Posted , 11 users are following.
hi all I am just looking for advice. I have been waiting for 5 years for shoulder surgery and have finally got my date in 3 weeks. just wondering what to expect post surgery about pain and recovery time and will I be in a sling for a while. thanks in advance.
0 likes, 19 replies
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mike1997 raymond25349
Posted
Hi, raymond:
I think you should share what exactly your MRI revealed. If you've been waiting 5 years that's a long time. If your injury was small 5 years ago it may have become more complicated. Do you have a single tendon injury or multiple, anyother related issues?
I think you can expect after surgery to be in a sling for anywhere from a couple of weeks to 3 or maybe even 4. It depends on what your surgery entails. You may have pain which I would suggest use of an ice machine and if necessary any of the pain meds they give you. I preferred using the ice machine and got off the pain meds within 3 days.
They will probably suggest you do codmans and pendulums regularly during this sling wearing period so your shoulder doesn't become too stiff.
If you're one of the lucky one whose insurance covers it, you may be sent home with a continuous passive motion machine that will exercise your shoulder for you. I know that after both my shoulder surgeries, I was incredibly stiff when I quit wearing the sling after 3-4 weeks and wondering if one of those machines might have made ROM recovery faster.
The worst part of surgery was the apprehension before surgery.
Welcome to the forum and looking forward to hearing more details of your case.
jaycee1956 raymond25349
Posted
Hi Raymond. I am currently on day 17 of arthroscopic surgery for impingement, otherwise known as subacromial decrompression . This was very different post surgery to open surgery I had four years ago for the same thing on the other shoulder, although a rotator cuff tear was discovered and repaired then. However both times a sling was only recommended for a short period of time and maybe only worn from a comfort point of view, i.e. when out and about so that people are aware and hopefully be a bit mindful, or perhaps when sleeping. I was in a lot of pain with the first surgery and this time not so much. I didn't actually need strong painkillers this time, although the ice is still very necessary at night. Both times I followed instruction re: exercise to the letter and I am hopeful, like the first one, I will regain full movement ultimately. It is pretty much there already although of course, there was no repair to contend with. Movement isn't pain free either but it is manageable and I am hopeful of a full recovery. Best advice is just do as you are instructed by your surgeon/PT and fingers crossed for you that it goes well. I think the worst part for me this time was not being able to get the wound wet for two weeks until the stitches were removed. Easier said than done with the recent hot weather and the need for frequent showers. Amazing what you can achieve with cling film.
RickCody raymond25349
Posted
Hi Raymond, what kind of shoulder surgery are you having? I had a full rotator cuff tendon detachment and had it reconnected to the bone. I had to wear a sling for three months and I was in extreme pain for about the first six weeks. I was using ice for many months and pain killers for at least a couple of months. Lots of rehab exercises too. I am about 14 months post surgery now and still fight a bit of stiffness at times, still have a bit of pain from certain movements, and constantly have to keep moving and exercising the shoulder. But full strength and range of motion has returned.
A lot of people have to sleep in a reclining chair for a period of time because it is too painful lying in bed. Luckily I was able to sleep on my side after about 3 weeks using a 5 pillow system I developed. But other people, depending on the type of surgery may not have to wear a sling for so long, nor will they have as much pain as I did. My tendon was separated from the bone by about 2 cm, which is considered to be a moderate tear. If the tear is less than a centimeter, and the tendon has not separated from the bone, then I assume the recovery would be faster and less painful. So it all depends on what type of shoulder surgery you’re having. Rotator cuff tendon reattachment it’s just one of the many shoulder surgeries that you will find people writing about on this site. The other thing is that if you waited five years to have the surgery and, as the other gentleman already mentioned, you might be a lot worse off now than you were five years ago. Once I had my tendon injury, and was diagnosed, I waited about eight months until having the surgery and things weren’t much worse yet. Many people don’t wait any time at all because there is a greater risk of muscle atrophy and fat build up around the muscle the longer you wait to get things repaired. The other thing is that, once you are above the age of 55, the likelihood of a successful tendon reattachment surgery greatly diminishes. Hopefully you are still a lot younger than that. Best wishes.
mike1997 RickCody
Posted
Rick!
Yes, I forgot to mention: pillows pillows pillows!
If you are going to have shoulder surgery your arm will need lots of support during those first few weeks after surgery because your shoulder is going to be pretty much uselessly weak and any pressure, stretching, in fact, just laying down will affect it and cause pain. The pillows serve to prop up your arm, surround them, whatever it takes in any position to relieve that pressure so you can be comfortable and get some rest and sleep.
And yes, some people find it easier to just sleep in one of those large comfy recliners. Just make sure the arm lever is on the side of your good arm so you can raise yourself from the reclining position.
I myself tried the lazy-boy recliner but found it difficult to sleep. Instead, what I did was put my bed at an incline raising the head several inches off the ground putting the bed at a slant. You can do the same with books or those readymade risers they sell.
raymond25349
Posted
thank you everyone . I have to have sub acromial decompression for supraspinitus bursitis plus some degenerative tears on tendons as well as possible bone spurs but the surgeon will know better once he is inside the shoulder. over the course of the years the pain has gotten steadily worse and the dosage of painkillers has increased also to which I'm on the maximum dosage of tramadol every day plus anti inflammatories. I have very little rom plus tendonitis which hurts constantly.
mike1997 raymond25349
Posted
Hi, Raymond:
Nothing but the best of luck to you with your surgery. And yes, the doctor will know better what is going on and what to do with your rotators and others issues once he's inside your shoulder with the camera and instruments.
My surgeon said the same thing. On both my shoulders he said it wasn't as bad as it appeared on the MRI, the tissue was ok. He did the decompression on my shoulder like with yours.
One thing he did mention before the surgery was that if things turned out to be really bad he would replace my tendon with muscle from my back I believe. So there are lots of options your surgeon can choose from and I'm sure he'll get you back your ROM and relieve that pain considerably.
Like I said the apprehension before surgery was the worst for me. Just getting it over with and getting on with rehab was a relief for me.
droopyshoulder raymond25349
Posted
I advise you research subacromial decompression and consult with your doctor about it. Specifically ask if they will have to shave away parts of your healthy acromion and if it's necessary. If all they find is spurs and scar tissue, perhaps they can remove those and leave everything else intact. They may not know exactly what they will find, but ask specifically what alterations they may make. I've had that procedure done along with an AC joint resection; I also had an unstable AC joint to accompany it from a shoulder separation. And I gained chronic rotator cuff tendinitis in trading off AC tendinitis. I fell into the group where this procedure wasn't as successful as others, despite everything being done right according to their evidence based statistics. If your AC joint is stable, then you have a better chance of recovery than I did. This procedure hurts like hell post surgery. Don't let your shoulder freeze up. Ice or heat to control swelling, whatever your preference, do not apply either for extended periods of time, I think like 20 minutes was the limit.
RickCody raymond25349
Posted
I forgot to mention that at first you will probably only be able to sleep on your back for the first month or so after surgery. So either in a reclining chair (as I mentioned) or with pillows on the bed under your back putting you in a partially upright position and with pillows under your arm to keep it raised up so it doesn’t fall lower than the elevation of your heart. Keeping your arm elevated above your heart will be important to reducing inflammation and pain as it will help increase blood flow to the area. It will also probably be the only position you will be able to lie in initially (post-surgery) without making the pain even worse. In the first few weeks after surgery the pain was so severe I was only able to get a few hours sleep at a time before the pain eventually woke me up. Basically I would pass out from exhaustion and then get a few hours sleep at a time. That was the only way I could fall asleep. Shoulder surgery recovery can be the most painful of all the soft tissue surgeries because it is the only joint in the body that can move 360 degrees and there is a lot of soft tissue there that is involved. Recovery is also much slower compared to knees and elbows for example. Anyway, once the surgery is over things will slowly start to improve. There were times I had my doubts I would be much better off given the amount of pain and immobility I had after surgery. I also lost a lot of weight and muscle from lying around for so long doing nothing. I couldn’t even dress myself initially because I had use of only one hand. It was very depressing and it all had an effect on my psyche and emotions for a while too. But slowly I got better and got my weight, muscle, strength, and life back. There will be a lot of rehab and physical therapy involved and needed to be done both at home and at a clinic post surgery as well, so be prepared for that. The faster you can work to get strength back in the muscles around the joint and tendons, then the sooner mobility will be restored and the pain will be relived. The rehab can be painful too, and there may be an urge to avoid some of it at times because it increases short term pain, but don’t neglect the rehab. It’s good because it will get you out of the house when you go to physical therapy and it’s the only way to get strength back and for the pain to eventually go away. But my surgery was a success and I’m sure yours will be too. Just hang in there and best wishes with your surgery and recovery.
RickCody raymond25349
Posted
P.S. - I was given morphine and tramadol post surgery, but I get nauseas so easily so I wasn’t able to take either of them very much. The morphine was the worst for me. So all that was a problem too. I eventually took a very low dose of tramadol various times throughout the day mixed with Tylenol. Synergistically the two work well together. But one of the best things that helped me was 400mg of Celebrex per day. I would cycle on an off it for 2 weeks at a time because staying on it all the time can be dangerous. But Celebrex reduces inflammation and inflammation is pain. So it was actually fixing the pain rather than just masking it like pain killers do. And the more tramadol you take, the more resistant and dependent you become on it, which isn’t good. Tramadol is a bad drug really. It effects quality of sleep, gives you overly vivid dreams, and has many other health risks with long term use, resistance and then addiction being the major downsides. If you are already taking close to 300mg per day of tramadol then that isn’t good at all. You may already have become resistant to the effect and formed a dependency I was taking no more than about 100mg total per day at the peak, and I felt horrible from it the whole time, but at least it gave me some pain relief. I was so happy though when I eventually didn’t need any of it anymore.
arj50436 raymond25349
Posted
Every surgery is different. My right shoulder surgery was subacromial decrompression and simply scraping off a bone spur so that a frozen shoulder could heal. I felt better almost immediately.
My left shoulder surgery was very different. I had a full rotator cuff tear and other issues about 15 months ago and just now am almost at 100% range of motion (get used to worrying about your ROM) with very little pain. Post surgery is something that nobody can really prepare you for but my advice is to be ready for the worst and hope for the best. The surgeon may not know how bad it is until they are actually doing the surgery. You will want to have lots of ice on hand, a way to elevate yourself while you are sleeping - a recliner chair, a wedge pillow or you can sleep on the couch or the futon with your surgery shoulder elevated. You will want to have some extra large t-shirts and sweats because this is what you are going to live in for a few weeks. I assume that you are a man, so no need for an open front bra.
Prior to the surgery a friend lent me a cyrocuff. I didn't think that I would need it, but boy did it help me get through the nights. If you can afford a motorized cold therapy system or borrow one from a friend, I strongly suggest that you do it. They say that you are supposed to have your own cuff, but I used the one that my friend used.
You probably will be advised not to take anti-inflammatories for a few weeks after your surgery but once those two weeks pass, I found voltaran gel to be really helpful and also a CBD based massage cream and CBD oil.
RickCody arj50436
Posted
Yes, good point. My surgeon had put me on anti-inflammatory drugs (Celebrex) for about a week right after surgery, but then he wanted me to get off it until the tendon started to reattach to the bone as it can hinder the reattachment process. So I didn’t get back on them I think for about 2 months. Then I started cycling on and off them. They really helped a lot, but if you have acid reflux, ulcers, or anything like that then Celebrex can make those conditions even worse. But when comparing Celebrex to Ibuprofen, Celebrex is still better on the stomach.
Anyway, all good advice and, as you said, hope for the best and prepare for the worst. Not only do the doctors not know how bad thing really are or aren’t until they get in there and see for themselves, they cannot also predict how fast you will regain ROM and become pain free. Everyone is different. So you just have to knuckle down and deal with the recovery. Eventually it all comes to pass.
arj50436 RickCody
Posted
I just happen to have acid reflux! It got horrible while I was suffering with shoulder pain. It took me a while to realize that ibuprofin was aggravating it. I found out when they made me stop taking it after the surgery.
Now, I take ranitadine every night and when I use the topical anti-inflammatory I always put it on at the same time and I never do it on an empty stomach! I hope that my liver survives my shoulder issues.
RickCody arj50436
Posted
Yes, ibuprofen will definitely aggravate acid reflux. But from studies I’ve read; Celebrex is less upsetting to the stomach and more effective on inflammation. So it’s a better drug than ibuprofen. Just costs a lot more.
Ranitidine is fine, but not as effective as Omeprazole. Neither is harmful to the liver, but long term use of Omeprazole hinders stomach absorption of calcium and vitamin B12. But for short term use after a surgery I wouldn’t worry about it. I would go with the Omeprazole if you feel the Ranitidine isn’t doing the job controlling your acid reflux well enough to get you through the recovery.
People who are on acid blockers like these long term though are advised to get B12 injections since the stomach can’t absorb it with the absence of hydrochloric acid in the stomach.
arj50436 RickCody
Posted
I will never be on an acid blocker again but I will definitely talk to my doctor about Celebrex.
I got myself into a bad cycle with medications. I took Ibuprofin for my shoulder pain. Ibuprofin made my heartburn worse and they prescribed Omeprazole for my heartburn which caused severe headaches and they prescribed neurontin for my headaches. Once I figured out the cycle, ironically because of the shoulder surgery and being taken off of ibuprofin, I was able to resolve those issues and focus on my shoulders.
I'm off of Ibuporfin, Neurontin and the Omeprazole now. I am largely headache free and otherwise doing very well on Ranitidine and Magnesium, and making sure that I take anti-inflammatories at the same time and with food if I do have to use a topical anti-inflammatory on my shoulders
jan34798 raymond25349
Posted
Hi Raymond. I am just recovering from a rotator cuff tear and decompression for the impingement at the age of 68! I haven't found it too bad at all and was off all pain killers by six days.
Also.. a few years ago I had a spur removed from the other shoulder which I believe is classed as an impingement. Quite honestly I didnt find that too bad a t all either. I was out of the sling the next day for that. Yes the exercises are painful but the good thing is the improvement is fast. Grit your teeth and just do them. I haven't had a prob with this shoulder since. I think I was driving short distances after about three weeks.
mike1997 jan34798
Posted
Hi, Jan:
Details about your rotator cuff tear would be helpful. Was it small, medium, large? Which tendon or tendons involved? How far along are you with your latest recovery regarding ROM, strength, etc.
I had 2 shoulder surgeries at 64 and 65 years of age first left then right shoulders. It was rough both times. Taking 18 months for the left to recover and now with the right at about 14 months and still a bit stiff, but full ROM and strength on both.
If you noticed Raymond's original post, he has barely no ROM at all pre-surgery. And that might be vastly different to what your condition was on your most recent rotator cuff. I had barely any ROM as well on my left shoulder due to an accident. It was quite scary and if it weren't for online videos on you-tube and help from forums like this it would have been worse.
Doctors don't prepare you enough for post surgery recovery. There are so many details you need to know to make your life bearable, simple things like an ice machine, tens machine, use of pillows, t-shirts cut so they are easy to slip over your head and wear, maybe even those elastic shoelaces so you don't have to tie them, etc. etc.
Everyone recovers differently, there doesn't seem to be any one scenario that covers everyone, even if you have the same exact symptoms and problems. A nurse told me it may take as long as 3 years for a complete recovery, that gives hope to many who are struggling and thinking of giving up.
I still perform all my ROM and strengthening exercises every week. I still abide by the restrictions the surgeon told me regarding lifting above shoulder height. My experience has made me more aware. For example, when I'm at the gym I notice other people who seem to be struggling with what appears to be shoulder problems. There are quite a few people who have rotator/shoulder problems and don't seek treatment out of fear and denial. I'm one of those who likes to know the truth.
Besides offering emotional support this forum can offer knowledge that helps fill in the gap I mentioned regarding post surgery recovery that can be very helpful and practical.
RickCody mike1997
Posted
Hi Mike. I’m at 15 months now post surgery on my rotator cuff tendon reattachment. Just a couple of comments on you last post. I still have a bit of pain with certain movements and a bit of stiffness too. I don’t focus on it much though. Even if it never fully goes away, I’m satisfied with the fact that I already got full range of motion back, as well all my strength. For me I feel this is a healthier approach not to expect that I will get back to 100%. You very well might, but if you don’t set your expectations too high, then you won’t be feeling any stress about it in general.
Also, I see people at the gym too sometimes who look injured. Some may not have insurance, some may be scared of doctors, don’t know what kind of doctor to see abut it, may not realize the injury could be serious etc. I may not assume they are all in denial.
I do think though you can lift things above your head again. I do. I was lifting 25 pound weights above my head with the recovering shoulder in fact a few weeks back. I’m taking a break now from that and focusing more on other movements, but it should be possible for you to least lift 10 pounds above your head. Start with 3-4 pounds to warm up, then go to 8, etc. Start slow, warm up and you should be able to build it up. You can even just start doing 20 reps with a 1 liter water bottle. It should help you regain more strength.
And one last, but very important thing. I started doing lots of movements lately where I try and put my recovering arm behind my back for external rotation and pull it as high up my back as I can with my other hand. Sometimes I use a cable machine at the gym with some weight on it to help pull my arm up higher on my back. It can be painful as anything when you reach the limit in your range of motion, but then I try and hold it there for 20-30 seconds or as long as I can. And after about 10 days of doing this for a few minutes everyday I have noticed a tremendous improvement in reduced stiffness, more strength when I reach out to grab something, and I don’t feel as much little bits of pain when I move in other ways. Try doing for a week if your still feeling stiff, just to see if it might help you too. It’s doing me a lot of good it seems.
Best wishes...
mike1997 RickCody
Posted
Hi, Rick:
I have pain and stiffness at the very endrange of movement. You know that point where you can push on it and move it a bit more but it's difficult and it starts to hurt? Ya that.
I don't have pain when I move it in all the other range of movement: forward, sideways, behind the back and overhead.
I will say I regained almost all my ROM back on both shoulders, but perhaps not as good as it was before surgery. I notice especially with my arms out to the sides shoulder height and parallel to the ground, I cannot swing them back as far as I used to. And I guess I could keep on working on that if I wanted to.
However something you mentioned about doing overhead presses with dumbells. Actually, my surgeon said not to do that. He gave me a lifetime restriction about lifting anything heavier than an empty coke can above shoulder height and restricted anykind of excessive repetitive arm movement above shoulder height in general such as you would be using if you were painting a ceiling.
He said, "It's not that you can't do that, it's that you put your tendons at risk, if you do. He said if I follow this my surgery would last a lifetime.
However when I go to gym, I still do all of my other exercises mostly on machines working out legs, abs, and even arms and chest. I just don't do the shoulder press machine where you are pressing weight overhead. I really want to, but remember what my surgeon said. Although to tell you the truth, it doesn't seem like doing it with 10-20 pounds would hurt keeping it to low reps and sets.
There's all kinds of bad statistics about failed large/massive rotator cuff repairs, lots of paranoia among patients who are afraid of their rotator repairs retearing. That's why I'm wondering why surgeons don't perform more Superior Capsule Reconstruction (SCR) surgery, which is relatively new, but enables recovery of strength and ROM with no restrictions!
The SCR which is a technique developed in Japan about 12 years ago is now practiced here in the USA. My understanding is that it is ideal for irreparable of large and massive rotator cuff tears where the tissue may have atrophied retracted and fatty infiltration as long as the shoulder joint has no or little arthritis. The technique involves using achors to bone on one end and attaching the retracted tendon via a patch/allograft.
Medical Science advances tends to procede slowly and cautiously but the outcomes and followups are very encouraging. Read this especially "Return to Sports and Physical Work After Arthroscopic Superior Capsule Reconstruction Among Patients With Irreparable Rotator Cuff Tears" search it on the internet it's a study, which I quote in part:
"From 2007 to 2014, we performed arthroscopic SCR in 105 patients with irreparable rotator cuff tears, 5 of whom were lost to follow-up. Consequently, 100 patients (mean age, 66.9 years; range, 43-82 years) were enrolled in the study. Before surgery, 26 patients had participated in sports (2 competitive, 24 recreational), and 34 patients had physical work. Rates of return to sports and physical work, the American Shoulder and Elbow Surgeons (ASES) score, active shoulder range of motion, and rate of graft tear were evaluated. The mean time to final follow-up was 48 months (range, 24-88 months).
RESULTS:
All 26 patients who played sports before their injuries returned fully to them. In addition, 32 patients returned fully to their previous physical work, whereas the 2 remaining patients returned with reduced hours and workloads."
THAT'S AMAZING! 105 patients with IRREPARABLE rotator cuff tears? Ages 43-82 years old? And all of them return to their work and sports? INCREDIBLE!
What's more, if the SCR fails, it can be repeated over and over! Talk about hope for the future of Rotator cuff injured patients!
RickCody mike1997
Posted
Hi Mike - You are certainly more versed in the various medical procedures for rotator cuff repair surgery than I am. But that more recent surgery technique you mentioned from Japan certainly sounds interesting and promising.
As for your own situation, the bit of stiffness you mention that you still have at the end of the ROM where you start to feel a bit of pain is similar to mine. In fact, I think it’s the external rotation movements that I am doing now that I feel are the ones that may also have something to do with helping with that final bit of stiffness. That is why I mentioned the results I feel I am getting from the hand behind the back exercises I mentioned. They are painful, but I think that in itself is an indication that there is still more work to be done in that area. And I definitely get the sense that external rotation is still a bit of an incomplete part of my recovery.
I have also watched videos from orthopedic surgeons on YouTube say that getting the hand high-up behind the back is one of the last ranges of motion to come back after a rotator cuff surgery. As you said, maybe continuing to work more on things will get rid of more stiffness, and I agree. Don’t ever stop trying to improve your ROM until you feel satisfied with it. I have read things to that effect too.
With lifting weight overhead, at one point I asked my surgeon if I should have any limits with what I do physically and he said to just go back to doing whatever it was I was doing before surgery in terms of weight lifting. He said I have no limits. But I may be about 15 years younger than you I think. I also use my judgment and never really try to push things too far to where I feel I am taking big chances. And as you said, 10-20 pounds overhead shouldn’t be a problem. Your surgeon might be right in that no overhead lifting at all will fully prevent a retear from ever happening in the future, but it also does sound a bit like he is erring on the side of caution a bit too much too perhaps (in trying to avoid any possible damage at all to your repair) rather than thinking about what you might want to do in terms of regaining your shoulder strength. In my opinion, muscle weakness and atrophy is also a source of pain. So I don't think weak muscles are good
I’m not sure exactly why your doctor said that of course. I’m just guessing here. And maybe given the nature of your repair, it is in itself the reason he said this. I guess ultimately you have to make a judgment call on this for yourself, all things considered, and weigh the positives versus the potential negatives in trying to lift anything overhead.