Rotator cuff more than just a tear
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I just was diagnosed with a major rotator cuff problem. Atrophy has set in with the top tendon of my right shoulder. About 6-7 years ago I fell while on the job and landed on my right hand with intense pain shooting up my right arm. Since then, repeated efforts to doctors in my health plan refused to allow an MRI to see just was happening within this shoulder. After repeated efforts I literally gave up on 'doctors'. With pain increasing every year I finally decided to give 'doctors' another chance. I had left my previous plan and now sought a shoulder specialist. MRI's were granted and I received the news...atrophy from a injury of years ago. A total shoulder replacement or fixing what was left was my choice. I'm choosing to fix what is left. I'm planning the operation for this coming Ocotber, 2019. But I'm not looking forward to it. My field of work is in construction and I'm self employed, have been for over 30 + years. Has anyone in this forum ever experienced a atrophied condition? The doctor said that I was among a small percentage of people with this kind of condition that can raise the arm over my head, in fact to perform most of my regular construction activities like installation of a roof, siding replacement, concrete placement, house painting, etc. Pain is there, yes, and at night this often wakes me. How I'm able to still work after so many years baffles me and the doctor. But the atrophied section of tendon is a full top semi-hemisphere of my right shoulder, with two other tears along each side. This is my current condition. Any insights from anyone would be appreciated.
0 likes, 3 replies
mike1997 robert94720
Posted
Hi, Robert:
Sounds like a serious injury. I've had rotator cuff repair on both shoulders. It's been pretty tough. The left shoulder was the worse with massive tears of supraspinatus/infraspinatus along with labrum tear. I could not even raise my arm. It happened after a bicycling accident.
The fact that you can lift heavy things overhead with all these injuries is a good sign because one of the things they told me before surgery was that the general rule is that you will come away from the surgery (after rehab) with at least as much as you go in...usually. That means if you have good shoulder strength and ROM (Range Of Motion) going into surgery you should be able to recover with something reasonably close to what you have after your surgery and rehab.
But, I think you should ask your surgeon what your chances of a full recovery . Ask about restrictions in exercise, work regarding 'above shoulder height' lifting
Probably for at least the next 6-9 months following surgery, you will be restricted from lifting heavy things or anything above shoulder height. You MIGHT be told that it would be better that you don't lift ANYTHING more than 20 pounds even after you recover, to protect your shoulder from injury in the future. It may depend alot on your age as well. Younger people's injuries may repair faster and more fully. If you are middle aged or older, that repair may be slower and less likely to recover as well and more likely to re-injure.
Like I said, you need to have an honest discussion with your surgeon, ask him: Doc can I lift heavy things overhead after I recover from surgery?
I am recovered to the point where I could lift heavy things overhead, but my surgeon said it's not that you can't it's that you shouldn't to protect your tendons from damage. Your repair will be expensive, long in recovery, and something precious you should protect. Get the final word from your doc and act wisely....let me repeat that: IF YOUR DOCTOR SAYS YOU ARE RESTRICTED FROM LIFTING HEAVY THINGS OR LIFTING A CERTAIN AMOUNT OF WEIGHT OVERHEAD...follow his instructions!
Regarding your work...it would be good if you had helpers, apprentices that could do the heavy lifting for the next year and you could act in a more supervisory position.
RickCody robert94720
Posted
Robert, so sorry to hear about the extent of your injury, especially knowing that if you were able to get an MRI at the time of the accident that perhaps the atrophy could have been avoided. Usually, when there is atrophy, there is also the amount of the shrunken muscle being replaced by permanent fat buildup in the area, which isn’t good.
Anyway, perhaps the MRI is showing that things are different than they really are. That has been my experience with my MRIs and I have had many, including ones that are simply inconclusive. So I don’t think MRI diagnosis is an exact science, interpreting the images is also part judgment perhaps, but unfortunately it’s the best they have for radio imaging of soft tissue damage. Maybe when the doctor goes in to do the repair he discovers the damage isn’t as bad as suspected, which will be better for you and your recovery. The reason I’m suggesting this is because if the damage was really that bad there would be no way you would still have the strength and range of motion that you do. So I’m suspecting you may not be the exception to the rule as the doctor suggested, but just not as bad off as the radiologist’s report is suggesting either.
Anyway, it sounds like you need surgery either way. Expect a full year for recovery and not being able to pick up anything more than 10 pounds with that arm for about 6 months. You probably won’t even want to try. Also, I don’t really want to get into talking about the pain I had and the challenges of sleeping and recovery after my rotator cuff (supraspinatos tendon) reattachment because it was intense for the first couple of months and it is just something everyone has to deal with unfortunately.
The only thing to consider in all this is that if you are above the age of 55 then statistically the chances of a successful tendon repair is significantly diminished. It doesn’t mean your surgery won’t be successful, but the chances of a failed reattachment and retear are much higher at that age. So if you are 55 or older then the recovery period will need to be taken very seriously and done with great caution and care to ensure a successful outcome.
I would also ask your doctor before the surgery what percentage of range of motion he expects you will regain after surgery and what percentage of overall recovery you can expect so that you go into it with open eyes and aren’t disappointed later if you don’t come out being 100% . The reason I say this is because the atrophy aspect of it could result in some permanent stiffness and partial loss of range of motion when the shrunken rotator cuff muscle is stretched back to reconnect the torn tendon with the bone.
Wishing you all the best with your surgery and for a fast recovery and hoping that you come out if this as best as possible and even better than expected.
mike1997 robert94720
Posted
Hi,
I just thought of something. Superior Capsular Reconstructions (SCR) as mentioned here:
https://icjr.net/articles/the-evolution-of-the-superior-capsular-reconstruction-technique
and in more layman's English here:
https://tcomn.com/wp-content/uploads/2018/06/Superior-Capsular-Reconstruction.pdf
This procedure is relatively new and developed by a surgeon in Japan - a Dr. Mihata. It is just fantastic in my opinion and you look like the perfect candidate as it seems to not only reduce pain but allow you to also retain your strength WITHOUT restrictions. That means you can go back to your construction job without worry about lifting heavy things.
The lack of restrictions after complete healing and the fact that it seems to work for patients of all ages (provided you meet the requirements), including those with past failed repairs AND that if your particular SCR fails it can be re-done...makes this one of the exciting developments addressing irreparable rotator cuff injuries.
I'd suggest you talk to your ortho about this...I know if I were in your position, I would rather have an SCR than a standard rotator cuff repair.
Let us know how things work out!