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I am having issues with my recently operated on shoulder, if anyone has similar experience or advice It would help me come to peace with my situation.
Current Situation: I had an arthroscopic posterior labral repair on my left shoulder on June 20th about 6 weeks ago. This is my second labral repair as I had a bankart repair on my right shoulder one year prior that resulted in frozen shoulder ( story for another time)
Anyways currently my shoulder is always aching, the pain is intense and it really aches. My recovery was going great for the first 3 weeks and i was far ahead of the average person but still only doing what my PT and Doc said. However is physical therapy at the 3.5 week mark we did a cupping treatment and my therapist had me do active range of motion while the cups were on my shoulder, it was supposed to break up muscle soreness. I didnt notice any issues during the session however i woke up the next day feeling like someone hit me with a bat on my shoulder with extreme tenderness to touch on my posterior shoulder area. My response was that i re tore it, and my body responded with tightness and inflammation. My surgeron and therpist said its highly unlikely i re tore the repair with something that light however they said anything is possible.
Im now out of the sling and 6 weeks post op and in more pain than i was 2 weeks post op. Every morning I wake up in pain and i have trouble doing passive range of motion. Everytime i do therapy im sore and achy the next day.
What could be my issue and what shoud i do? I fear I re tore my labral repair which would be devastating as its my second surgery within a year. I have gone to my doctor two times in the past two weeks to complain and he has said there isnt much to do, he recommended I dial it back in therapy but i feel i am too far out of surgery ( 7 weeks) to not be able to lift my arm and living in constant pain.
Thanks for the support.
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This definitely sounds like a question you should be asking your therapist. The first thing out of my therapist mouth every session: "How's your shoulder feeling?" I would tell him it was fine, or a lil sore, or whatever it was I was feeling. If necessary, he would dial back the exercises, or try and adapt the regimen whether strengthening and/or ROM to my personal needs.
Also, every therapy session began with electro-stim, hands on massage, and Biofreeze. Every session ended with ice. At home I followed this regimen with a tens, machine, my own pain ointment if necessary (you can buy biofreeze from the store otc), and ice after I exercised. I also had an ice machine which is a unit you fill with ice and water and it attaches to a tube that circulates this water through a pad that you attach to your shoulder. It numbs the shoulder. You can wear it as you sleep if you want to.
Sometimes pain meds might be what you need, but I personally preferred my ice to that.
Does and of what I just described reflect what your therapist and what you do? Has your therapist suggested or done any of this or tailored your therapy to your needs and personal situation? Has your surgeon suggested pain meds, an ice machine, etc?
Perhaps you aggravated your shoulder with exercises too early on in your recovery. From what you described with the after pain, it's quite common not to feel the pain until hours or even a day later after your exercise. Everyone seems to recover at their own rate. My therapists said everyone is different and some recover faster, some slower. I think if you start pushing too much too early it results in what you may be experiencing. I don't think you retore the repair. My suggestion is try the ice. Yes, it may be as simple as that because ice really does calm down everything and seems to promote healing reduce swelling, inflammation and pain . Also your therapist should massage and use that biofreeze daily . And you might also try getting a Tens unit which you can use for hours on end when you're at home or even out and about.
Seems like we all experience pain from these surgeries and everyone has a different degree of pain and ways of dealing with it. I think no patient should have to suffer with constant horrendous pain.
thanks for the response and i appreciate your tips!
my therapist does talk to me before every session and we have adjusted mt exersizes based on how my shoulder has responded. overall i have taken a big step back since my incident at therapy a few week back, im only doing passive range of motion.
ill keep on the ice and take therapy easy. going to follow with my doctor next week if nothing improves.
I was wondering about the therapist who decided to put you through active range of motion exercises after just a week or 2. Was that a licensed therapist? An intern? Aid?
At my physical therapy there were 2-3 fully licensed therapists. There were anywhere from 4-6 assistants and aids who simply handed you your equipment to exercise with, maybe attached the electro-stim pads, etc.
Some of these interns were working towards a pHd in Physical Therapy, others were just there to work waiting for a better opportunity perhaps not even related to healthcare.
The students of physical therapy who were not fully licensed yet were sometimes allowed to do some physical manipulations. I remember one who helped me passively raise my arm the 1st week, it hurt so much. I got the feeling he was just testing out what he had learned in class and I was the guinea pig.
Maybe that is what happened to you. It seems like a grave mistake for a therapist to put you through active range exercises too early and set you back with all that pain you are experiencing now.
I say this for those who may read this later with the caution that you have a right to ask the therapist their credentials and if you don't like their treatment or if for any reason you don't feel like they are able to help you in a way that benefits you, you can request another therapist.
thanks for the reply! yes it was a licensed therapist with over 10 years of expireience .
my doctor allowed active range of motion at 3 weeks out which is when we started. I was cleared for passive after week 1.
this is fairly normal for most therapy protocols online for a labrum repair. active range of motions starts around 4 weeks and passive starts right after surgery.
ok, Im an RN and ive had 2 rotator cuff surgeries. Im always having to lift things. For the 1st 6 weeks you should be in a sling. After that, its passive range of motion and slight exercising directed by PT. The only way to tell if you've torn it again is not just an MRI but an MRI with an injection of dye right into the shoulder. NO F---- WAY. ICE, ICE, ICE. Scale back on PT. You still want to do mild movement but nothing heavy. If your shoulder continues to hurt, you'll have no choice but an MRI. (Arthrogram). Ive been very careful because I retore my right one 7 mos post op and I have no intention of screwing up the left one. Personally, I'd take pain meds, ice my shoulder frequently, continue with PT but go easy and if you're still in pain in 2 weeks, ask MD for an arthrogram. It's actually the only way to see a tear so soon after surgery.
The dye is only going to fill in any gaps or spaces with color to make the MRI easier to read, but, at 6 weeks post surgery, there will be all kinds of false positives of a tear from an MRI at that point. As I mentioned below, my surgeon said I needed to wait a year for an accurate MRI diagnostic result to check for a retear. From what I’ve read from other surgeons writing about it online, they all say at the very minimum 4 months post surgery for an accurate MRI assessment for possible retear. At this point an MRI wouldn’t be useful at all for someone who is only 6 weeks post surgery.
After my rotator cuff repair surgery my doctor had said it’s impossible to see much from an MRI about a possible retear until around 1 year post surgery. Things are still healing and anchors and sutures need time to dissolve before you can get a clear image.
Anyway, I had thought I retore mine many times during the recovery process and luckily I didn’t. It was only inflammation and things were still healing. I doubt you retore anything if you were doing light movements under PT instruction. Your pain is probably related to the fact that it is so soon after surgery and shoulders take a very long time to heal. I would say take a couple of weeks off from trying to do any resistance stuff. Just do some light stretching and passive assisted movements to try and prevent things from getting stiff right now. In the meantime, I would say ice and anti-inflammatory meds for 2-3 weeks. Celebrex at 400mg per day works the best for me.
Thanks that what i think is going on also. Have never tried celebrex, will check it out.
Sorry, it didn’t register that you are still only 6 weeks post surgery when I first read your post. I was only doing passive assisted movements at 6 weeks, no active motion yet. Active motion didn’t start until about 3 months post surgery if I recall correctly. I would go back to just passive assisted movements for now. As I said, you probably have pain from the fact that you are only 6 weeks post surgery and you may have caused some inflammation from those exercises you did. Just back off any movements that really cause any pain for now, but try and keep the shoulder moving at least every other day with some passive assisted movements to prevent too much stiffness, weakness, and muscular atrophy from developing. Use ice at least 5 times a day for 15 minutes to help manage the pain and inflammation and perhaps take anti-inflammatories as I mentioned for a few weeks. You should get back on track again after that and what happened is probably only a minor setback. I had plenty of those setbacks and scares during my recovery process too.
Thanks! I know a rotator cuff repair is diffrent than a labral repair so most rehab protocol have you doing passive range of motion after week 1. I will dial it back and hope for some healing and pain relif.
All noted. Best wishes with your recovery and hope you are back in great form Godspeed.
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