rotator cuff repair

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bodia
New Member


Date Joined Feb 2017
Total Posts : 5
   Posted 2/17/2017 2:00 PM (GMT -7)   
I had shoulder surgery 4 months ago to repair a medium size rotator tendon tear and repair a bicep tendon.
I have had extensive physical therapy and I am still in a lot of pain. I am considering acupuncture as I am desperate to get back to the links and alleviate the pain has anyone had any experience with acupuncture and shoulder pain.

pitmom
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Date Joined Jan 2015
Total Posts : 2177
   Posted 2/17/2017 2:35 PM (GMT -7)   
Welcome to the forum.

It takes the shoulder about 1 full year before it is considered 'fully healed' at whatever degree it ends up to be.

Was your surgery an arthroscopy or an open decompression?

Acupuncture is not covered on my health plan. I will be interested to see any replies by those that have used it, too.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, wrist ganglionectomies/denervectomies/tenolysis, multiple herniated discs, tarlov cyst, whiplash, bursitis of hips, tendonitis, torus, 3rd degree shoulder separation, torn labrum, ovarian cysts, fibroid tumors of the uterus

bodia
New Member


Date Joined Feb 2017
Total Posts : 5
   Posted 2/17/2017 6:04 PM (GMT -7)   
hi pitmom, well i just had my first acupuncture cost $90 no insurance coverage my surgery was arthro.
Well no miracle cures from the needles I signed up for another one I feel like Don Quiote chasing windmills but I am desperate to get back to playing golf and building things.

Thanks for the reply

bigecase
Regular Member


Date Joined Mar 2010
Total Posts : 324
   Posted 2/17/2017 7:01 PM (GMT -7)   
I have had 3 on the right and 2 on the left. They take a long time to get over. All of my pt's tell me it is the worst injury to get over. I do believe they are correct.
bigecase
Age 46

bulging disc C6, c7, L4 &L5, L5S1 Spinal Stenosis, degenerative disc, mild anterolisthesis FAILED back Surgery 11/29/12. Torn rotator cuff, torn bicep tendon, and spurs all in right shoulder--3 shoulder surgeries. ESOPHYX TIFF surgery. Hypothyrodism, anxiety, migraines, tmj,2 left shoulder surgeries
12/14, SCS implant

pitmom
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Date Joined Jan 2015
Total Posts : 2177
   Posted 2/17/2017 9:00 PM (GMT -7)   
If you're still experiencing a lot of pain after "extensive physical therapy" you may need to have an open decompression/acromioplasy done, as I did.

Blood vessels and nerves need the space and if you have scarring or continued inflammation you may continue to experience pain.

I had arthroscopy done on each shoulder first. I had open decompression/acromioplasty done on each shoulder after about 6 months with no great relief of symptoms.

I have almost full restoration of the left shoulder range of motion and strength. The right was not quite as good and then I had two additional injuries to it, so it's a mess.

I hope you do regain full range of motion and strength but be prepared if you don't. The ball and socket joints are difficult to bring back to what we used to enjoy. You might always have a degree of pain after using the joint, especially with a sport so demanding on the shoulder. I still use heat/ice/massage this many years later. Be careful of using NSAIDS too much, they can cause stomach problems that can get serious.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, wrist ganglionectomies/denervectomies/tenolysis, multiple herniated discs, tarlov cyst, whiplash, bursitis of hips, tendonitis, torus, 3rd degree shoulder separation, torn labrum, ovarian cysts, fibroid tumors of the uterus

(Seashell)
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Date Joined Dec 2012
Total Posts : 679
   Posted 2/17/2017 10:28 PM (GMT -7)   
Bodia:
In your writings I hear a longing to hit the golf course fairways and to tinkering and building things. You mention that you have had "extensive physical therapy" post-operatively of the rotator cuff and biceps tendon repair.

I have to wonder if the discomforting pain that you are experiencing is less associated post-operative pain and more pain due to an overly zealous rehabilitation program.

"No pain, no gain" is not an universally accepted mantra.

There can be too much of a good thing. There can be too much therapy.

What does too much therapy feel like? What are the implications of an overly strenuous recovery program?

Inflammation of surrounding tissues. Adhesions. Calcifications. Tethering of scar tissue to tendons and ligaments. All of which contributes to pain.

I would encourage you to consider a more modest and gentle approach to your rehabilitation and to a longer horizon before resuming your beloved golfing and other shoulder-intensive hobbies/avocations.

Consider going back to some of the post-operative basics with your therapist and medical providers.
1. Pendulum movement, gentle circular motion, with the arm dangling at your side.

2. Use of cold/cryotherapy/ice for 10-15 minutes post prescribed exercises/range of motion.

3. Use of a small, rolled hand towel of wash cloth placed up high into the armpit. The purpose of the towel roll is to provide an upward gradient to the humeral head into the glenoid fossa.

One of the reasons that rotator cuff recovery is thwarted is owing to the nature of the humeral head and glenoid fossa. The shoulder is basically a sling-suspeded joint. The humeral head is supported in position by tendons. There is no deep bony union as is in the hip, where the femoral head sits deeply in the bony enclave of the acetabulum. You want to avoid downward forces of the humeral head. The use of a rolled hand towel or wash cloth provides a nice upward nudge.

4. Reduce the number of repetitions of your exercise program. If you are doing 15 repetitions of a given exercise/motion, cut back to 10 repetitions.

5. Make sure that your scapula is mobile and moving. In order for the shoulder to have full range of motion, the scapula must move in a prescribed ratio to the movement of the shoulder. Some people with rotator cuff repairs do poorly not due to poor surgical technique but do poorly due to a "frozen" scapula. Make sure that your therapist is making notice of your scapular movement and motility.

6. Give yourself a wider berth of period for healing and restoration.

Of these ideas, see what makes sense for you and your particular situation. Each of us is unique in our needs in healing.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

bodia
New Member


Date Joined Feb 2017
Total Posts : 5
   Posted 2/18/2017 6:31 AM (GMT -7)   
Hi Seashell thanks for the reply and useful comments my current physical therapist is doing a lot of work on training me to properly use my scapula/ shoulder blade and has decreased the amount of strength work. I had my first acupuncture yesterday and he claims the stimulation of the needles should increase the blood flow to speed up the healing process. I'm sure i have been somewhat over zealous as you stated but I'm following what my therapist has told me and I had the right shoulder repaired 6 years ago with no problems and was back on the links after 4 months. I will slow down on the weights and see if it makes a difference.

Cranky1
New Member


Date Joined Mar 2017
Total Posts : 1
   Posted 3/18/2017 5:07 AM (GMT -7)   
I have had 23 surguries and I must say that my rotator cuff was by far the most painful, with the longest recovery.

I agree with Seashell, it takes 12 months or more to heal and being overly aggressive during your recovery could be part of continued extreme pain. I found that for me I was over working my shoulder which was causing/keeping the inflammation from going down. And as Seashell stated getting back to basics may help significantly; especially using ice and perfirming pendulum/gravity type excercises . I did have to get toradol injections, which helped better than the narcotics (combo of fentanyl patch, mscotin and norco). But keep in mind that toradol is a high strength NSAID, which can cause gastic issues, like bleeding ulcers, so the risks may not make it a good option. Check with your physician based on your history.

I hope your recovery gets better soon.

bodia
New Member


Date Joined Feb 2017
Total Posts : 5
   Posted 3/18/2017 1:56 PM (GMT -7)   
Thanks Cranky1 I guess I will have to be patient it has been almost 6 months now and does not seem to be getting any better. I had the right shoulder done 6 years ago and was pretty much back to normal after 5 months this one has been completely different. I will be seeing another ortho doc Monday for a second opinion although I do not know how he can evaluate it without another MRI and or rescope it.

germ
New Member


Date Joined Mar 2017
Total Posts : 2
   Posted 3/19/2017 11:13 AM (GMT -7)   
I had arthroscopic surgery done one my shoulder last March to repair a SLAP tear, bursitis, rotator cuff tendonosis, and bicep tendonosis. I've gained most of my mobility back, only losing some lateral movement. I still have some discomfort when I do anything over head.. At 4 months you shouldn't be in constant pain any more. I stopped taking the hydrocodone after about a week of the surgery. The pt will be painful, but if you still experience pain all the time, I'd contact your surgeon about it. The shoulder is very fragile after these surgeries, and it's possible you re injured it.

bigecase
Regular Member


Date Joined Mar 2010
Total Posts : 324
   Posted 3/19/2017 4:09 PM (GMT -7)   
I had my second manipulation Dec 29 2016. I still have pain. It wakes me up every morning between 3 and 4 and I have to start moving. I just finished pt last week. I know I have a partial rotator cuff tear still but I don't think that is what is hurting in the night. I have not been without shoulder pain on the left one since about June of 2016. My first surgery on it was Sept 29 2016. I have been through this before so I am not surprised at all. It takes a long time especially with a rotator cuff injury. (at least mine did)
bigecase
Age 46

bulging disc C6, c7, L4 &L5, L5S1 Spinal Stenosis, degenerative disc, mild anterolisthesis FAILED back Surgery 11/29/12. Torn rotator cuff, torn bicep tendon, and spurs all in right shoulder--3 shoulder surgeries. ESOPHYX TIFF surgery. Hypothyrodism, anxiety, migraines, tmj,2 left shoulder surgeries
12/14, SCS implant

bodia
New Member


Date Joined Feb 2017
Total Posts : 5
   Posted 3/19/2017 4:49 PM (GMT -7)   
Hey bigecase I never had a manipulation is that done to get rid of scar tissue. How do they know when and if you need that procedure. I'm seeing another Ortho Doc tomorrow for a second opinion I will ask him about it.

bigecase
Regular Member


Date Joined Mar 2010
Total Posts : 324
   Posted 3/19/2017 6:39 PM (GMT -7)   
They do this when you have a frozen shoulder. I actually had better luck with my right one when they scoped it. I didn't think the close shoulder manipulation was as good.

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 679
   Posted 3/19/2017 7:03 PM (GMT -7)   
I will comment in general about shoulder recoveries . . . my comments are not specific to any one person or situation.

The shoulder is an inherently weak joint. It is like a coat hanger with a heavily weighted winter coat dangling in suspension. There is no bony stability as is present in the hip - the hip having a deep acentabulum that receives the femoral head. The shoulder relies solely on ligamentous and tendon attachments for support and stabilization.

That said, chronic shoulder pain is not always a sign of inherent joint pathology. There can be ongoing inflammation post arthroscopic procedure and rotator cuff repair. Inflammation can last for up to 12 months - or longer. Overly aggressive physical therapy and/or rehabilitation efforts can also do more harm than good. Overly aggressive therapy focusing on expedited range of motion can further traumatize the joint and soft tissue, setting into motion hyper-esthesia and parathesias. Overly aggressive therapy can cause the surrounding musculature to become chronically fatigued. This then sets up a sequela of increased joint instability - which contributes to further muscular fatigue - which contributes to further joint instability as a continuing cycle.

Bottom Line: Low to mild chronic should pain post rotator cuff repair is not uncommon. Pain is not necessarily a sign of inherent joint pathology nor a sign that further surgical intervention is called for. In fact, further surgery can cause additional trauma and risk of reflex sympathetic dystrophy (regional pain syndrome). Conservative management is often the best course along with toning down therapy goals and expectations.

Remember too, that most of us are aging . . . the shoulder's rotator cuff is particularly vulnerable to the effects of general aging, the common tendon insertion fibers more febrile and delicate and less able to hold/heal surgical sutures and surgical anastamosis.

Tred gently in your recovery is often the best advice post shoulder arthroscopic surgery and repair.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)
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