ICU post-op until his release after about 3 days. Once home the surgeon arranged for in-home visits from an RN for wound dressing, checking vitals, monitoring meds, and observation for infection. You will need help at home with wound dressing, bathing, and doctor follow up visits (no driving because your arm will be in a pillowed sling), etc.
He also immediately began passive physical therapy using a Kinex CPM device for six weeks followed by active physical therapy. The Kinex is a machine delivered by the company rep. who sets it up and teaches you and/or a family member how to operate it. It's basically a chair with an arm lift that increases range of motion in increments every other day, 3 hours per day (1 hour sessions), for six weeks until full range of motion in the shoulder is achieved. This is followed up with active physical therapy with a licensed physical therapist. We found a very good one close to our home.
Hope this offers some insight if you have to go the surgery route. It's a serious operation but worth the outcome.
Are you in the US? I've never heard of anyone staying in ICU for 3 days following a shoulder operation. Did he have some high risk factor?
Yes, we're in South Florida and he does have other health issues including age. Additionally, his shoulder was completely mangled from scar tissue and tears and that added hours to the surgery.
Thanks for the clarification, 3 days in the hospital seemed out of the ordinary. We had a neighbor age 70+ get both knees replaced and I believe they just kept him one night.
Anyone I've personally known that had shoulder surgery was outpatient.0 -
Packerjohn wrote: »I agree with @sgt1372 and @Packerjohn
You have three high grade tears and PT is good but not a miracle that could fix them. I had surgery in both shoulder with less problems than yours.
See your orthopedic doctor and follow his lead. If you do need surgery, don't let it pass thinking that the problem will go away, or you may lose the full range of motion in your shoulder/arm even after surgery. The doctor can't perform miracles either. PT after surgery is very important and crucial to your complete rehabilitation. Take it seriously and deal with it. It will not be easy but very necessary.
What I am going to say is not going to make you happy but: be ready for some *kitten* pain. Good luck to you!!
I'm going out on a limb, but the pain issue is a very personal one. I've had 6 shoulder operations (including rotator cuff) and pain was not a big deal. I believe I took maybe 3 doses of the prescription pain meds total over the 6 procedures. Several times, I got on my laptop and did a few things for work in the afternoon after an early morning procedure.
My wife had rotator cuff surgery and had a few more issues with pain. Personal thing.
Glad to know that your pain was not bad, and sorry for your wife. I didn't have arthroscopic surgery; both were open shoulder surgeries do to the damage and the location of the tears; therefore, the procedures were more invasive and so was the rehabilitation. I even developed a frozen shoulder on my left one (doctors' fault), and that was not fun to deal with and to overcame. I now have bursitis, arthritis and tendinitis in that shoulder so I am restricted with the kind of exercises that I can and should do.1 -
Packerjohn wrote: »Packerjohn wrote: »My husband had several surgeries on his shoulder dating back to the 1960s; the first after he fell off a bridge in Germany while in the Army. Over the years his shoulder deteriorated even further, which led to more surgeries. Eventually the pain became so bad that he finally when to an orthopedic surgeon.
He ended up having a full reverse shoulder replacement (titanium) six months ago. He is now free of pain with full range of motion after surgery followed by about 12 weeks of PT. I guess he's a bionic man now. I wonder if he'll set off the alarms at airport security? We haven't tried it yet.
His surgeon did an amazing job. Equally important was his post-surgical care in the hospital and at home. The doctor made sure that he stayed in ICU post-op until his release after about 3 days. Once home the surgeon arranged for in-home visits from an RN for wound dressing, checking vitals, monitoring meds, and observation for infection. You will need help at home with wound dressing, bathing, and doctor follow up visits (no driving because your arm will be in a pillowed sling), etc.
He also immediately began passive physical therapy using a Kinex CPM device for six weeks followed by active physical therapy. The Kinex is a machine delivered by the company rep. who sets it up and teaches you and/or a family member how to operate it. It's basically a chair with an arm lift that increases range of motion in increments every other day, 3 hours per day (1 hour sessions), for six weeks until full range of motion in the shoulder is achieved. This is followed up with active physical therapy with a licensed physical therapist. We found a very good one close to our home.
Hope this offers some insight if you have to go the surgery route. It's a serious operation but worth the outcome.
Are you in the US? I've never heard of anyone staying in ICU for 3 days following a shoulder operation. Did he have some high risk factor?
Yes, we're in South Florida and he does have other health issues including age. Additionally, his shoulder was completely mangled from scar tissue and tears and that added hours to the surgery.
Thanks for the clarification, 3 days in the hospital seemed out of the ordinary. We had a neighbor age 70+ get both knees replaced and I believe they just kept him one night.
Anyone I've personally known that had shoulder surgery was outpatient.
These days, I think most places do it in a drive thru (at least you get some fries afterward).
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