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Thread: Rotator Cuff Tear Repair - Would Like To Hear About Your Experience

  1. #1
    Senior Member wheeliegirl's Avatar
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    Rotator Cuff Tear Repair - Would Like To Hear About Your Experience

    I would like to hear from anyone who has had a rotator cuff tear repair. I found out yesterday that I have a small tear in my left shoulder. I am left handed. I realize that the implications of having surgery are huge (basically will need round the clock care and won't be able to drive my car cuz I won't be able to get my chair in it independently, etc. etc. etc.)

    Doctor is not keen on doing the surgery right now (or ever), and we are going to work on reducing the pain by having physical therapy sessions. However, I still would like to know about how other's dealt with their surgeries who are in similar situation as me just in case the worst happens and the tear grows larger, more painful....

    I am T2 para, live by myself, drive a car, use an ultralight weight wheelchair which I put in the car myself. I have little to no support from family or friends to assist me with daily living needs. I must get myself to work, shopping, doctor appointments, etc by myself. I am 48 and also a couple of years ago had spinal fusioin T1-T9 and am still taking pain meds for this (but they don't help with the shoulder pain).

    How did you deal with your ADL's, especially managing your bowels? I must remove stool manually, and use my left hand. How did you dress? Did you have to do major renovations to accommodate using a power chair? Did you recover completely or do you still deal with pain and immobility of the shoulder?

  2. #2
    Here's a big hug for ya WG, I know the scared feeling of that dreaded rip in the shoulder news. For me they do get better and trustfuly, we get stronger. We have had good discussions on this in previous threads you could look up.


    The doc is absolutely right about being hesitant on surgery. The rehab can be arduous and eventual failure again is very high. Once you're cut, you're cut; there's no going back.

    I have some rips tears and other shoulder detachments that aren't important to get into. My otrho told me that it would be months before I could even try to transfer independently again and that trial alone could rip out all his work as well as just falling over on it. He basically told me to come in for the "juice" ,cotrizone, when I needed to and to get what was left as strong as I can. Which I do.

    Small tears to the rotators is not unusual, even for ab's. I suggest you get a good routine to work the rotators and shoulder to strengthen the supporting muscles; everything will fall into place.
    A good trainer would really be beneificial or one just to show you the routine. Do anything you can to avoid surgery. I gave myself six months with the first tear, if it didn't get better then I would have it done. It got better as did the rest. Not up to 100% but up to around it would be with the surg. The pain has diminshed considerably. I find the hurt more if I don't use them than when I do; in a smarter way.

    I looked into powerchairs and yes, it is a big adjustment for sure; instead, I bought one of Pat's ZX-1's and it is really the cats meow. I can do so many things while using it that I would not have been able to do in a pc and much less renovation to my living areas.

    Trustfully, just some lifestyle changes and time will do the trick. Stay strong.
    Last edited by Patrick Madsen; 06-11-2011 at 08:21 PM.

  3. #3

    My experience ...

    From post http://sci.rutgers.edu/forum/showthr...=136782&page=2

    Let me tell you about rotator cuff injuries.

    Ever since I sustained a spinal cord injury in 1987 I have always taken extra care of myself. Injuries do happen. I tore my rotator cuff(s) in 2007 from lifting a dumb bell. I had to get arthroscopic surgery to “anchor” the tear. I had two anchors put in.

    It first started out as a constant burning pain in the shoulder that didn’t go away. I realized I injured it because I couldn’t lift the weight above my head, not at all. I knew something was wrong. I went to see my shoulder doctor who is an orthopedic surgeon. He evaluated me first by extending my arm out and he would either push on it or have me push on his hand. He could tell you which muscle/tendon is injured.


    An X-ray is the first step to see the shoulder. I saw mine and I do have arthritis which is clearly visible. The rotator cuff injury we couldn’t see. At this visit I was given pain medicine but it only dulled the pain. So I had to get a magnetic resonance imaging, MRI, done. When the doctor reviewed the MRI I was called into his office to go over the MRI and to setup a surgery appointment. They were able to get me in within 10 days.


    Day of surgery I was at the hospital at 8:00 a.m. Three little incisions, three pokes with instruments, two anchors, stitched up, recovery and out the door by noon. Bed rest for the first three days. For an ambulatory person they would be in a sling for three months. ‘chair people the healing takes longer. Just because you get surgery to repair a torn rotator cuff doesn’t mean the pain goes away when they send you home!


    Once inside the shoulder with the scope the doctor was able to see the actual damage to the rotator cuff tendons.

    A funny thing though. When I was home I saw in the mirror this pin sticking out of my back. I thought that was the anchor? About ten days later in the shower it fell off! It was a tab the EKG machine used that a nurse didn't remove after surgery.

    I never experienced pain before during my spinal cord injury but after arthroscopic surgery. My God, (Please forgive me.) I know what severe pain is now. From 1 to 10 on the pain chart I had 10. The pain doesn’t get immediately better but worse because you just now had surgery. I was given vicodin (generic hydrocodone) and it didn’t even touch the pain. I was so miserable! I went back to see my orthopedic surgeon and he couldn’t give me any more narcotics otherwise the DEA would be knocking on our doors. He referred me to a pain management specialist who is licensed by the state to issue narcotics. I got so sick from the vicodin I ended up go to the emergency room! I was never so sick in my entire life! Not even during my initial spinal cord injury.


    After my surgery I did faithfully attended physical therapy three times a week for 90 days. That is what my insurance covered. What I learned in PT is ice and light exercise helps with pain.


    The pain management doctor was great! God bless him! We tried two pain medicines first.

    First week was one medicine that didn’t work. Office visits were weekly until the pain was under control.

    Second week we tried another pain medicine that didn’t work.

    Week three he asked, “Have I ever been on morphine?”

    I said, “Never.”

    He put me on morphine 30mg every eight hours (3x a day). It worked but it didn’t nip the pain all the way.

    Week four we increased the morphine to four times a day and BINGO! It worked! I was pain free, for now. I took it every six hours on the dime! I was on morphine for five more months until one day I missed taking my pain medicine. I went for six hours to twelve hours and no pain. I continued longer to eighteen hours and a day. No pain. Then two days. Three days no pain. The rotator cuff healed.


    Did I have withdrawal symptoms from the morphine? Yes, insomnia.


    For the next year I was easy on my shoulder. Days I was hard on my shoulder I felt a little pain but pain I was able to live with. It wasn’t until two years later I started lifting weights again. I can tell my shoulders are out of balance. The shoulder with surgery is not as strong as the non-injured shoulder.


    I had a friend who told me years ago, “After twenty years pushing a ‘chair you’re going to experience shoulder problems.” He was right in sense of the word but my injury was from a dumb bell and not pushing a manual ‘chair.


    This was my first serious injury or surgery I had post spinal cord injury. Take care of your shoulders if you push a manual 'chair. Keep your weight down and exercise your shoulders to keep them strong for years to come.


    Ti
    "We must overcome difficulties rather than being overcome by difficulties."

  4. #4
    Senior Member wheeliegirl's Avatar
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    Thankyou. Please keep the stories coming. Surgery is definately ging to be a last resort for me, that's for sure!

  5. #5
    Ok.... here's another story for ya

    I had been having awful left shoulder pain for about a year before I was sent to therapy. My doctor tried cortisone shots prior to that. I asked him about images and he said he didn't think they would show anything. When the cortisone shots didn't help for more then a day, at the most, he then decided to get images- that was last June. I was visiting a friend for the weekend and he called me up on a Saturday telling me that I needed to make an appointment with a surgeon. He then told me about the tears, the impingement syndrome, and the multiple bone spurs. I had my shoulder surgery this past September 2010. I am still in terrible pain. The pain goes from my shoulder all the way down to my elbow. I still have weakness in my left arm so pushing my manual is very lopsided still. It is better on even laminated surfaces but outdoors just looks ridiculous. I'm so glad that you are making it a last resort!!! I wish that I would have been more demanding with the more conservative therapies earlier in the pain arriving but I thought that it was just a natural thing with using my arms so much.
    Best of luck to you!!!!

    Oh, one more thing, I am right handed so that was the only saving grace.

    Becky
    T8-9 according to latest scoring.......
    since 1/3/04

    I am the best at being me. No matter how that happens to be!!

  6. #6
    totally agree w/ pat. surgery isnt even an option. luckily most tears will heal and after a mth or 2 your back to normal. in 25 yrs ive had 2 issues. detatched something in my bicep, healed fine after about a mth and in april i tore something in the back of my shoulder either rotator cuff or rear delt. shoulder dislocated when this happened in middle of car transfer. this was 3 weeks b4 clevelnd marathon. i trained through the pain and weakness then completed the marathon. i didnt drive for a few weeks. im nearly back to full strength in that shoulder now. so 2 mths recovery time. imo, any ortho that suggests surgery to a gimp is a fucking moron. any gimp that lets someone cut on their shoulder is a fool. i have heard many shoulder surgery stories and every gimp said it was a huge mistake.

    high protein, motrin and heat/ice should help you. and mega doses of guclosamine chondroiton. but you gotta train to strengthen everything back up. the handcycle motion REALLY feels good on a bad shoulder injury.
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  7. #7
    Quote Originally Posted by fuentejps View Post
    totally agree w/ pat. surgery isnt even an option. luckily most tears will heal and after a mth or 2 your back to normal. in 25 yrs ive had 2 issues. detatched something in my bicep, healed fine after about a mth and in april i tore something in the back of my shoulder either rotator cuff or rear delt. shoulder dislocated when this happened in middle of car transfer. this was 3 weeks b4 clevelnd marathon. i trained through the pain and weakness then completed the marathon. i didnt drive for a few weeks. im nearly back to full strength in that shoulder now. so 2 mths recovery time. imo, any ortho that suggests surgery to a gimp is a fucking moron. any gimp that lets someone cut on their shoulder is a fool. i have heard many shoulder surgery stories and every gimp said it was a huge mistake.

    high protein, motrin and heat/ice should help you. and mega doses of guclosamine chondroiton. but you gotta train to strengthen everything back up. the handcycle motion REALLY feels good on a bad shoulder injury.
    thanks, Fuente. i respect your input! - got a wicked knot under my left scapula right now........hopefully just overuse - goes around my tricep/deltoid down to my pinkie. Rock on, man. - Garro.

  8. #8
    Agreeing with the rest. I had and maybe still have a bad right cuff, got it from a transfer in June of 08. Doc wanted to do surgery and if not that then shots. I asked about therapy, he said oh, you want to work? I could only do 5 reps with theraband but eventually worked up to 100, the harder it's worked the better it feels. After 41 years I'm still manual. At times it hurts like hell, especially at night. I don't like eating pills as they're hard on the stomach & kidneys and hate needles so it's put up with the pain. I still think it was the right choice. Best of luck to you!
    From the time you were born till you ride in a hearse, there is nothing so bad that it couldn't be worse!

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  9. #9
    Senior Member wheeliegirl's Avatar
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    Thanks everyone. I am in the process of seeking a pain doctor (for back issues and possibly on going shoulder issues) and a physical therapist that is in side my insurance network. I think I might even buy a table top hand cycle machine, but that is a huge expense. I used to attend a special needs exercise class at a nearby community college, but quit becuase there were never enough attendants (physiology students) to help setting up the machines (some machines couldn't be set up due to strength limitations and sometimes assistance was needed to do particular exercises). But they did have 2 hand cycles. I always enjoyed working on them, but got easily bored due to no "scenery" ha ha ha. Also, had to share the machines with the other students so one could only spend about 15 minutes on the machine. I should check and see if it is too late to register for the Summer semester, or, if the class is till available due to budget cuts.

    My insurance will only pay for 24 sessions, so if I go for 2 per week thats only 3 months of PT. The last time I went (I've been for each shoulder once already) it helped, except for the last time, when I did succomb to a cortisone shot, but it did wonders.

    I will take what you all have said and keep it in mind.

  10. #10
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    Sorry to not have seen this sooner. 68 year old T4 para 45 years in a manual chair. Major tears in both shoulders, some decades old. Lots of shoulder pain and very restricted movement. Wife is polio 37 years in manual chair. Less tearing, but some shoulder pain. Wife's uncle is orthopedic surgeon.

    Surgery is not a good idea. Wheelchair folks impose loads on their shoulder that walking around folks cannot imagine, and the probability that you will heal properly is near zero. Also, surgery has the best success immediately after injury and that is almost never the situation with us wheelchair folk. I would be very leary of any doc who says they can do surgery on you.

    The shoulder is a ball and socket joint http://www.webmd.com/pain-management...e-rotator-cuff The key to avoiding injury and living reasonably seems to be keeping the ball tight in the socket. This is done with small muscles attached to the rotator cuff. Pushing the wheelchair and transfers over exercise one set of muscles with repetitive motion, and under exercise others with no usage. This weakens all of the involved muscles and allows the ball to loosen in the socket. With the ball loose, then pushing the chair, transfers etc push the ball up. Pushing the loose ball up clamps the supraspinatus tendon between the ball and t
    he collar bone. Once the supraspinatus is clamped any stress tears it, which loosens the ball farther and things go down from there.

    It is small muscles across your upper chest and upper back that keep the ball tight in socket, not the big ones. Judging from my now well calibrated pain, each of the small muscles seems to handle a specific motion over a limited range. For exercise, this implies gentle exercise with limited range of motion for each exercise, and exercising every possible motion you can make with the shoulder. Absolutely NO heavy weights, large ranges, and NO pain. No pain no gain is nonsense. Don't do it if it hurts.

    Over the years I have tried everything in the way of PT with limited success. The best I have found is the 4 foot Body Bar Flex 20. http://www.bodybar.com/Body-Bar-Store/Body-Bar-Flex I got mine at the lowest price I could find on the web.

    I heard about this a few weeks ago from an acquaintance 33 years in a chair who told me it took away the pain he had for years after two or three days of use. This was exactly my wife's experience. Two or three days and the pain was gone. In my case the Flex 20 is too much for me. It is helping my stronger arm, but the currently weaker more torn up shoulder is going much more slowly. I emailed the president of the company and asked about the possibility of a Body Bar Flex 10. He said they had one in development and would be happy to send me a development sample to try. I was amazed. It is supposed to arrive this week, so I will report back.

    I think the reason this thing is effective is that it exercises the small muscles around the joint in ways that our daily life does not. I think it is better than stretch bands because there is zero set up, almost zero time is required to change to a different exercise, and it is easy to experiment and see what feels right to you. So you can quickly do a variety of exercises, and if it does not feel right move on. It is not a cure -- it does not magically repair torn tendons. But in 3 out of 3 cases that I am aware of it has been beneficial, and in 2 out of three it removed the pain.

    I have no financial interest in this, just excited because it is the best thing I have seen in years of attempting to deal with shoulder pain.

    So that is my two cents.


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