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Thread: Shoulder muscle breakage.

  1. #1
    Junior Member
    Join Date
    Mar 2004
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    norway
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    Question Shoulder muscle breakage.

    Have been SCI , complete Th6 , post 29 years. Have also lived a active life , doing what
    I what able to do like a "normal" life.
    The last year specially, I have had problems with pain in shoulder and upper arms-area.
    Now to the real problem : Last week I lost balance in my manual-wheelchair , and got
    a hard "punch" to the left side of the shoulder. Got a lot of pain and lost movement
    in my left arm. Went to doctor , and he stated that I had "broke loose " muscles in shoulder.
    "Ruptur in supraspinatus and infraspinatus " is the term name , and that I must go through an operation
    within two weeks.
    Now I have big problems just getting out of bed to my chair or moving myself from one chair
    to another. I just dont have power anymore in some of the muscles. Have fallen down betwen chairs lots of times.
    Have anyone other experienced about the same ,with torn muscles and how to manage in the period arm
    cant be used at all after the operation. I mean how to manage all normal things we all have to do.(get dressed,stay clean,toilet and so on.

    I would be happy if some of you have some advise and tips what to do to easy this period
    after operation. Ps: My wife work 100% , and therefore alot of time on my own.
    (hope you understand my bad language in writing , I live in Norway)

  2. #2
    I did that to both shoulders and also ripped the biceps off both longheads. I'm 39 yrs. post. My doc told me at my age, time in and my extreme active lifestyle, that they would probably not last very long till they did it again.

    For the pain I got a cortizone shot. I have chiropratory, massage and work out with a trainer to try to keep the opposing muscle groups strong. I also handcycle using a roadrace powerpod to help with the cardio and strength. I use those stretchy bands and cords of various strengths rather than heavy weights now and started out gently getting the shoulders in better shape. It's been around four years now and still at it.

    I can't transfer like I used to so my wife and I have a buddy system where she just grabs the back of my pants and gives that little boost I need to get started. When she's not around, I use a transfer board. I was blessed to get one of those ZX-1 power add-on's for my chair and use it occassionaly.

    It's part of aging and life Yo. Get a cortizone shot for the pain, a second opinion and really prepare for after surgery if you decide cause I hear it's a hell of a time. Good luck, stay positive.

  3. #3
    You will have to change your lifestyle for 6-12 weeks after surgery. You can not use that shoulder and you msut do what the doctor says or it won't heal. Maybe your wife can help get you set up and adapt things to make it easier but you can't transfer or anything without her full support or assistance.Can you get a provider or someone to come in during this post operative recovery period??
    CWO

  4. #4
    If it is possible in Norway, I agree that a second opinion should be sought. Regardless, you need to find out what the consequence of not getting repairs will be. That is something that can only be answered by someone with the details of the injury. Then make the decision.

    I do not see how it would be possible to manage during the recovery period without considerable assistance and a power wheelchair to operate with one hand.In the short term, using a sliding board might help with transfers. With the falls, you are risking fractures that will compound the problem.
    You will find a guide to preserving shoulder function @
    http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

    See my personal webpage @
    http://cccforum55.freehostia.com/

  5. #5
    Senior Member
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    Hi Yo, I agree with everything said here. A cortisone shot will help a little with the pain, but you really need to be careful about not doing any further damage. A power chair will be necessary for you to have any sense of mobility as you heal and recover. Perhaps it is possible to rent one for the time needed, or it might be a good time to think of transitioning to one as a full time option. I know that comes at a huge emotional price (or it did for me, at least) but in the end it is all about maintaining function so that there is quality of life, and a power chair definitely opens up areas that otherwise would be closed off to you because of pain and fatigue.
    I chose not to have surgery because I have no one in my life who could help me for the many weeks necessary, so I try to just be very careful, take things like oxycodone and tramadol for pain, and hope for the best.
    Wishing you the best, no matter what your decisions are. Keep writing and let us know how it is going for you.

    I forgot to mention that I am coming up on 46 years post injury......
    Last edited by Eileen; 06-16-2012 at 10:45 AM. Reason: To let Yo know how long I have been SCI

  6. #6
    Senior Member
    Join Date
    Apr 2011
    Location
    San Diego, CA, USA
    Posts
    325
    When the SCI nurse says change you life style, it might be a big understatement. After this surgery in the USA, you cannot move your arm at all for several days, and then you must wear a restrictive brace for a few weeks.

    It seems that about 30 years in the chair is when these things begin to appear for most of us.

    I think the surgery is fairly routine, but I would discuss in detail how they will handle the several weeks of recovery where you have one arm.

    If you are going to do the surgery, it is probably best to do it now. The success rate is poor on long term injury.

    Good luck.
    T4 complete, 150 ft fall, 1966. Completely fused hips, partially fused knees and spine, heterotopic ossification. Unsuccessful DREZ surgery about 1990. Successful bladder augmentation using small intestine about 1992. Normal SCI IC UTI problems culminating in a hospital stay in 2001. No antibiotics or doctor visits for UTI since 2001: d-mannose. Your mileage may vary.

  7. #7

    Let me tell you about rotator cuff injuries.

    Yo, your English is very good.

    For rotator cuff injuries? Keep reading. At the end, it does get better. Your shoulders will be out of balance strength wise but with time, patience and weight lifting you can get them near the same strength.

    Look here:

    http://sci.rutgers.edu/forum/showthr...14#post1508214

    But ... [This is from a previous post.]

    Let me tell you about rotator cuff injuries.

    You will have pain after your surgery.

    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."

  8. #8
    Junior Member
    Join Date
    Mar 2004
    Location
    norway
    Posts
    15
    Hello everywone !
    I am most happy for all your advice and help for what to do, THANKS !
    You see , when I was to "shoulder-doc" , he said to me that there is no other options than surgery. Asked him what will happend if not surgery , then he just said my left arm will continue like now , that is major problems for me in everyday-life.
    Can not lift my arm more than about 40 degrees right out to the left of my body. It is strange, when I lift up my both arms , like a plain with my arms as wings , right side goes fine and also all the way up to straight pointing the roof. Left stop before it is
    up in the shoulder-height.
    I belive I must start preparring for living almost without left arm , and a hole lotta pain.

    Thanks again to You all !

  9. #9
    Senior Member
    Join Date
    Apr 2011
    Location
    San Diego, CA, USA
    Posts
    325
    Interesting response from your surgeon. I cannot lift my left arm at all to the side. My elbow rarely leaves my side. 40 degrees to the side would be happy days indeed. If I need my left hand above my head, I pick it up with my right hand. Once it is up, it is usable for light tasks like hanging clothes.

    In contrast to Norway where surgery is the only option, in the USA they have refused to do surgery on me and told me to tough it out. Part of it is my age, but I think the big thing is no one is willing to pay for the extended rehab.

    Good luck.
    T4 complete, 150 ft fall, 1966. Completely fused hips, partially fused knees and spine, heterotopic ossification. Unsuccessful DREZ surgery about 1990. Successful bladder augmentation using small intestine about 1992. Normal SCI IC UTI problems culminating in a hospital stay in 2001. No antibiotics or doctor visits for UTI since 2001: d-mannose. Your mileage may vary.

  10. #10
    Dear yo,
    Additional thoughts...you may want to get a power wheelchair temporarily before and after surgery to minimize additional stress to your shoulder; make changes in how you transfer. After the surgery your shoulder will need to rest and the surgeon will decide when you start PT on the shoulder. I have many patients who have had surgery done and it minimizes pain will limit your ROM. You can still be active, you will just have to make adjustments to how extreme your activity will be.

    pbr

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