Rotator Cuff operation
 

Can some of the people here help me understand how much pain I can expect with medium to some what serious tears and separations of rotator cuff. Possible bicep detachment as well. Thanks in advance, Paul.

It's a painful recovery. My post surgery pain (replacement) is nil but the PT is gonna be rough. I have on hand to help with the PT:
pain meds indicated before sessions. I take this to mean when you see the therapist 2wice a week because otherwise you are doing the exercises 3 times a day. 6 days a week.
an ice water bladder with pump in ice chest
special clothing
adjustable bed or recliner chair
grab bar in shower plus stool

Some of that doesn't answer your question. The answer is buck up, this is why we are the tough azzes we are. I mean it. I had a couple hours in the hospital (you will go home) where I lay and cry. Well, it seemed that long. They came with liquid Dilaudid. I don't think that should have happened. For you it probably won't.

Find and read my thread.

Oh, and good luck. One key is to find the best doc. Any sports medicine joint :D isn't enough. Do your due diligence. It took me 6 months to find what seems like the right guy. A fellow Pelican helped me there.

Find a good therapist. I've been looking around for months and the day before surgery I interviewed where I will be going. If they don't seem to be spot on when I start, I walk out.

Ask for an interscalene brachial plexus sheath catheter to be placed BEFORE surgery.

Where I went they are down on drips and big on blocks. You can't take either home with you. Will that work for outpatient? RCP is usually outpatient.

What do I know? Just one out of many.

Wow. I’m getting surgery for my torn rotator cuff in a few weeks. Can’t imagine the pain from surgery being worse then what I’m going through now. My quality of life has seriously eroded. Hoping for the best.

My right one was done twice (8 years apart) left once. Wasn't too bad, make sure you allow healing time before you start any rehab. Remember Harry's advice
' Good Man's gotta know his limitations '

Good Luck
Rich

The catheter facilitates pain control by infusing local anesthetic onto the nerves that feed your shoulder and arm/hand. The pumps can be disposable or reusable (hospitals or surgery centers may use either or both). They are typically used for 2 or so days then removed. The beauty of them is that you typically go home pain free that day.

Some places only offer a single injection which can't be made to last as long an infusion but are still better than nothing. The trouble with single injections is that when they wear off (usually early AM when the patient is asleep) it seems like throwing a switch to turn on all the pain, all at once. Of course, the pain was slowly happening while the patient was asleep but the train was leaving the station for quite awhile before reaching the waking threshold.

I did ask for one. Not their style. Now we're talking about Cedars Sinai here.

An aside, the morning check in 6 am was different for me as I've never had major surgery before. After being interviewed for my data (again and again) I was called by a nurse to line up and follow. We 8 or so patients walked down the hallway about 3 miles and then got out little curtained off booths. One by one each was rolled away. Last thing I remembered until I was awake and I was awake like I had never left. Good ol' times chatting with the doc and wife like I'd just come in from a few laps.

W i i i d e awake. I stayed awake for 40 hours straight until the pain hit like pavalon said. A few more hours awake with first intravenous dilaudid and a 2nd block. It's been a week today and I haven't taken any pain meds for 2 days. No pain at all.

Rehab will be different, IK.

Thanks for the tips. Just have to suck it up and deal with it. Just looking forward to getting it over with.

I had surgery for a full thickness supraspinatus tear on Sept 24 2018. 3 weeks prior I had 2 lumbar laminectomies with 2 fusions and 4 cages. Back is doing great. Shoulder was somewhat tough for a few weeks after surgery. It’s a very slow recovery because the tear was as bad as they can get. I’m still only doing passive ( assisted) range of motion therapy. I had to wear the sling for 3 months. Dr won’t let me do active motion until the 6th month mark.
To your question about pain , I have a fairly high threshold and took pain pills for 2 weeks after surgery. The pain wasn’t as severe as some had warned it would be.
Follow Drs orders and know it’s going to be a very long recovery.
Good luck, Tim

My gf had it done several years ago. IIRC, it was 6 months of PT, then she was good to go.

Yup, I had this about 7 years ago. You are looking at a 6 month deal, from surgery until "normal" function. Post surgical pain wasn't bad; it's all about the therapy. But the first part is the roughest: pretty soon after surgery you have to start stretching it out so it doesn't freeze due to scar tissue build up. Man that sucks. You have to get range of motion back, and because they shorten all the tendons they have to be physically stretched. But once you get through everything, you will love the outcome. My shoulder feels like I am 21 again (even 7 years later). Of course, my other one seems shot in comparison. And I echo what was said earlier: shop for a good doc. But mostly, be resigned to doing the therapy, and do it with gusto.

Added note: a lot of the outcome depends on age and how severe the tear. I’m told by Dr and therapist it will take me about a year to reach maximal healing and function, (due to full thickness tear). FYI: I’m 59, therapist keeps telling me all I’m losing is time. Dr is advising me to become left hand dominant and never lift more than 20 lbs overhead with right. Tim

I'm curious, what was the cause of these rotator cuff tears? Were they due to a single event (impact/trama) or just excessive wear over time?

I have been playing competitive tennis for over 40 yrs, raced motocross and was a chiropractor for 20 yrs. I believe all of this was a factor. Crowning blow around 18 months ago I was shoveling mud out of car wash pits into a 5 gallon bucket and dumping up high into a dumpster, about the 40th bucket right hand underneath pushing up heard and felt a tearing sound, pain was mild to moderate. I continued life as normal, Dr said impingement syndrome and couple cortisone shots with minimal help. Around 8 months ago playing tennis extended right arm out running back to retrieve a lob, felt and heard the same tear as when I was doing mud. I believe each incident tore it 50% resulting in a complete thickness tear.
My advice to anyone who has a significant tear is to fix ASAP. Since I waited so long tendon wasn’t in good shape kinda like hamburger and acromion was damaged. If this doesn’t work I’m looking at total shoulder replacement. Be careful lifting anything overhead, get help on heavy stuff and try and keep shoulder muscles strong including deltoid. Tim

That makes sense. It sounds like with most older guys its usually excess weight/resistance and range of motion on the shoulder that leads to the tear and for younger guys its impact/trauma. I can see how tennis would be extremely tough on the shoulders. I hope you have a full recovery, shoulder injuries suck. I've had a few myself.

I had mine done alittle over a year ago.bicep tear and 3 major tears. Pain was not bad trying to sleep with the brace on was the worst happened when I was turning 60. Shoulder feels great now bicep cramps now and then.

My gf had about a 70% tear on her supraspinatus. Her PCP kind of ignored it for years and told her to go to PT. PT didn't help much, so pushed for a specialist to see her. He finally gave in and that's when she got an MRI, then surgery.

After the surgery, my gf noticed there was a lack of crepitus in the joint as the surgeon cleaned that out while she was in there.

I just turned 65. have not worked out much in 4 years. I know, I know. Mine is a full tear. About 3cm if I remember correctly. That's one tear the other I'm not sure of, I'm not home to check. Mine was from trama.

Thanks all for the info.

Get the surgery. You will be much happier without the pain, and you will be able to sleep.

Oh, I'm in for surgery on Thursday. Be gland to get it over with.

The gf went for surgery almost 4 years ago. PT was 2 days after surgery.

Paul, any updates?

JA

Yesterday was five months since my shoulder surgery. I have been very fortunate. No pain after surgery. No pain pills needed except for ibuprofen now and then. I’m still a little sore but my strength is good and I have full range of motion. What’s weird is the occasional burning sensation from the back of my shoulder. I’m guessing it’s the nerves that were cut during surgery. I’m getting my right rotator cuff repaired this October. I had forgotten how nice it was to sleep without being awakened by the throbbing in my shoulder. Nice to be pain free.

I'm at 8 months from total replacement and have unfortunately forgotten that it was replaced. For 3 days I abused it, first day using a hammer, second day using a hand plane and Sunday running a vacuum all over the house trying to control the cat's extreme flea infestation. It got a little irritated telling me to watch it.

But that's good results for the surgery. On a stupid man.

I be stupid too! But, that’s all I know....or don’t know...🤪🤪

Get the surgery, not a fun experience but better than the long term suffering. My only suggestion is to be pretty medicated when the nerve block wears off. I waited a bit too long and paid for it for a few hours. After the first two days the biggest problem is getting used to the sling and padding. Start PT right away.

My ortho told me I has slight tearing on my left RC. It as been painful, but I have frozen shoulder as well. He said surgery in my case, may make it worse. Let the shoulder thaw, then look at the RC.

I forgot all about this tread. had a second surgery in June. I was lighting my grill two weeks after my first surgery and re-tore the same muscles in the area of the attachments when I had a bit of an explosion causing me to jerk my arm back. Knew I was screwed right away.
Anyway, feeling much better now 8 weeks post-op. Will probably start therapy next week.
Thanks all

8 weeks post op, and now you start PT? That must have been a really bad tear, and the ortho took no chances.

Therapy start dates range from next day to weeks. Depends on the type of surgery and what repairs are done. Moving muscle attachments or re-attaching requires a lot of non movement while the repair area heals. Many rotator cuff and partial replacements allow for PT right away. I have a friend who is not paying attention to the doc's orders and has had his sling time extended another 8 weeks. That's unnecessary.

Here's the link to another thread on the same subject:

http://forums.pelicanparts.com/off-topic-discussions/998097-anyone-have-total-shoulder-replacement.html

Paul,

Were you wearing your sling when you lit the grill and jerked your arm back? When/how did they eventually confirm the re-tearing? Were you required to wait until June for the second surgery?

Asking for a friend :eek:...thanks in advance.

JA

you can get the nerve block.
my arm swelled up twice its size and was freaky, but really no pain, but mine was not as bad as yours.

also, I only wore the sling for one day. I would just let my arm hang and naturally move when I walked, I never had to do any therapy. I didn't use it, but I did not keep it 100% immobile

jandrews: I was out of my sling. Had to wait for the scaring to heal a little for a clearer MRI.

I had mine done 6 weeks ago.

Repair of full thickness tear, including anchors, etc.

It actually was not anyways near as bad as I expected. Sure, the first few days after were not great, but I had thought ahead enough that I could avoid using that arm. (It was my right shoulder and I am VERY right-handed.) Sleeping in the recliner was required for a least a week or two after surgery.

I took pain killers (Percoset) a/r and still do - mostly after PT and occasionally for sleeping.

I was only out of work for a week (I have a desk job) and started PT as soon as the surgeon said it was ok to do so - about 2 weeks after surgery.

Starting PT early is a MAJOR key to recovery. I did 3x per week for 4 weeks and will be backing off to 2x per week starting next week.

My biggest pain is emotional - I can't drive my '87 3.2 because I still can't handle the shifting! I missed out on some great driving weather.

A few tips:
- A seat belt latch extension was very helpful because I could not reach across to buckle my seat belt with my left hand and I still have limited mobility that limits reaching behind me to buckle it with my right arm.
- A left-handed mouse remains very helpful when using a PC.
- Do as much as you can, pushing a bit beyond your limit, but don't overdo excessively.

Drove the M5 for the first time since mid June last week and paid the pain price a little the next day.
I assume it was the shifting that caused a little more pain. I didn't find the operations or the recovery that bad. Prescription pain meds for about a week, then just OTC stuff. My ex wife, who is a PT said it will probably be a year till normal function returns. Yesterday was 1st day of PT.

Good updates. I had mine done 2.5 weeks ago and it has been brutal. Way more pain than I was expecting. And I have been through lower back surgery (laminectomy and vertebral fusion) and this was worse, for sure.

I did have two (supra and infra) full thickness tears with both tendons completely detached. Also had some significant bone removed in two places, clavicle and acromion. Lastly, they debrided some fraying of the labrum in that shoulder, so a fair amount of work was done.

Surgeon said that due to the amount of work, he wants me in the immobilizer sling for a full six weeks and no active therapy until then. I am concerned about that for multiple reasons, but he is a highly respected and in-demand orthopedic surgeon, so I will be following his orders. Until then, I am just doing the passive hanging "pendulum" swings and my range of motion is already a tiny fraction of normal, i.e. maybe 30 degrees. In my case, I am prepared for therapy to be excruciating.

I only took the pain pills for the first 5 days after surgery, and have used Tylenol as needed since then. I suspect I will have to break out the "good stuff" again once therapy starts.

Quick question for dw1.....what is 'a/r' referring to in your post?


JA

Also, any particular seat belt extender you recommend, brand and length?

Thanks,

JA

To answer both questions from Jandrews:

a/r is just my shorthand for "as required". Basically, when the discomfort gets too distracting to function properly or to sleep. 6 weeks post-surgery, this still means once a day or a bit less.

By the way, I was in a sling for between 3 & 4 weeks, but was able to wean myself from it on the early side of what the doctor recommended. PT started while I was still using the sling, but focused on passive range-of-motion stuff for the first few weeks. I was driving with the sling, but my commute is a fairly easy one and my daily driver is an automatic with most of the controls on the left side of the steering column, and I could reach across for the auto trans shifter.

I actually ordered two different seat belt extenders, one rigid (but bendable) and one flexible mesh. I have found them both of value. In my daily driver, because I drive with the seat low, the rigid one is better. In my wife's car, because the seat is much higher, the flexible one is better.

Both were ordered from Amazon, as was my good shoulder ice pack (something else I recommend having for the first several weeks after surgery and also at least for the first week of PT to supplement the icing done at the PT facility.

https://www.amazon.com/Seat-Belt-Lengthening-Accessory-Tongue/dp/B07VF574FP/ref=sr_1_1_sspa?keywords=seat+belt+extender&qid=15 66949843&s=gateway&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUExUjlLR TQ2NkZUTktTJmVuY3J5cHRlZElkPUEwNTg2NzE4M1ROTlBCVEJ RRlc5RSZlbmNyeXB0ZWRBZElkPUEwNDMyOTg3MzNNODFXMzlWU 09DSCZ3aWRnZXROYW1lPXNwX2F0ZiZhY3Rpb249Y2xpY2tSZWR pcmVjdCZkb05vdExvZ0NsaWNrPXRydWU=

https://www.amazon.com/Extended-products-Non-Universal-Buckle-Certified/dp/B07VY76WSW/ref=sr_1_5?keywords=seat+belt+extender&qid=1566949 890&s=gateway&sr=8-5