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Thread: Torn Rotator Cuff: Should I wait it out or get the minimally invasive surgery? page 2

  1. #11
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    As a few others have said, the decision to have surgery or not totally depends on the degree of the tear and what you want to do with your shoulder once recovered.

    If the tear is a partial thickness compared to a full thickness tear then there is a relatively good chance of it healing on its own, provided you give it the proper rest are relatively healthy, and work with a good therapist. A full thickness tear most often will need surgery to repair itself unless it is fairly small.

    Did the doctor tell you what percentage the tear was? The biggest concern with putting off surgery is that depending on your age, or overall health. Overtime the tendon can retract, and degenerate and then the surgeon is unable to repair it. That most often occurs in older patients who hurt their shoulder then go a long time without seeing anybody about it then its too late.

    Rotator cuff surgery is a very successful surgery, and there are very few risks too worry about. The standard surgical risk apply, but if they do it arthoscopically, then the risks of infection etc are decreased dramatically as opposed to an open procedure. The first six weeks of rehab are the worst, and then it gets better from there.

    As far as cause I am concerned, I have never read any evidence that specifically identifies the GTO as the culprit. GTO's are going to be guilty in instances of spontaneous rupture. (i.e. a weightlifter rupturing the biceps while doing a deadlift, an athlete rupturing the patellar tendon etc) RTC tears most often occur from overuse, chronic degeneration, poor scapular kinematics causing rubbing/fraying, shoulder impingement etc. Though it can occur from falling on your shoulder.

    Hope that all helps in making your decision, basically my advice would be that if the Doctor says the tear is beyond 50%, I would get them to repair it otherwise you could potentially consider going through therapy and allowing it heal on its own. Just find a good sports medicine orthopedist to perform the surgery and not a general (do everything) orthopedic surgeon.

  2. #12
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    Stu: well you learn something new every day! I was making a poor joke in saying the torn rotator cuff sounded like a GTO malfunction. I was meaning the old muscle car, pontiac GTO. My spouse had one in our 60s college days; I used to say you had to rest after driving it. Anyway, I looked up the gto as you interpreted and was enlighted. Thanks for your thoughts and suggestions. I did not learn the percentage the thing is torn, and will follow up on that.
    Last edited by Digby; 01-08-2011 at 09:46 AM. Reason: Typing gaff
    This time, like all times, is a very good one, if we but know what to do with it. Ralph Waldo Emerson

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  3. #13
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    No worries, I feel equally stupid for being young and completely missing the joke. Oh well! Anyways glad you learned something. Hope you get your shoulder taken care of.

  4. #14
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    the only thing I have to add is that it seems that you can go from a shoulder/RC injury to a frozen shoulder quickly and that is a real bitch. 1 year on and I'm still in pain. so if you can avoid that, all good. I hope you heal naturally and fast.

  5. #15
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    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 is not recommended for hips (or shoulders) but works a treat for me on the hip area. Sometimes I can't get out of bed without it, the pain is so bad.

    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 to use it for my occasional flare ups. You do have to be careful though, not to overdo it again when it reduces the pain, it is easy to exacerbate an injury when the pain is masked.
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  6. #16
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    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.

  7. #17
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    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.

  8. #18
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    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

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  9. #19
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    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.

  10. #20
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    Quote 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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