Rotator Cuff Repair With Arthroscopic Acromioplasty

[wheeliegirl]

Hi everyone;

I saw my shoulder ortho Dr. today to ask for another round of PT for my right shoulder. It seems that my shoulders take turns switching off being painful. This will be the 4th round of PT, so twice for each shoulder. I opted to not get a cortisone shot this time, in the hopes that a few weeks of PT will help.

He is recommending bone shaving for my issue, and wants to do one shoulder at a time. Have any of you had this surgery? He made it sound as if the recovery was rather quick, and seemed to think that I'd be "back to mostly normal in a couple of months". His description of normal is living as I do now, which is almost doing nothing and going nowhere to save my shoulders. I order groceries online for delivery and only go to Target and other stores when I am absolutely out of everything that I need, and I buy a lot in bulk so that I don't need to go that often. I live alone and have no one to speak of to assist me with ADL's or chores, such as getting clothes out of my dryer, which is on top of my washer, vacuuming, etc. I can't afford to pay anyone for help either.

I am a T2 para with a lot of spasticity in my lower extremities that makes transferring, especially into my tub shower a challenge. It's amazing how heavy our legs are!

For those of you who have had the procedure:
When did you have the procedure?
Are you a manual wheelchair user?
What is the level of your injury.
What was the pain like (days/week) afterwards?
How long after the procedure could you complete ADL's, transfers, toileting, bath/shower, dressing and driving a car and getting your wheelchair in and out without assistance?
Has your shoulder pain gone away and how long did it take to feel "normal"?
Would you do it again or recommend it to someone else (like me)?

Thanks!

[JoeMonte]

It really depends on if you can rehab yourself. I had my left shoulder done and now going for an MRI in the morning for my right. Just use light free weights. It really helps. After surgery, it does take a couple months to get back in the swing of things. I wish you well. Also if they will give you a cortisone shot every three months, take it. I have been doing it for the last two years and it really helps.

[Patrick Madsen]

As one with torn biceps off both longheads, rotator tears a truck could drive thru and spinatuses that yell all the time, try to take as few cortisone shots as possible. they eventually weaken the tendons and turn them into mush.
I did the same with the cortisone and over the years took it's toll. If it's not painful don't do the Cortisone. Chiro, Massage and a good trainer who thinks outside the box will help more IMO.

Most shoulder problems come from having unbalanced muscle groups. We are so used to a pushing motion that the rhomboids and other opposing groups are overlooked.

Just remember that once they cut, there is no going back. I have a rubber cord in my seatpouch that I bring out and use while waiting etc. I can do an entire workout with it anywhere I am. really helps in maximizing my potential with what I have left. No more Cortizone for me.

[graybeard]

I have a frapped out right shoulder....torn bicep tendon, and the rotator cuff is torn. After reading a lot of the posts here, I decided against surgery for now. I will wait till the arm is useless before I get cut. The pain can get gnarly, but doing some exercising and ice/heat w/stim helps get thru the day.

Best of luck to you, and am curious to hear how you do.

[David Berg]

I had shoulder surgery about 3 years ago. My doc had to do little carving on a SLAP lesion and a bone spur digging into the bursa (which required removing the bursa) and found a rotator cuff tear while he was in there that hadn't shown on imaging. I underestimated the recovery time and magnitude in my case. I strongly recommend getting into range-of-motion exercises as soon as you can manage, and strengthening exercises right behind that. I started with just a rope and pulley to help pull my arm up. Plan to work on ROM and strengthening long-term, it makes a difference. Wait until you see how your recovery from the first surgery is going before you even talk about the second one. I had one PT tell me that it could take a year before my shoulder really felt like my own again. Hopefully your's will be a little smoother.

Oh yeah, I also got a lot of benefit from a TENS unit during recovery. I got mine from http://www.lgmedsupply.com/ for a reasonable price, in case you don't have insurance to help supply one. If I were to get a new one today, I'd get one with an interferential mode.

[aidan416]

I had a total of 5 cortisone shots and PT for my left shoulder over the past 18 mos. I actually tore my cuff some time after injection # 4 or 5. I just had an appointment at Mass General yesterday and the Doc said that my tear was most likely caused by the injections-most likely the last two. I knew the potential for weakening the tendon was there but I was just trying to get through the last of my race season and gambled. A really big mistake. Stay away from cortisone shots if you can-I am really regretting my choice now. I am just hoping to make it through this upcoming season.

[wheeliegirl]

Thank you. Im having a VERY hard time dealing with the pain. My PT cant see me until the 24th. The pain is so bad that i can barely even make a cup of coffee. Transfers are almost unbearable. I have stayed at home for 5 days in the hopes that i would see some relief but its only gotten worse. Im really scared and have no one to turn to to ask for temp help with household chores. Putting a bra and top on is painful too. I was considerkng going in for a shot on Monday but your responses have me scared. Ive never felt so uncomfortable before. Pain meds dont help, icing doesnt help and anti-inflamatories arent doing a thing.

For those of you who bad a procedure what did you do to care for yourselves afterwards? I do not want to go to a nursing home. This is all so depressing and scary and i think this may. E as. Ad as the pain, is fearing losing even temporarily what little independance that i have. Im sure you a can understand this.

Im not a "baby" by any means. Ive gone through 3 back surgeries the most recent being t1-9 fusion 3 years ago. Im trying hard to be prepared. But without a suppor system of family and friends around it isnt easy. I cant just sit around and cry aboit it.

Im sorry to share so much of my personal problems.

Ease telll me about what happened afterwards. How were you able to get to the toilet, in and out of bed etc.

Thanks.

[Patrick Madsen]

If you're in that much pain, ya need the shot.

[stephen212]

Originally Posted by wheeliegirl

I opted to not get a cortisone shot this time, in the hopes that a few weeks of PT will help.

When you say that you opted to not get a cortisone shot this time, does that mean you've gotten them before?

I agree with Patrick that if you're in serious pain you should consider getting the injection even if the result is only temporary. It would at least buy you some time to get a few more opinions regarding surgery.

I would approach surgery with caution as it frequently seems that each surgeon understands the problem differently (and often inaccurately) and uses different surgical approaches. You know the expression, "If all you have is a hammer, everything looks like a nail." Surgeons like to cut and their predictions regarding recovery time and return of function have to be taken with a boulder of salt.

The fact that your shoulder pain seems to be alternating from one shoulder to the other is, maybe, an encouraging sign. If the pain is remitting maybe the damage isn't severe enough to warrant surgery.

I had a small rotator cuff tear about 8 years ago. Weight bearing when doing transfers were excruciatingly painful. I got a cortisone shot. The pain was gone and my shoulder is near perfect. One or two injections isn't the end of the world. It's the conservative approach and I would suggest you give it a try before going under the knife.

[SCI-Nurse]

Having this surgery is a big decision, esp. with your living situation.

When we do rotator cuff reconstruction at our center, the person is on total shoulder rest for 6 weeks post-op. This means no lifting, no active movement of the arm (it is usually tied down to a bolster at your side) at the shoulder or elbow, no arm weight bearing, and only limited use of your wrist and hand.

We therefore do not allow manual or independent transfers (a mechanical lift only), or use of a manual wheelchair (we loan a power chair with the controls on the opposite side), long or short sitting with the arms supporting the trunk, no manual wheelchair weight shifts, and assistance or total dependence with most personal care and activities of daily living (bowel care, dressing, bathing, etc.).

If you can get someone to stay with you in your home for this time, and provide you the care that you will need, this may be an option rather than going to a nursing home for those 6 weeks. Otherwise, that is what most people have to do outside the VA system, as it is rare to get approved for other than a 24 hour hospital stay for this procedure...for ABs it is usually done as outpatient surgery.

At about 3 weeks post-op, PASSIVE movement of the shoulder is usually begun with a PT or OT doing these exercises and making sure that you don't do active motion during this. At 6 weeks, if all goes well, active shoulder and elbow exercise (but no weight bearing) is begun, and then gradually weight bearing is added over several weeks of therapy. Some on our forums have been able to go to an acute inpatient rehab center for this phase of recovery, which would be much better than a nursing home.

It doesn't sound like this surgeon has done this before for someone with SCI and does not at all understand the activities you normally have to do using your shoulders. I would strongly encourage you to get at least a second, and perhaps third, opinion from someone who has done this for people with SCI, and who also has a better understanding of your needs and usual activities.

(KLD)