# Rotator cuff surgery - tips and tricks



## salinity (Sep 14, 2019)

Injured my left shoulder about 9 weeks ago on a lame “tip-over” type fall & it’s not responding to PT etc. like I’d hoped (have 80% ROM, but persistent pain and dead arm feeling). Ortho suspects rotator cuff tear (supraspanitus) - I have an MRI & follow up in a couple weeks.

I’m preparing myself mentally for the possibility I’ll need surgery (kind of hoping for it, as the past 2-1/2 months haven’t been much fun). To those who have had the surgery, do you have any life tips to share? How do you dress the first couple of weeks? Do I need to get a bunch of XXXL shirts to put on over my slung arm? What about washing / showering? Perhaps the biggest question is work - I can presumably do desk work (remotely) as long as need be (I’m a marine scientist and typically do a mix of field & desk work) - how soon can I expect to be able to operate a computer? I’m right handed and the injury is to my left shoulder, so a mouse isn’t an issue.

Anything I should be doing physically?

thanks for any insight/advice (and Merry Christmas!).


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## mxmtbb17 (Jul 15, 2020)

salinity said:


> Injured my left shoulder about 9 weeks ago on a lame "tip-over" type fall & it's not responding to PT etc. like I'd hoped (have 80% ROM, but persistent pain and dead arm feeling). Ortho suspects rotator cuff tear (supraspanitus) - I have an MRI & follow up in a couple weeks.
> 
> I'm preparing myself mentally for the possibility I'll need surgery (kind of hoping for it, as the past 2-1/2 months haven't been much fun). To those who have had the surgery, do you have any life tips to share? How do you dress the first couple of weeks? Do I need to get a bunch of XXXL shirts to put on over my slung arm? What about washing / showering? Perhaps the biggest question is work - I can presumably do desk work (remotely) as long as need be (I'm a marine scientist and typically do a mix of field & desk work) - how soon can I expect to be able to operate a computer? I'm right handed and the injury is to my left shoulder, so a mouse isn't an issue.
> 
> ...


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## davec113 (May 31, 2006)

I had a near complete tear of Supraspinatus and Teres Minor, torn labrum, torn bicep tendon, and more. 

Hate to say it, but 2.5m months is very early for this kind of injury. I didn't do surgery and took 1.5 yrs for the muscles to heal, and it was likely they wouldn't. Now I'm back to 99%, just took years of doing PT. 

My surgeon also works with CO Rockies and Denver Broncos so I trust his advice, I think many surgeons would have recommended surgery in this case but he's into not doing surgery if you maintain progress recovering. Any way you go there are no guarantees and I'd consider thinking about full recovery happening over a couple years and not a few months. You may get lucky and it'll go faster but it's pretty hard to tell. You can ride bikes and do a lot of normal stuff way before you can get back to doing pull ups and overhead presses, I was riding again after 4-6 months but I could feel it healing over several years.


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## Nat (Dec 30, 2003)

I'm on postop week #5 of a full thickness supraspinatus tear repair. Once I got my mri results I was gung ho for surgery 100%.

The evidence shows that early repair of an acute traumatic injury leads to better outcomes and easier recovery. Apparently repair within four months of injury is best.

I haven't needed oversized shirts but button up shirts are easiest to wear. I've been wearing mostly flannel shirts.

A recliner helps for sleeping at first. If you don't have one then people seem to like a wedge pillow or propping up pillows.

An ice machine is also helpful for the first several days.I woke up from anesthesia with one on me.

It seems like most people appreciate a nerve block to prevent pain for the first 24 hours but if I ever need another shoulder surgery then I will decline the block. I hated the loss of motor control and the cadaver arm sensation. There's also a risk of impaired breathing, which I had, since the block can anesthetize part of your diaphragm. The inability to draw a full breath felt awful. I'd rather have pain.

Showering hasn't been an issue. You just have to take your time and be careful to not accidentally try to use your surgical arm when it's out of the sling. I place the palm of my hand against my abdomen and make sure it stays there.

Either have a bunch of slip on shoes available or learn to tie your shoes one-handed. It's not as difficult as it sounds. I took video of technique if you need to see how to do it.

Sweatpants. Lots of sweatpants.

While you _could_ possibly return to a desk job in a week you won't feel like it. Mostly you'll just want to sit there watching tv or doing nothing. Your body will be using a lot of energy to recover.

Is cannabis legal where you live? A lot of people say they benefit from CBD/THC gummies to help with sleep and with pain control.

There are at least two sizable Facebook groups for rotator cuff surgery patients if you use Facebook. It seems like the people on those pages who fare the best also have the best mental game. The ones who are scared and dreading surgery like it's the end of the world seem to have a very rough recovery.

Best of luck!


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## mxmtbb17 (Jul 15, 2020)

@salinity , I have had rotator cuff surgery on both shoulders as well as separated shoulder injuries on both shoulders so I've had a lot of experience with the injury, surgery and rehab. The surgery itself was not a big deal but the early recovery phase was tough on one and not too bad on the other. The tuff one had a lot of pain and the other one had a mild amount of pain. WIth regard the pain you really should try to have your surgeon prescribe a continuous temperature regulated cold therapy machine as it will really decrease pain and swelling while reducing strong pain control medication. Contolling the early pain will help with sleep which will help with the rehab exercises which will be tough to begin with simple routines that will piss you off because you will fell like you should already be there. A really good sports medicine PT that is strong on shoulder rehab will guide you and that is key because keeping ROM is critical which will make it much easier to build strength. Both times for me took about 12 weeks to begin to see some gains and a path forward. Another 12 weeks to be back to a point where I felt comfortable riding fast on gravel or smooth terrain and another couple of months to be back to full speed. After being cleared by the doctor I began pool swimming and focused on freestyle to gain strength, ROM and fitness. You'll regain your strength, endurance and confidence. Hope you have a speedy recovery.


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## salinity (Sep 14, 2019)

Slip on shoes - that’s a good one! 

How about being able to use a computer after, say 2 weeks? I have vacation, but I’m also trying to land a new job, so I want to get this done but be able to show my worth ASAP. And I’m on FB, but currently only for select MTB groups - seems like it might also be a good place for some rotator cuff recovery support (if I can avoid being distracted by those questionable “friend suggestions” from hot women who have no legitimate connection to me).

oh, and yes - it’s not Rec legal yet in RI, but my wife has a card & I live 5 min from a shop in MA.


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## salinity (Sep 14, 2019)

@davec113 - man - I'll tell you - after the past 2+ months, if surgery is even slightly recommended, I'm gonna do it. I love biking and can bike at 70% as I am now, but my first love is surfing & I can't surf worth a damn right now. For that reason alone I'm hoping getting cut will solve me. Looking back, if I somehow got surgery the day after it all happened, I'd be well on my way to recovery by now - and I've lost a lot of good surf and biking over the ensuing 2+ months - so 4-6 months off for a full-ish recovery to enjoy the things I love is looking like the right call now. It's just the work thing I need to figure out, as that pays the bills!


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## Nat (Dec 30, 2003)

I bet you’d be able to return to work in 2 weeks. That sounds reasonable. I was off all pain meds by day 4.

In hindsight I wish I had made the appointment with my orthopedic surgeon within a couple of weeks after my crash so I would’ve gotten the MRI and subsequent surgery sooner. I’d likely be snowboarding by now but since I thought my shoulder was healing I delayed treatment and had surgery at week 12. I won’t be able to do much this winter for exercise other than go for walks.


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## salinity (Sep 14, 2019)

Nat said:


> I bet you'd be able to return to work in 2 weeks. That sounds reasonable. I was off all pain meds by day 4.
> 
> In hindsight I wish I had made the appointment with my orthopedic surgeon within a couple of weeks after my crash so I would've gotten the MRI and subsequent surgery sooner. I'd likely be snowboarding by now but since I thought my shoulder was healing I delayed treatment and had surgery at week 12. I won't be able to do much this winter for exercise other than go for walks.


Thanks for that info - unfortunately, the work deal is a big stress factor. And I feel ya in the timing - I delayed the MRI due to the stupid insurance game (had no hits to my deductible in 2020, so decided to push it to 2021assuming a lot more "need", essentially saving me $500 out of pocket). But looking back, based on the typical recovery timeline, I'd be 3 months from near full recovery by now - and ready to surf and get after it on the trails come spring. If I'm lucky, now I'll be looking at lifting a leg over the top tube in late summer.


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## Nat (Dec 30, 2003)

Yep, I was playing the deductible game too. I went over the bars and landed with my arm pinned beneath me in late August. I had zero medical expenses for the year at that point so I didn’t call the doctor’s office like I could have. I told myself that if it were still hurting on January 1 I’d call.

For about six weeks I thought I was going to heal up without any intervention but by mid-October I realized that my progress had stalled and my arm really was nearly nonfunctional. I finally got an appointment in early November then surgery at the end of the month. At that point it was a race to get everything done before the end of the year when insurance resets (and before any Covid-19 shutdown).

I missed out on all the excellent fall riding and got a refund on my ski pass but my arm feels so much better than it did preoperatively.


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## davec113 (May 31, 2006)

Nat said:


> I bet you'd be able to return to work in 2 weeks. That sounds reasonable. I was off all pain meds by day 4.
> 
> In hindsight I wish I had made the appointment with my orthopedic surgeon within a couple of weeks after my crash so I would've gotten the MRI and subsequent surgery sooner. I'd likely be snowboarding by now but since I thought my shoulder was healing I delayed treatment and had surgery at week 12. I won't be able to do much this winter for exercise other than go for walks.


It's not that easy to qualify for an MRI so I wouldn't worry about it.



salinity said:


> @davec113 - man - I'll tell you - after the past 2+ months, if surgery is even slightly recommended, I'm gonna do it. I love biking and can bike at 70% as I am now, but my first love is surfing & I can't surf worth a damn right now. For that reason alone I'm hoping getting cut will solve me. Looking back, if I somehow got surgery the day after it all happened, I'd be well on my way to recovery by now - and I've lost a lot of good surf and biking over the ensuing 2+ months - so 4-6 months off for a full-ish recovery to enjoy the things I love is looking like the right call now. It's just the work thing I need to figure out, as that pays the bills!


On work, I think you'll have to wait to talk to your surgeon after your MRI to know much of anything. Shoulder injuries are all different, there's so much going on in the area it's hard to generalize. Desk job might be just a few days out, but idk.

On surgery, it just depends on the damage. If you have a full tear you'll need surgery. Otherwise it's so specific to the particular injury it's hard to even speculate.


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## slowrider (May 15, 2004)

salinity said:


> Injured my left shoulder about 9 weeks ago on a lame "tip-over" type fall & it's not responding to PT etc. like I'd hoped (have 80% ROM, but persistent pain and dead arm feeling). Ortho suspects rotator cuff tear (supraspanitus) - I have an MRI & follow up in a couple weeks.
> 
> I'm preparing myself mentally for the possibility I'll need surgery (kind of hoping for it, as the past 2-1/2 months haven't been much fun). To those who have had the surgery, do you have any life tips to share? How do you dress the first couple of weeks? Do I need to get a bunch of XXXL shirts to put on over my slung arm? What about washing / showering? Perhaps the biggest question is work - I can presumably do desk work (remotely) as long as need be (I'm a marine scientist and typically do a mix of field & desk work) - how soon can I expect to be able to operate a computer? I'm right handed and the injury is to my left shoulder, so a mouse isn't an issue.
> 
> ...


My subscapularis??? detached in my right shoulder and required surgery back in the "open it up and cut with a scalpel" age. My old time surgery was so much worse than my crash, but that has improved immensely. I had to sleep upright in a chair for 6 weeks and underwent 6 months, 2 days a week PT at a rehab facility and then 6 months of continuing the same work at home before being cleared for full exercise. Showering for the first 6 weeks was minimal due to the total lack of activity and consisted largely of bird bath type cleansing. After the stitches came out of the 4" incision I had enough freedome of movement to shower. I think most of these surgeries these days is arthroscopic or robotic or both and much less invasive. Clothing was a loose button-down only when leaving the house; I suggest flexible fabric and oversized. Good luck.


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## RickBullottaPA (Mar 4, 2015)

I would avoid surgery until you've done a good bit of PT and strengthening of the supporting musculature around the injured area. I've had a partial tear for nearly 5 years and am able to manage it successfully with exercise and ROM work. It'll get a bit sore now and then, and can get a little uncomfortable sleeping on occasion, but it beats 6+ months of downtime at this stage.

The reality is that a surgeon will almost always recommend surgery - shocking, I know.

FWIW, I've had a hip resurfacing done, so I'm not anti-surgery. I just prefer non-surgical approaches when the results are comparable or better, or when there are alternative types of surgery or treatment to consider.

The defining moment for me in understanding how medical "professionals" operate was about 10 years ago when I was suffering a loss of strength + some numbness in my left leg. I went to a neurosurgeon, who declared that I needed a microdiskectomy to relieve pressure on the nerve. I then went to an orthopedist, who declared that I had spinal disc compression and needed 30 days of VAX-D (decompression) treatment to relieve it. I then went to a chiropractor, who took a standup X-ray and realized that the root issue was an undiagnosed scoliosis. She showed me a stretch (piriformis stretch) that made the nerve issues go away, forever. The real issue was that the sciatic nerve was being pinched under a tight piriformis muscle. BTW I still do that stretch today.


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## Nat (Dec 30, 2003)

davec113 said:


> It's not that easy to qualify for an MRI so I wouldn't worry about it.


It's actually very insurance-dependent. My doctor ordered the MRI at the first visit. Some insurance companies/plans require prior authorization and some don't. Mine does not, but regardless, that ship has sailed and I'm happy to be in the post-op phase. I just wish I'd gone in sooner but I can't change that.


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## salinity (Sep 14, 2019)

@RickBullottaPA: My ortho is definitely not a huge proponent of surgery - I went through a separation and recurrent impingement in my right shoulder & despite a partial tear in that RC, he actually preferred to treat that conservatively. This feels different though - the deaf arm feeling is pretty persistent despite about 6 weeks of PR thus far. The MRI will tell the story - I assume full thickness tear = surgery; partial thickness = maybe not. I have a sneaking suspicion there's a labrum issue in there as well.

I do want to have as much info as I can regarding surgery & recovery - if I need it I want to get it done ASAP for a few different reasons (possible eve job etc).


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## Dawgprimo (Mar 7, 2004)

Arthroscopic Rotator Cuff repair is not for the faint of heart.
I work as a carpenter for years (Still do) and I am right handed.
Many years of abuse........play sports all my life.
Biked and skied for years and have had my injuries from wipeouts, hitting trees and what ever other stupid things I have done. 
It started off tearing my bicep muscle in my right arm......during a ride..(Nothing spectacular either....)...pain was something but finished the ride.
Iced like crazy and Ibuprofen.....
Settled down in a couple of months...a bit...never lost time from work but it was interesting......icing became a daily thing. Took a couple months to get on a bike.
Doing the belt buckle or turning the key in the ignition or shifting the car was not fun.....working above my head not fun. The aching was the worst.......never went away and I would wake up during the night and had to find a spot it ached the least......learned to live with it.
Had it ultra-sounded but was told to live with it as it gets better.......?
6 months to get over a torn bicep........or more.
I biked/worked and had to live with the aching.
Did physio and lots of stretching with in reason without doing more damage. Whatever felt good for it.
1 1/2 years later I was riding in Moab and wiped out ....my stupidity but......The pain was back! 
Still finished the ride.......and another 2 more before I left.
I was in Moab.......had too!
Came back home had it checked again and my family doctor got me in with a Specialist.
3 months later in for surgery. Was suppose to be in for 1 hour but ended up on the table for 2 1/2 hours and he had to repair 3 of the 4......major surgery he called it! I had 5 or 6 incisions. 
First month was rough! Had to wear a sling for the first 7 weeks 24/7.......hated it!
The aching was terrible but icing was king and I tried not to take to many pain killers. Took 4 weeks to get my first decent night sleep. Took 3 months off work and worked with a physio under the doctors orders. Really stiff once I started physio.....
I had to do light work when I went back to work and luckily I have a government job doing maintenance.......of course Covid hit in March......
I was riding a stationary bike and stretching with in 2 months from surgery for a 1/2 hours per week which was amazing. Started road riding 6 months after surgery......
I made sure I did not want to re tear my shoulder so I was being good........it was killing me! 
The aching slowly went away and a year after surgery it felt pretty good! Still had to be careful!
It is now 1 1/2 since my surgery. 
It took me 10 months to get my first mountain bike ride in.
I am still working on my shoulder, strengthening, stretching and a lot of motion workout.
It aches a bit if I over do it or it get cold. 
I love riding my mountain bike and no aching.......amazing.
Never got my bicep muscle fixed........to old (55).

Sorry for the novel........hope that answers some questions......I would say I am 90 percent.
Right shoulder still does not like some positions, like pushing from the right side to left.

Good luck!


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## pctloper (Jan 3, 2016)

9 months before aggressive riding for a major surgery would not be unusual----this is a big deal----a minor issue would be less----


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## davec113 (May 31, 2006)

salinity said:


> @RickBullottaPA: My ortho is definitely not a huge proponent of surgery - I went through a separation and recurrent impingement in my right shoulder & despite a partial tear in that RC, he actually preferred to treat that conservatively. This feels different though - the deaf arm feeling is pretty persistent despite about 6 weeks of PR thus far. The MRI will tell the story - I assume full thickness tear = surgery; partial thickness = maybe not. I have a sneaking suspicion there's a labrum issue in there as well.
> 
> I do want to have as much info as I can regarding surgery & recovery - if I need it I want to get it done ASAP for a few different reasons (possible eve job etc).


Unfortunately, nerve damage is a real possibility with shoulder injuries too, that may not be a muscle issue. I managed to partially dislocate or sublux my right shoulder about 16 months ago and the nerve tunnel got pulled and resulted in me fumbling and dropping stuff randomly for 6-9 months. That injury may require surgery as a there is a bursae that gets inflamed, which in turn inflames a bunch of other stuff including my bicep tendons. Apparently the injury caused something that could be fixed with a minor "clean-up" and may solve that issue.

Also, the tears I had on my left side Supraspinatus and Teres Minor were near full thickness and the surgeon did not think they could recover, but they did after 1.5 years of band exercises. He was really surprised to find in a MRI that the muscles were fully healed with no signs of injury, he though I adapted but I had fully healed. Never give up on PT! And the truth is people without any shoulder injuries would be well served by doing rotator cuff exercises anyways, they are often neglected.


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## RickBullottaPA (Mar 4, 2015)

davec113 said:


> Unfortunately, nerve damage is a real possibility with shoulder injuries too, that may not be a muscle issue. I managed to partially dislocate or sublux my right shoulder about 16 months ago and the nerve tunnel got pulled and resulted in me fumbling and dropping stuff randomly for 6-9 months. That injury may require surgery as a there is a bursae that gets inflamed, which in turn inflames a bunch of other stuff including my bicep tendons. Apparently the injury caused something that could be fixed with a minor "clean-up" and may solve that issue.
> 
> Also, the tears I had on my left side Supraspinatus and Teres Minor were near full thickness and the surgeon did not think they could recover, but they did after 1.5 years of band exercises. He was really surprised to find in a MRI that the muscles were fully healed with no signs of injury, he though I adapted but I had fully healed. Never give up on PT! And the truth is people without any shoulder injuries would be well served by doing rotator cuff exercises anyways, they are often neglected.


Yup. My bad (worse?) shoulder is the byproduct of two separations, a broken collarbone, torn muscles in a dirt bike crash, and "a life well lived". At 58 years old, since I'm still active, the 6-12 month downtime just isn't worth it for me. If I was 40, I'd probably think differently.

One other piece of advice : over-the-head weightlifting is a fundamentally unnatural movement for your shoulder, and it would be wise for anyone who values long term shoulder health (particularly those over 50) to reconsider what those reps are doing for you (to you?).


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## WHALENARD (Feb 21, 2010)

RickBullottaPA said:


> over-the-head weightlifting is a fundamentally unnatural movement for your shoulder, and it would be wise for anyone who values long term shoulder health (particularly those over 50) to reconsider what those reps are doing for you (to you?).


Is there conclusive literature on this? I've read about it somewhat thoroughly but that was several years ago now. My understanding was there is no conclusive evidence it causes impingement or anything else deleterious.

Sent from my moto g(6) forge using Tapatalk


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## RickBullottaPA (Mar 4, 2015)

WHALENARD said:


> Is there conclusive literature on this? I've read about it somewhat thoroughly but that was several years ago now. My understanding was there is no conclusive evidence it causes impingement or anything else deleterious.


Literally every shoulder specialist I spoke with regarding my situation said "don't lift heavy stuff over your head". ;-)

I used to do standing skullcrushers and those _really_ tweaked my shoulder a couple years back, which triggered me asking the docs their opinion.

Also, if you think about it (reach for the sky right now), you're putting a ball and socket joint at the limit of its normal range of motion. The acromion seems to get in the way at the top of the movement. I've switched to doing many of the same exercises on an incline bench, and so far, no issues.

If you search on the topic, you'll see that trainers generally agree that it is specific to the person, though it appears that a significant number of people do not have a natural anatomy that is conducive to overhead lifts.


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## Nat (Dec 30, 2003)

Oh yeah, after surgery one item that I absolutely LOVE is my backscratcher. I consider it essential. Get one.


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## salinity (Sep 14, 2019)

Nat said:


> Oh yeah, after surgery one item that I absolutely LOVE is my backscratcher. I consider it essential. Get one.


A seemingly innocuous item, but this is the type of info I'm looking for!

Not quite sure what is up with the shoulder, but there is some pronounced swelling I didn't notice before (really noticeable if I raise my arm in front of me) and some added pain/discomfort over the past couple of days. I backed off on the exercises a bit and am being a bit more gentle. MRI scheduled for this coming Sunday and follow up on Wednesday. I'm ready for some more definitive "answers" and a proper path forward.


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## Dawgprimo (Mar 7, 2004)

I am sure others have said it .......
I was told by many friends and people that work in the field including nurses, physiotherapist and my Doctor. 
That a lot of surgeries don't hold due to either failure or they re-tear their Rotator cuff repair. 
(Can't remember the percentage but it was close to 40-50%.)
I heard of one guy slipped walking down some stairs at home about 4 weeks after surgery and the physiotherapist figured he screwed himself......
As severe as my repair was, mine so far has gone quite (Knock on wood) well but I did take it easy and did a lot of stretching and physio at home. 
It is considered one the more difficult surgeries to do and to recover from.
I heard second time is even worse.......less to work with and harder to anchor to........

Before surgery I could not with a open hand (palm towards my stomach) push against my stomach.'
In fact I could only get to within an inch of it.......with was pathetic.
But now my right arm/shoulder can push my stomach in but not as good as my left arm.
I am still working on it!


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## salinity (Sep 14, 2019)

That's the thing about my "situation" - I seem to be able to do most things one shouldn't be able to do with large rotator cuff tears (my external and internal rotation is actually STRONGER on the injured side). I can wash my hair, put stuff in my back pocket, etc. Outstretched arm is much worse than bent arm motions, but overall ROM is probably 80-90%, but not without pain for certain motions. And it hasn't gotten better with 3 months of conservative treatment (NSAIDS, ice/heat, PT, etc.). Things like resetting the paddle stroke on a surfboard though are extremely painful, to the point of weakness. A full night's sleep? Well, that's the biggest issue. 

Interestingly, working the infraspinatus and teres minor trigger points give me near-instant relief and provide full pain-free ROM for a brief time. I don't know what that means (if anything). I've also recently noted some acute swelling in the front of my injured shoulder (right where the supraspinatus/bicep tendon would attach) - it's most noticable if I raise both my arms out in front of me.

MRI tomorrow, follow up on Wednesday, so the countdown begins!


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## salinity (Sep 14, 2019)

Welp, initial info from the doc is a ~2cm full thickness supraspinatus tear (will have further follow-up on Wednesday). Seems I'm destined for surgery - may schedule it as soon as Jan 15th. Not sure what to do about work and all (no short-term disability, but have a few weeks of vacation). Ortho says 6 weeks immobile + 6 more non-weight bearing in the sling - appears he's ultra conservative. Hopefully if all goes well I can open the pool on Memorial day (gotta have goals!). 

Any other prep work I can do in the next week +? Would it be at all beneficial to work the hell out of my shoulder? I imagine I'm going to atrophy like a SOB no matter what, but couldn't find much definitive info out there on pre-op PT benefits.


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## davec113 (May 31, 2006)

salinity said:


> Welp, initial info from the doc is a ~2cm full thickness supraspinatus tear (will have further follow-up on Wednesday). Seems I'm destined for surgery - may schedule it as soon as Jan 15th. Not sure what to do about work and all (no short-term disability, but have a few weeks of vacation). Ortho says 6 weeks immobile + 6 more non-weight bearing in the sling - appears he's ultra conservative. Hopefully if all goes well I can open the pool on Memorial day (gotta have goals!).
> 
> Any other prep work I can do in the next week +? Would it be at all beneficial to work the hell out of my shoulder? I imagine I'm going to atrophy like a SOB no matter what, but couldn't find much definitive info out there on pre-op PT benefits.


Ugh, sorry to hear it's a full thickness tear! Seems like surgery is in your future, hopefully it'll lead to a full recovery. Good luck!


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## Nat (Dec 30, 2003)

salinity said:


> Welp, initial info from the doc is a ~2cm full thickness supraspinatus tear (will have further follow-up on Wednesday). Seems I'm destined for surgery - may schedule it as soon as Jan 15th. Not sure what to do about work and all (no short-term disability, but have a few weeks of vacation). Ortho says 6 weeks immobile + 6 more non-weight bearing in the sling - appears he's ultra conservative. Hopefully if all goes well I can open the pool on Memorial day (gotta have goals!).
> 
> Any other prep work I can do in the next week +? Would it be at all beneficial to work the hell out of my shoulder? I imagine I'm going to atrophy like a SOB no matter what, but couldn't find much definitive info out there on pre-op PT benefits.


Damn. A 2cm full thickness tear is significant. Mine was "only" 1cm. Yeah surgery is where you're headed.

I wouldn't bother with PT preoperatively. I'd spend some time practicing living with only one arm though (getting dressed, basic hygiene, cooking, etc.). For anything that you find too challenging buy whatever tool or gizmo to help so you have it in your home by surgery day. Ask your surgeon if they plan to fit you with an ice machine at surgery. If not, buy one for immediate use if the doctor doesn't object. Do you have a recliner to sleep in for awhile?

I'm at week six in my sling and have one more week to go. After that it'll be another five weeks of lifting nothing heavier than a phone. I feel like the time has gone quickly.


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## salinity (Sep 14, 2019)

Nat said:


> Damn. A 2cm full thickness tear is significant. Mine was "only" 1cm. Yeah surgery is where you're headed.
> 
> I wouldn't bother with PT preoperatively. I'd spend some time practicing living with only one arm though (getting dressed, basic hygiene, cooking, etc.). For anything that you find too challenging buy whatever tool or gizmo to help so you have it in your home by surgery day. Ask your surgeon if they plan to fit you with an ice machine at surgery. If not, buy one for immediate use if the doctor doesn't object. Do you have a recliner to sleep in for awhile?
> 
> I'm at week six in my sling and have one more week to go. After that it'll be another five weeks of lifting nothing heavier than a phone. I feel like the time has gone quickly.


Good advice. Any ice machine or sling recommendations (I've heard sling comfort can be quite a difference maker)? I started practicing the one arm thing a bit ago - can't figure out how to effectively wash dishes, but hopefully the wife won't mind picking that up for a couple months! Dressing, showering, what to wear - these are the things that occupy my mind. That and not being able to bike or surf until late summer at best - yikes. Good luck with your healing - feel free to post your progress - I may do the same for others who find it useful.


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## Nat (Dec 30, 2003)

I have a Breg Polar Care Cube. I can’t say I love it or anything. Sometimes it malfunctions and water doesn’t flow through properly. I don’t know about any other brands or models. The Facebook groups that I mentioned earlier might be a good resource; I recall seeing a few threads recently regarding ice machines.

I’m sure that your surgeon will fit you with whatever sling they feel is most appropriate.


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## Dawgprimo (Mar 7, 2004)

My surgeon told what sling he wanted me to wear.
Had it fitted and ready to go.
I woke up from surgery and I was wearing it.
I will be honest with you but I hated that sling even though it was good for me and it held my shoulder in the position it had to be in but I was a very happy when I did not have to wear it anymore......5th or 6th week. I think the Doctor would have liked me wear it longer specially at night but I just could not......
I was told to practice putting on the sling before surgery and if you have a someone with you like a wife or husband, for them to know how to put it on. Easier before then after....
Once you have permission to have a shower (4th or 5th day for me), you got to get back in the sling with no issues.
I was off work for 3 months.
1 month after surgery I use to go for daily walkouts for about 45 minutes which was 3 -4 kms.
I did start riding a stationary bike for 30 minutes, stretching and pilates (carefully) about 2 months after surgery.
(Only once a week)
It was awesome....... 
And I was seeing the physio at about the 6 weeks time.......2 times a week.
I also went for massages that were amazing......
I figured the more you start doing the bigger chances that you could re-injure yourself, so no hikes and I stayed away from doing anything stupid.
First road ride I did was 7 months after surgery and first mountain ride was 8 months.
But I took it easy.
No aching was the best feeling ever but I continue to rehab my shoulder and still work as a carpenter.
Take it and let it heal.

The only one big problem with being off on sick leave and way to much time on your hands......ended up buying a mountain bike frame (Sept 2019) which I had to wait for and build up during COVID 19. 
But I am loving the bike and the shoulder is pretty good!
Good Luck!


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## salinity (Sep 14, 2019)

Glad to hear you're well on the way to recovery. One thing is clear - this surgery is no joke. My Ortho is suggesting 2+ months in the sling - 6 immobile and 6 more non-weight bearing. Figuring out how to contribute to work is going to be the biggest challenge - I'm a field biologist, but can (and will) do "desktop research", proposal writing, etc. I have a few weeks of vacation time I can use (what a crappy vacation), but I'm hoping between one-hand typing, some talk to type software, etc. I can get back to work at least part-time after a couple weeks.


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## Dawgprimo (Mar 7, 2004)

I was just giving an idea what it was like but like I said all it takes is something stupid like stumble on the stair case at home and your arm goes out to brace yourself or grab on to a hand rail and you could blow you shoulder out... ...which happened to another patient that was going to the same physio.
I figured the more activities that I would do, just increases the chances. So I stayed home.......
I know my physiotherapist figured I would blow my shoulder out or could have been a candidate considering how active I am and what my career is as a carpenter, so she has been very surprised (I think) how well I have done!
The thing is I have played sports all my life and surgeries, physio and rehab is nothing new to me. You got to know your body, what feels right or doesn't feel right, how to push it without damage, prepare to do a lot of rehab at home and take an active interest in your rehab. (I know my physio told me if all her patients were like me, she would have to second job......which I doubt!)
I will say this surgery was the toughest so far.......with lack of sleep for 3 weeks-the aching-the rehab-and not doing to much for 3 months.

Lucky for me I am a government employee now, so I was off on sick leave for 3 months that I had banked up. I could take the time off and take care of myself........but I have been self employed for many years and did not have anything like sick leave.......so I was very appreciated of my opportunity.

It sounds like you got a handle of the situation and you will be fine!
Good luck!
Kevin


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## salinity (Sep 14, 2019)

Thanks Kevin - yeah, I plan on being extra careful with the repair and following the protocols & PT to the letter. Any return to work would be remote, at least for the first couple of months (I work remotely now).

My pre-op visit with the surgeon yielded a slight ray of hope - the surgeon & radiologist have slightly different interpretations of the MRI (moderate tear vs severe tendonopathy). Given my symptoms and lack of progress, surgery would be recommended in either case (I know my body too, and something is seriously wrong in there), and I tend to think the Dr. has the upper hand in terms of expertise, but if the Dr goes in and finds the tendon still attached, it’s a much different approach and a much shorter post-op recovery. Not hanging my hat on that, but it sure would be nice.


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## Dan Zulu (Jul 5, 2008)

Good luck with the surgery. I had a SLAP tear debridement and biceps tenodesis this winter. My rotator cuff was intact which was unexpected. I was off work for 36 hours and then back at my desk typing with both hands. I wore the sling for two weeks until the doctor told me to discard it. My biceps and AC joint have been very susceptible to aggravation so I am not doing any lifting or overhead reaching other than at supervised PT.
I am eager to get back on the bike but I know that one fall could ruin the fix. If a patient pulls the biceps off of the new anchor on the humerus the surgeon often just leaves it as is and does not attempt a second relocation. In a few months I’ll have more confidence in its durability.


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## Dan Zulu (Jul 5, 2008)

Also, sweatpants are nice. For the office it was easy to wear belted dress pants. I simply threaded the belt through the pants before I put the pants on. Buckling with one hand was easy.


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## salinity (Sep 14, 2019)

Thanks for that info. Interestingly, although my doc interpreted my MRI as showing a full thickness RC tear, I just got a hold of the MRI report and the radiologist saw severe supraspinatus tendoniopathy (no tear) PLUS a degenerated and torn superior labrum. Ortho Doc didn’t mention the labrum (even though I asked). He said he’s willing and happy to be wrong about the tear - maybe mine will turn out similar to your story. Here’s what I’ve gathered so far ahead of surgery Friday:

-sweatpants
-bigger shirts
-pregnancy pillow
-elastic no-tie shoelaces
-back scratcher
-tooth flossers/picks (bamboo)
-ice machine (hospital sending me home with one)
-Dry Robe as a winter jacket (I had this to change after surfing)
-memory foam mattress on a zero gravity chair


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## RickBullottaPA (Mar 4, 2015)

salinity said:


> Thanks for that info. Interestingly, although my doc interpreted my MRI as showing a full thickness RC tear, I just got a hold of the MRI report and the radiologist saw severe supraspinatus tendoniopathy (no tear) PLUS a degenerated and torn superior labrum. Ortho Doc didn't mention the labrum (even though I asked). He said he's willing and happy to be wrong about the tear - maybe mine will turn out similar to your story. Here's what I've gathered so far ahead of surgery Friday:
> 
> -sweatpants
> -bigger shirts
> ...



omnipresent water bottle : stay hydrated
sounds silly, but if you use a certain hand for "posterior cleaning", practice with the other one now!


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## davec113 (May 31, 2006)

Now's the time to get a bidet.


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## salinity (Sep 14, 2019)

Had the surgery today. Gonna start a new thread to record recovery process as able. Any tips and tricks I encounter along the way I'll post here.

immediate post-op tips:

if it's a choice, I recommend the nerve block
make sure you have or will be sent home with a cold therapy cooler (or whatever they're called).


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## Nat (Dec 30, 2003)




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## bingemtbr (Apr 1, 2004)

I'm late to the game. I destroyed both shoulders in July 2015. 90%+ labrum tears, tricep torn, bi-cep torn, bone spurs and found out post operation that I _had_ arthritis in my right shoulder. Total recovery period was expected to be 9 mos bc you can only do one shoulder at a time. I'm left handed, so I did my right shoulder first.


Recovery time on right shoulder until I was out of the sling and cleared for spin class: 10 days. Surgery date: Jan 28, 2016. 
Recovery time on the left should until I was out of the sling and cleared for spin class: 4 days. Surgery date: February 25, 2016. 
Back riding the bike on the weekend after St. Patty's Day, March 19th, 2016. 

Lessons learned: 

Get several second opinions. At the time, I lived in central IL. I spoke with Ortho doc's locally and in both Chicago and St. Louis
Search out the Ortho doc who is the team doctor for the local professional NHL, NFL, and MLB teams. 
Go to the Anschutz Health Center in Vail, CO if at all possible. Its where all the NHL, Olympic athletes, and pro-skiers go.
The team doc (at the time) for the StL Cardinals and StL Blues did my shoulders. The most humble and confident human I have ever met. And he did his residency at Anschutz. Cost was VERY competitive--his office admin shopped my insurance to the 3 largest StL networks and 4+ private surgical suites. The only difference in care being the time of the surgery. The big 3 health systems get all the early morning appointments. I ended up having my procedure done at a surgical suite in a strip mall adjacent to a bank and across the street from a BBQ joint. Bonus: we had BBQ for lunch after both surgeries.


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## Nat (Dec 30, 2003)

Pro tip: going to a professional team's doctor might not mean you're getting a physician that's any more skilled than any other community practitioner. It's a marketing arrangement (and a great one as far as that goes) in which the doctor pays the team to be able to say they're the official team doc. Therefore, if you find a doctor in your community who has a great reputation and credentials then you might not gain anything from traveling far away for a team doc.


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## salinity (Sep 14, 2019)

16 days PO. First actual PT session tomorrow. Still getting some pain - especially at night / morning and mostly associated with the bicep repair / anchor. Anecdotally, it seems that for those who have RC + bicep anchored, the bicep is the more painful and troublesome muscle.

I'm able to shower and do most things on my own one-handed by now. Pain / discomfort is still the driving force behind my general malaise now, but I do feel better if I'm up and about a bit. Once the weather clears I'll probably start taking some walks this week.

@bingemtbr - I have no idea how those timelines worked out for you, unless you didn't have actual rotator cuff repair (though I'm glad you were able to get back to action so quickly). There is a mountain of clinical evidence that a repaired tendon to bone interface doesn't heal with any sort of integrity until 6-12 weeks. However anomalous your experience may have been, it does give me hope that perhaps my timeline may be shortened, even if just by a little bit. My biggest fear is damaging the repair and having to do this over again - assuming you had anchors etc, the fact that you were jostling the shoulder around a couple weeks after surgery might assuage those fears a bit.


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## davec113 (May 31, 2006)

salinity said:


> 16 days PO. First actual PT session tomorrow. Still getting some pain - especially at night / morning and mostly associated with the bicep repair / anchor. Anecdotally, it seems that for those who have RC + bicep anchored, the bicep is the more painful and troublesome muscle.
> 
> I'm able to shower and do most things on my own one-handed by now. Pain / discomfort is still the driving force behind my general malaise now, but I do feel better if I'm up and about a bit. Once the weather clears I'll probably start taking some walks this week.
> 
> @bingemtbr - I have no idea how those timelines worked out for you, unless you didn't have actual rotator cuff repair (though I'm glad you were able to get back to action so quickly). There is a mountain of clinical evidence that a repaired tendon to bone interface doesn't heal with any sort of integrity until 6-12 weeks. However anomalous your experience may have been, it does give me hope that perhaps my timeline may be shortened, even if just by a little bit. My biggest fear is damaging the repair and having to do this over again - assuming you had anchors etc, the fact that you were jostling the shoulder around a couple weeks after surgery might assuage those fears a bit.


I tore some connective tissue, including the long head bicep tendon on my left side by going a little too hard in PT/lifting too early. Now I have "Elway Arm" or Popeye deformity on my left bicep.

Unfortunately, I'm going in for the right side next week. Bursitis has kept it from fully recovering from a crash a little over a year ago, and I have not been able to remedy the situation with acupuncture, stretching/yoga, PT, it just seems to go back and forth from not bad to moderately painful and it's weak in some ways. I can't even do curls without irritating my entire shoulder... Then a couple days ago I crashed, seemed moderately hard but not too bad, my lighter weight Fox D30 Enduro pads worked amazingly well, but my weakened right shoulder wasn't up for it and I broke my glenoid, the socket of the shoulder. The bottom half is broken off! What's crazy is I thought I was fine, I was testing out my range of movement and it felt normal.... until I lifted my arm above my head, then the f%^king thing popped out of it's socket. I had to grab my right arm with my left and gently guide it back down. I could even ride out, I just had to keep my elbow close to my body, and it wasn't even painful. Right now there's some pain but surprisingly little, and no "deep ache" you typically get with a fracture. It's so odd...


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## salinity (Sep 14, 2019)

davec113 said:


> I tore some connective tissue, including the long head bicep tendon on my left side by going a little too hard in PT/lifting too early. Now I have "Elway Arm" or Popeye deformity on my left bicep.
> 
> Unfortunately, I'm going in for the right side next week. Bursitis has kept it from fully recovering from a crash a little over a year ago, and I have not been able to remedy the situation with acupuncture, stretching/yoga, PT, it just seems to go back and forth from not bad to moderately painful and it's weak in some ways. I can't even do curls without irritating my entire shoulder... Then a couple days ago I crashed, seemed moderately hard but not too bad, my lighter weight Fox D30 Enduro pads worked amazingly well, but my weakened right shoulder wasn't up for it and I broke my glenoid, the socket of the shoulder. The bottom half is broken off! What's crazy is I thought I was fine, I was testing out my range of movement and it felt normal.... until I lifted my arm above my head, then the f%^king thing popped out of it's socket. I had to grab my right arm with my left and gently guide it back down. I could even ride out, I just had to keep my elbow close to my body, and it wasn't even painful. Right now there's some pain but surprisingly little, and no "deep ache" you typically get with a fracture. It's so odd...


Yikes - good luck getting that cleaned up! 
At 18 days PO I started using heat quite a bit yesterday and it helped a lot. I have broken free of the ball and chain known as the cold care cube (a godsend in the first couple weeks) and am just alternating ice packs and heating pads. I do keep the cold cube by the couch while sleeping.
First PT session in a couple hours!


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## bingemtbr (Apr 1, 2004)

davec113 said:


> I tore some connective tissue, including the long head bicep tendon on my left side by going a little too hard in PT/lifting too early. Now I have "Elway Arm" or Popeye deformity on my left bicep.


That sucks. I am so sorry.


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## Dan Zulu (Jul 5, 2008)

I wish you well on that recovery. Makes me grateful that mine isn’t worse than it is.


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## Nat (Dec 30, 2003)

I'm 10 weeks post-op now. I slipped on ice on a sidehill yesterday and fell onto my surgical side. My shoulder took a minor hit but it wasn't terrible because I broke the fall with my kidney. It scared me pretty good though. I laid there on the ground waiting to see if my shoulder was going to start screaming at me in pain but thankfully it didn't. I think it's going to be awhile before I feel confident mountain biking though.


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## Dawgprimo (Mar 7, 2004)

Nat said:


> I'm 10 weeks post-op now. I slipped on ice on a sidehill yesterday and fell onto my surgical side. My shoulder took a minor hit but it wasn't terrible because I broke the fall with my kidney. It scared me pretty good though. I laid there on the ground waiting to see if my shoulder was going to start screaming at me in pain but thankfully it didn't. I think it's going to be awhile before I feel confident mountain biking though.


I would say you are lucky! Very Lucky!
It took me about the 8th month before I did my first mountain bike ride and I took it easy!
Did not push too hard (so I would not wipeout) and at the same time I was unsure how my shoulder would react to mountain biking?
Stay safe!


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## Nat (Dec 30, 2003)

Dawgprimo said:


> I would say you are lucky! Very Lucky!
> It took me about the 8th month before I did my first mountain bike ride and I took it easy!
> Did not push too hard (so I would not wipeout) and at the same time I was unsure how my shoulder would react to mountain biking?
> Stay safe!


Hey, thank you! I should have been more clear though-I was walking when I slipped and fell. I'm not feeling physically ready to mountain bike. I _was_ able to roll around the neighborhood a little yesterday without any strain at least.


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## Bikeworks (Sep 10, 2020)

salinity said:


> Yikes - good luck getting that cleaned up!
> At 18 days PO I started using heat quite a bit yesterday and it helped a lot. I have broken free of the ball and chain known as the cold care cube (a godsend in the first couple weeks) and am just alternating ice packs and heating pads. I do keep the cold cube by the couch while sleeping.
> First PT session in a couple hours!


Shoulder injuries suck!!! I had a complete reconstruction of the L (non-dominant) shoulder ~25 years ago after experiencing multiple dislocations (all traumatic). The joint was absolutely wrecked, glenoid was basically sheered away, multiple labrum tears, and some tendon/ligament involvement. I ended up with 3 anchors in the joint as a parting gift. I was very diligent about my rehab, but it took me an entire year to really 'trust' the joint. The surgery on my R shoulder was a simple SLAP repair that was scoped about 12 years ago, rehab was way easier and I recovered faster as well. Just wanted to share my experience so you had another insight. Hope you heal up quickly, and DO YOUR HOMEWORK exercises!


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## malebundle1 (5 mo ago)

They are responsible for 2 main functions: *1)* Keeping the shoulder in joint *2)* Move the ball around in the socket.
There are 3 main tendons called the
*Supraspinatus* – responsible for reaching upwards
*Infraspinatus* – responsible for turning the arm out towards the side
*Subscapularis* – responsible for reaching up behind your back


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## LanceWeaklegs (Dec 24, 2019)

I have had 4 rotator cuff surgeries, and two A.C joint re-sections. the issue is time. If you‘ve got months or years to try and magically heal up, while riding (or not riding) in pain, then go to PT for a year and hope you heal. A lot of time and money. Or have the scope and you’ll know you’ll heal in a few months. Staple here and there, shave the impingement, there tiny scars.


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## Alleytom (10 mo ago)

This is a frightening thread for me, I'm seeing a specialist on Monday for a torn through supraspinatus, I crashed my bike in October & ended up with a concussion, two broken teeth & my arm hurt. Head & teeth were taken care of but my shoulder kept hurting, I thought it would heal, but finally went to a physical therapist, they diagnosed the torn through supraspinatus with smaller tears in the other muscles via ultrasound. Having my MRI tomorrow. It sounds like this is going to be a long haul...


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## kevjob (Jan 25, 2021)

Alleytom said:


> This is a frightening thread for me, I'm seeing a specialist on Monday for a torn through supraspinatus, I crashed my bike in October & ended up with a concussion, two broken teeth & my arm hurt. Head & teeth were taken care of but my shoulder kept hurting, I thought it would heal, but finally went to a physical therapist, they diagnosed the torn through supraspinatus with smaller tears in the other muscles via ultrasound. Having my MRI tomorrow. It sounds like this is going to be a long haul...


I had a crash on easy trail end of june, clipped pedal shot me across trail into boulder, broke 2 ribs, gash on knee and full thickness tears of both the infraspinatus and supraspinatus tendons. Had surgey december 5th, no pain at all in shoulder with no opiods. Recovery will be 6 months to get to 80%. I wear a sling fo another4 weeks the pt. Good luck on mri and surgery if needed.


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## Dawgprimo (Mar 7, 2004)

Good luck guys!
Everyone is recovery is not all the same but make sure you take it easy and don't push it too early.

Let it heal up!
It does not take much to screw it up......like a slip on the stair while walking down and grab the railing. Happened to a fellow that was going to the same Physio.
I hated the sling......I was in it for 6 weeks!

Been shovelling snow for the last 3 days and my shoulder is a bit angry with me!
Cheers!


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## Alleytom (10 mo ago)

kevjob said:


> I had a crash on easy trail end of june, clipped pedal shot me across trail into boulder, broke 2 ribs, gash on knee and full thickness tears of both the infraspinatus and supraspinatus tendons. Had surgey december 5th, no pain at all in shoulder with no opiods. Recovery will be 6 months to get to 80%. I wear a sling fo another4 weeks the pt. Good luck on mri and surgery if needed.


Thanks,

Surgery set for the 26th of this month, MRI confirmed what the PT diagnosed. Looking forward to being better, I miss my bike. I'm in a shoulder brace and I haven't been on a ride since the crash. Per the Dr. I will have to be in PT 3 times a week for some time, and out of work for up to a month.


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## kevjob (Jan 25, 2021)

Alleytom said:


> Thanks,
> 
> Surgery set for the 26th of this month, MRI confirmed what the PT diagnosed. Looking forward to being better, I miss my bike. I'm in a shoulder brace and I haven't been on a ride since the crash. Per the Dr. I will have to be in PT 3 times a week for some time, and out of work for up to a month.


look into cold therapy ice machines, i wore my shoulder pad fo first week all the time. Freeze some water bottles to keep ice and wate cooler longer. Get a wedge pillow if you dont have a recliner. Good luck hope it goes smoothly.


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