Way OT - rotator cuff surgery. Anyone have success stories?
So I fell in the spring. I'm 47, fat, but still active. They are still doing imagery but based on my xrays they think I have a complete rotator cuff tear; and maybe have had one for awhile but the fall 'highlighted it'. They want to put a piece of fascia in to replace my RC. They say if I don't I'm looking at getting a new shoulder in 2 years.
What wigs me out is that the failure rate on RC surgery looks like it SUCKS.
I like to lift weights; do the occasional Judo match. It's my version of my Dad's golf for stress relief.
Has anyone had RC surgery and been able to come back with a good functioning arm? I'm just struggling with 'You were asymptomatic before but now you are symptomatic and we have to do this surgery with a high failure rate and super long recovery or you'll get a new shoulder'.
I have not had it but I know at least half a dozen guys that have had it in the past 5 years and all of them severely regretted it for about a year and then after that were very happy they did it. Totally better in the end but life absolutely SUCKED for roughly a year depending on the guy
I had accumulated wear and tear over a number of years from different separations and tears etc. Finally had it and would suggest doing it if it is at that point for you. The worst part is the rehab, but if you get through that it’s a huge improvement.
I had a full rotator cuff tear about 6 years ago (while lifting weights). Had it fixed and shoulder has been great once the recovery was done...I'd say near full recovery in 6 months. I was about 50 years old when it occured. It helps catching and fixing it soon after it tears as over time the tendon will shorten and make it harder to reconnect.
RTC surgery is very dependent on the surgeon. I have treated a lot of pts and it’s honestly the largest factor of their outcome. If your in the Detroit area or within a couple hour drive I would highly recommend Dr. Laith Farjo. He is an amazing surgeon all around
Farjo did mine. Tried to make myself believe my shoulder would improve without surgery. I figured at the age of 55 why do I need to ever throw a ball of any kind again. When you can’t sleep at night anymore because it’s impossible to be comfortable... you have the surgery. P.T. Is hard but do it correctly after surgery and you will improve. Initially remember that ice is your best friend. It’s been several years now for me and I still do many of the exercises I learned in PT but the key is do them correctly!
Not RC but similar. My friend absolutely tore up his knee. Got ACL surgery. He really liked his PT and thinks that was huge in his recovery.
Also, I don't know a whole lot of details about how it went, but my dad had his rotator cuff torn, had surgery, and seems mostly fine. He swims regularly.
Sorry to hear about your injury, hope you have a speedy rehab!
I did my grad degree working on RC injuries and studying ways to improve recovery. Your recovery depends a lot on how long you've had the injury. If the tear was minor or incomplete prior to your fall, you actually have a pretty good chance of success with your outcomes after recovery.
You are also right in that the failure rate is high after surgery, but that doesn't tell the complete story. Research has come a long way in trying to improve the surgery, including the fascia technique among others.
Since the primary reason we have a RC is to keep our shoulder joint in tact, despite the failure rate, it still makes sense to go along with it, because as you noted, shoulder replacements are really tough.
I've met loads of patients who have had good success after surgery, but again it depends on how old your tear is. I don't know where you're based but UM has an excellent Ortho department (so does Henry Ford, and Cleveland Clinic too).
That's what I'm really worried about. Doc said that I've had this for awhile and just been compensating based on the X-ray. But I looked at the images the day of the injury where my humeral head was in the right spot; and one taken 10 days later at the orthopedics office where my humeral head looks like it was filled with helium and its bumping against whatever bone is on top.
I'm hoping I had a minor tear they can fix. But if it's really an old tear and the imaging shows that... I don't know.
I had it on my right shoulder in 2013. Gives me significantly less trouble than my left shoulder does. Until Covid, I was lifting every morning before work and I did a lot of shoulder work. It did take quite a while to fully recover, but hasn't caused any issues since.
Can you go heavy?
I could bench 250 with no pain, so yeah, heavy for me. Probably not heavy for someone like MgoStrength.
Interesting timing - my shoulder has been hurting for the last month or so and I was told it might be my rotator cuff. I also lift.
I will have to go in soon to get it checked out
I had zero symptoms prior to falling. I was doing power cleans in my house gym with only 150lbs, but I had no issues at all with my shoulders. I'd like to get back to that as I like the olympic lifts. What scares me is that I might not
Not at all an expert, but if have some pain you can work through lifting, maybe you don't have a tear. But also probably shouldn't be lifting, at least exercises that hurt. Get it checked out for sure. But you may just need some bodywork like rolfing. That's helped me a lot.
If anyone is in the LA area there's a guy named Mike Tan who's really good. It's painful but good. No idea how much he charges now. He used to live in Thailand but moved back to LA. It's Thai style. He got some knots out of my hamstrings that yoga couldn't.
Could be one of multiple things. The docs thought I had a tear, but it ended up being a labral tear. Same symptoms.
Post surgery I'm about 95% of what would be considered normal -- so no complaints here about having the surgery.
I will say from what I've seen while at PT and in talking to the doctor, there are a number of factors which go into the surgery being considered a success.
- Aside from genetics, activity and fitness play a key role. Healthy people come out of surgery better than people who are not.
- PT is a bitch. It's painful and not fun. But if one wants any kind of semblance of a normal recovery they need to take the PT seriously. Based my observations, people generally don't. They half ass their PT and/or they don't push through the discomfort.
Then, why they didn't do the work and their shoulder is now worse, it suddenly becomes the doctor's fault. Grrr.
I'm just struggling with 'You were asymptomatic before but now you are symptomatic and we have to do this surgery with a high failure rate and super long recovery or you'll get a new shoulder'.
I think rotator cuff disability happens quickly. So you may have felt fine recently but it sucks now. I'm not a doc... just a guy who has been through this before -- but in my experience I would second the notion that you pay now or you pay later.
So do you want do nothing now and eventually get a new shoulder? I would say that's a LOT riskier than the surgery you're apprehensive about.
A final takeaway...
Have you gotten a 2nd opinion? You ask a lot of good questions but no MGoBlogger has access to your history, the MRI, and only a few in here are medical doctors.
Oh yeah. And I couldn't agree more about the PT. I've seen too many relatives get the surgery and not do the PT.... and frankly with that way of working they shouldn't have gotten the surgery.
I'm confident I'll do the PT.
I'm getting a 2nd opinion. My big thing is I want to find a doc who has done this a fair amount. I'm a big believer in experience.
"Have you gotten a 2nd opinion? You ask a lot of good questions but no MGoBlogger has access to your history, the MRI, and only a few in here are medical doctors."
100%. I was just wondering off hand what kind of experiences people had. It's one thing to read about the procedure, its another to get first hand comments, at least for me.
Both my parents had them my Mom had it on both shoulders and my Dad on the same shoulder twice. Helped them both. One thing both of them said was make sure you do all your PT that is prescribed. They had so many friends that would tell them they didn't get much better, then when they asked them if they did all their at home PT they said no.
I've had both shoulders done. Depends on what "good functioning" means to you. I had my first rotator cuff done 12 years ago and the other one done 2 years ago. I don't have the range of movement that I had before, but I play a lot of golf and they don't bother me. I must admit, though, that I am exceedingly cautious of reinjury because I don't EVER want to go through that rehab (1 year) again!
Not me personally, but I see tons of them done and have several friends who have had them done. The surgeons I work with are all pretty good. As people have said, months of rehab. Miserable discomfort for weeks. But success rate is really pretty good. I've seen people come back for more issues. Many say they pushed their rehab. Don't do more than you're supposed to after surgery.
My golf partner had the surgery and went from a 15 handicap with a bad slice, to a 9 handi and now he hits a draw. ??♂️
Either way, it’s worked out well for us ?
Can’t be working out too well, that’s 6 strokes he’s not getting anymore. He needs to work on his cap management
We use buzz management as the primary tool in cap management.
True, but your handi adjusts over rounds played. So it took a good two and a half years to adjust from a 15 to a 9.
Almost half of my labrum is torn, from top of the shoulder down to armpit. I have a 1/2 inch tear in my rotator cuff, and arthritis in my now degrading AC joint. Been that way for 5 years or so (since my late 30s).
I skipped surgery as I just had knee surgery a couple years earlier. I occasionally suffer from frozen shoulder but it isn’t too bad. Nine days out of ten I get around fine and can do anything I want to. I just ignore the constant crunching and popping sounds as they don’t really hurt.
Basically, as everyone else said, find a phenomenal doctor. It’s going to suck bad for 6 months to a year and you’ll be doing PT for a year or more but it’ll be worth it in the long haul. I just figured I’m early 40s so I’ll put off going under the knife for a while.
I am dealing with a labral tear too. How bad is the frozen shoulder. Doc told me I am developing it too last week.
Rub some dirt on it.
The shoulder isn't all that far from the heart...... I got nothing.
Herb Brooks
It's nothing... you just got your bell rung. Now get back out there and kill 'em!
I had rotator cuff surgery on my right shoulder 7 years ago in early 50’s. Didn’t really have a choice as I couldn’t sleep for more than an hour at a time as a result of the pain. Mine was a complete tear and they were able to reattach using a couple anchors. The surgeon gave me a pretty cool video of it all. Agree with the 6 months of recovery. For the first few weeks after surgery, the pain was pretty intense, especially when trying to sleep, even with the short acting opioids. Highly recommend an ice machine during this time. Mine has been well used by several colleagues. Don’t push it as much with heavy weights any more. Would rather not go through that again!
not mine, but 3 for 3 of the guys i know went pretty well. two were 50's age, in good shape, were smart during rehab and were back at the gym. one was a brother also in his 50's, total tear needing anchor posts (film of that). he was disciplined about rehab and seems fine. he is not one for much weight lifting though.
judo is a different type of loading and from many angles. i would be reluctant to do that any time soon after that surgery. good luck JFW, sorry for the tear. i hear top down driving in the sun might speed healing....get that miata out and go for a drive.
I've had two, both on the right shoulder. Before the first, my arm would just fall out of joint. I'd wake up with it out of joint. First surgery was an arthroscopic capsular shift. I think it was pretty new procedure back then (1993), at least it was for the military docs. I know it was a new thing to the physical therapist! She pulled my arm out of joint on the first rehab appointment, twice! That surgery wasn't successful.
The second surgery was a couple of years later. It was an open surgery. Docs said it was pretty difficult to get my wing situated for the procedure because every time they picked up my arm, it would dislocate. He said he's only seen shoulders like mine from car accidents and falls from heights.
Compared to the first, this one was successful. My arm doesn't dislocate anymore. I also cannot throw hard overhand and my right arm is shorter than my left arm by about 1/2" now.
Before the surgeries, my right arm was a real problem. Knowing the limitations I've had post surgery, I wouldn't recommend the repair unless the arm really limits you now.
Does anyone have any "amazing surgeon" recommendations in the Grand Rapids area?
In priority of pain/frequency:
- Wrist
- Shoulder
- Knee
Thanks!
You think you need surgery on all 3? No idea about you of course, but surgery should be a last resort. It would seem you're basically unable function if all 3 of those were so bad you need surgery. Get some soft tissue bodywork done, like rolfing. Also Foundation Training helped me.
Full RC tear here.
Hurt it diving for a ball while playing baseball. It was a partial tear, and I was being recruited for college ball at that time and didn't want to risk my senior year, so I decided not to get the surgery. About 4 years later, I woke up one day and couldn't lift my arm above the shoulder socket, found out it had then progressed to being a full tear.
Got the surgery, and like others said, it's a bitch of a recovery. Probably 6 months before I could do routine movements, about 9 months before I could consider doing anything remotely athletic.
But get it done. I eventually made a 100% recovery and it's been over 10 years for me with no residual issues.
Good luck with this. This is a potentially trick part of the body to operate on.
Two small thoughts:
1. Second opinion - it is worth the time and get an honest assessment of your rehab plans after surgery.
2. The judo part caught my attention - assuming that since you used the term match you are not talking about judo for fitness but stuff like Ippon seoi nage (one handed shoulder throws) or morote seoi nage (two handed shoulder throws) realm of judo - I'm not a judoka but a friend is/was until he sustained some serious shoulder injuries in a match in a national meet - long story - surgery and he had limited range thereafter. In everyday life, can't tell but reaching up and around there is definitely a point there the shoulder won't go. No one's fault - that was four decades ago in terms of technique, and both competitors super fit trying to throw and counter each other and his shoulder "came apart". Might consider a new hobby that doesn't stress the shoulder joint as much.
Honestly at this age I can do hip throws or just ground technique. I just don't want to be sidelined forever.
The surgeon is a runner, which is fine, but he kind of views all activity that isn't running as not real activity; so I'm concerned that he isn't as invested in this as I am. 'Well your bench is limited to 140 but hey you can run like me!!!'
I'm really concerned about the failure rates. If I do nothing and he says I need a new shoulder in 2 years, what happens if I get it done and it fails? Now I have a torn shoulder plus scar tissue. I'm not sure if that's worth it TBH. But, if I get 2 opinions (one from up here in TC, one from UM) and they both say the same thing I'll pull the trigger.
Going under freaks me out. Yes. I'm a big baby.
You should find out what type of anesthesia the various practices use. I had surgery to repair a torn labrum just over a year ago (obviously not a rotator cuff but still has the same level of recovery time around 6 months), and they used Propofol to put me under. Maybe Propofol is common practice now, but it had never been used on me the previous times I've gone under.
Regardless, it was a much more pleasant experience than the previous times I've gone under. I didn't feel terrible for a couple of days afterwards, was honestly pretty much back to "normal" several hours later.
I had shoulder surgery to clean my rotator cuff and labrum but mainly for a SLAP tear. My doc was confident that he could fix the SLAP tear and the rest he did just because he was in there. My shoulder feels a lot better now but I think that is mainly due to reconnecting the bicep.
Contrary to above, your success is probably less due to the surgeon (obviously within reason) than what he or she has to work with. All cuff tears are definitely not created equal so extrapolating one person's result to yours is fraught with peril. Size of the tear, location of tear within the cuff and patient age are very important in terms of predicting results.
If you have a tear large enough to have a high riding humeral head, that's probably indicative of a tear that is not repairable in the standard sense and, given your young age, they are probably considering you a candidate for a superior capsular reconstruction. In researching success rates, it's probably worth looking at those results for guidance.
"If you have a tear large enough to have a high riding humeral head, that's probably indicative of a tear that is not repairable in the standard sense and, given your young age, they are probably considering you a candidate for a superior capsular reconstruction. In researching success rates, it's probably worth looking at those results for guidance."
Yup. That is what they are seeing in the X-ray.
It doesn't hurt just feels... weird. And I can't raise my arm without shrugging.
He tried to get me to do surgery, sign up that day and buy all the stuff. This was without seeing the MRI. I'm getting a second opinion and we'll see how it goes.
The superior reconstruction sounds like it sucks.
Everyone has a different practice style but I've never been a fan of booking someone for surgery without as much information as I can gather. Second opinions are never a bad idea. Get another perspective. Any surgeon offended by the thought of you getting one should probably be avoided, IMO.
If you have signs of fatty replacement on the MRI the muscle is atrophied which is important information.
So, no muscle atrophy but apparently it's retracted. Oh, and I have arthritis; which I honestly knew about prior to the injury without any diagnostics. ;-)
March 16th, 2021 at 12:03 PM ^
Arthritis of the glenohumeral joint (ball and socket) or acromioclavicular (AC joint). If you have a high riding humeral head and arthritic changes of your glenohumeral joint, you may want to do the occasional injection and someday get a reverse shoulder arthroplasty when pain and function dictate.
I had RC surgery When I was about 15. I dont know if it was because I was young but it healed great. Im 34 now and have benched over 350lbs, overhead pressed hundreds of lbs and have played competitive volleyball without issue. The recovery was fairly quick ... but I remember it being very painful. The one thing I do regret is not properly rehabbing to throw a baseball.
My father in law tore his RC 2 years ago and he struggles holding items above his head still. I really think it has to do with the surgeon and your overall health.
side story. I tore my bicep back in 2016. It took almost 2 years for it to fully heal.
I don't understand how you could have had a full tear and been asymptomatic? I had a partial tear and the range of motion in my arm was immediately noticeable, let alone the pain. Unless you got really good at getting around it, simple things like lifting your shirt to put on deodorant should have been immediately noticeable.
Anyway, I rehabbed mine because it was partial and that was fine after about a year. My mother in law did have surgery and it was fine. She's older so much less active, but mostly has no long term limitations.
I don't know either, and that doesn't make sense to me. That bugs me a little. I want someone to look at all the images and come to a conclusion, not one set of X-rays.
I don't know either, and that doesn't make sense to me. That bugs me a little. I want someone to look at all the images and come to a conclusion, not one set of X-rays.
Symptoms related to cuff size are all over the map. Someone can have a small full thickness tear or even tendonosis (cuff degeneration, partial thickness tears without full thickness tear) and be quite painful and sometimes people walk in with no cuff left and they're surprisingly comfortable with surprisingly good motion.