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Torn Rotator Cuff: Should I wait it out or get the minimally invasive surgery?

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  • #16
    The shoulder joint is notoriously difficult to correctly and completely diagnose via MRI. My doc thought I had a possible labrum tear *only* and it turned out I had a full thickness tear, labral tear AND I needed a decompression and excision. Just looking at the MRI (and arthrogram) you couldn't see ANY of it, and I had that thing looked at by half a dozen radiologists.

    So, the doc isn't going to know what is really going on unless and until he gets in there with the arthroscope to look around. Until then it's all educated guessing.

    I'd base your decision on your level of pain, ROM and how active you want to be going forward (and what exactly you want to be able to do... competitive tennis is different than someone who just wants to be able to get things off of a shelf, kwim?)

    Don't let the rehab scare you. It sucks, but it's SO worth it if you're in enough pain, etc. to choose surgery. It's a relief... but it is still disheartening to me to be unable to do a decent set of pushups LOL. That's just purely a time thing - I haven't taken the time to rebuild the muscles.

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    • #17
      Oh, and I forgot to mention that before the surgery, I had FULL ROM (albeit with intense pain at certain points) which is why he thought it was "just" the labrum... so, clinical diagnosis is unreliable as well because everyone is different and someone could have limited ROM and no tear, or be like me and have full ROM and a complete mess in there.

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      • #18
        At this point my ROM is very good, accepting that there are catch points which will make me yelp, like reaching to the side with a cup of tea to put it on a table--now I go across my body to the left to avoid that. When I had to have back surgery, I was in so much pain, and had been for three years, it was a no brainer to get the surgery. This is different, in that I can have good days and nights with no major pain, just the occasional reminder that it's still there. There are days when it hurts more. Still, I was very surprised when the orthopedist said there was a tear (from the mri it looks about an inch long). Thanks to some of the info you all have shared I have decided to at least wait until the weather is warm and fewer clothes like socks and sweaters are needed. I know some have mentioned that the shoulder can "freeze" so I hope that my daily exercises will keep that from happening. I would like to get back to rowing, but in general I am not looking to do heavy lifting, or a pushup--I don't think I could ever do more than a couple even in my fittest/thin days. I truly appreciate your sharing. It helps to clarify my concerns.
        This time, like all times, is a very good one, if we but know what to do with it. Ralph Waldo Emerson

        Any given day you are surrounded by 10,000 idiots.
        Lao Tsu, founder of Taoism

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        • #19
          i would focus on getting ROM without pain. there are lots of modalities that can help -- good massage and also feldenkrais go a long way.

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          • #20
            Originally posted by Analog6 View Post
            Digby, I have no experience with this injury, but I have a chronic hip problem (not arthritic, mine is nerve damage problem) which sometimes flares up if I overdo things. When it does I use Voltaren gel for reducing the inflammation and managing the pain.
            It may be of use to you in reducing inflammation and pain too, you could check with your doctor. I can buy it over the counter here without a script, and my doctor has said it is Ok .
            Where do you live? I'd love to try it.

            I got a sample of a prescription topical antiinflammatory Pennsaid (same active ingredient as Voltaren), that was a liquid and it did not help at all. Also technically not for hips.

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            • #21
              Voltaren is prescription here in the states. But everyone that I've met that has used it, said it works really well.

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              • #22
                Originally posted by Stu View Post
                Voltaren is prescription here in the states. But everyone that I've met that has used it, said it works really well.
                I take generic Voltaren, diclofenac sodium and it has stopped being effective for me. Infind I need to switch out my NSAIDS every so often te reboot them. This week I'm taking old fashioned aspirin with pretty decent results.

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                • #23
                  Just be careful with how much NSAID's you take, they can wreak havoc on your liver if you overdo them.

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                  • #24
                    Originally posted by Stu View Post
                    Just be careful with how much NSAID's you take, they can wreak havoc on your liver if you overdo them.
                    I wish I could live without them but I can't, I have my bloodwork checked every 4 months. I'm working with an MD to try to transition to alternatives but have not seen much benefit after a month.

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                    • #25
                      I had what the MRI showed as a partial labral tear and a partial RC tear. When the doc went in with the arthroscope, it turned out that the labrum was holding on by a thread and the RC was torn through about 70%, so he completed the tear and repaired it.

                      Unless this is a minor tear and not giving you much grief, surgery is inevitable. PT and anti-inflammatories won't do much. By the time I opted for the surgery, I couldn't sleep through the night and every time I rolled over on my shoulder, I woke up. I too had excellent ROM, but the pain ultimately was too much.

                      Rehab sucked. 6 weeks in a sling, with PT starting a few days after surgery. But I'm two years post-op and much stronger than I was before.

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                      • #26
                        Originally posted by JBGrokerty View Post
                        Do watch out for "frozen shoulder" (aka "adhesive encapsulation", you can google it). It can accompany any shoulder injury, sets in for no apparent reason -- that is to say, sometimes someone gets it, while someone else with exact same injury does not
                        My sister had the frozen shoulder. Her right rotator cuff was torn during a scooter accident. She needed surgery to fix the tear. She had 2 more surgeries to deal with the frozen shoulder problem. Still no improvement to this day.
                        You donít stop riding because youíre getting old, you get old because you stop riding.

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                        • #27
                          I was with a group of friends a couple days ago, and one, a popular psychologist in our area with a busy practice, said that he heard more about rotator cuff injuries than any other physical complaint, and encouraged me to get the surgery. I can't imagine what we are doing that is bringing this on, since by and large we are less physical in our work. At any rate, I'm resigned to the surgery, but want to wait for warmer weather to make clothing easier. If it gets worse, of course, I'll do what I have to, but I'm still mystified that this has become such a common injury. You'd think we were all a bunch of lumberjacks!
                          This time, like all times, is a very good one, if we but know what to do with it. Ralph Waldo Emerson

                          Any given day you are surrounded by 10,000 idiots.
                          Lao Tsu, founder of Taoism

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                          • #28
                            Before you consider the surgery, try Bio Sync.... Check it out on line.... Of form of healing that is very powerful... Saved hundreds of people from the surgery.....

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                            • #29
                              Originally posted by Adrianag View Post
                              Where do you live? I'd love to try it.

                              I got a sample of a prescription topical antiinflammatory Pennsaid (same active ingredient as Voltaren), that was a liquid and it did not help at all. Also technically not for hips.
                              Sorry for the delay in replying, we've been a bit mad here with the floods all round us (we are on the Qld/NSW border). I can buy it over the counter here in Australia, it mau be a prescription medication for the US. But it does work. I don't know how you'd go using it constantly, I need it a couple of times a month at the most frequent and it works a treat.
                              Odille
                              F 58 / 170cms / SW 131.5 kgs / Current 112.4/ GW 65
                              following Primal Lifestyle and swimming my way to health

                              My Primal Blog / Photo Blog / RedBubble shop / My Calendars / My Facebook

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                              • #30
                                Originally posted by Analog6 View Post
                                Sorry for the delay in replying, we've been a bit mad here with the floods all round us (we are on the Qld/NSW border). I can buy it over the counter here in Australia, it mau be a prescription medication for the US. But it does work. I don't know how you'd go using it constantly, I need it a couple of times a month at the most frequent and it works a treat.
                                I might just need to schedule a trip to visit a great friend in NSW...

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