Injury advise.

[LEX]

Guys, about 6 weeks ago had a rotator cuff tear, got MRI and consult last week said was 30% tear in supersp. and said maybe 50-50 chance that I could re-hab and come back with out surgury.
Now, scince I dont want to rehab and then get back to pupmin the big wheels and have another blow out just to have surgury, would rather just have it cut now.
Any one have this % of tear and come back all the way..I have rehabed a lesser tear on the other side but this one is worse.
any ideas thanks LEX

 

[xcelbeyond]

I nearly tore off my infraspanatus - about 90%, just attached on each "sides" to the bone. It took 5 years before ANY doctor discovered the "problem." Due to delicacy of reattachment, they would not let me move my arm AT ALL for 6 weeks. After it came out of the sling, it was virtually "locked up" - I couldn't even reach my mouth to brush my teeth. It took about 6 months of tortuous rehabilitation - then I went back into the gym.

I thought I'd bench press (this is how I tore it!) and would "warm up" by just using the bar. It was all I could do to push just the bar - very frustrating when I was pushing 305 with the muscle nearly torn off!

To make a long story short, I fully recovered and have far exceeded any pre-surgery lifts! Just be consistent and as Churchill said "Never, Never, NEVER GIVE UP!"

xcel

 

[Brent D.]

rotator cuff

LEX,

I had the good fortune to work for an upper extremities orthopedic surgeon several years ago. He performed many successful rotator cuff repair surgeries. Quite a few of the surgeries were performed on total separations (100% tear of the supraspinatus). He also recommended conservative treatment (physical therapy) for many patients who had less severe injuries to the supraspinatus.

I also noticed that either surgery in combination with physical therapy, or physical therapy alone, as the two primary methods of treatment, both took about the same time for recovery for the patients who only had partial tears. The recovery time was as long as ONE YEAR to full recovery for some patients in either group. The only drawback to surgical intervention other than the obvious risks, was the additional scar tissues in the shoulder region.

One problem that occurred in most patients with a supraspinatus injury was subacromial impingement. Inflammation from the injury was the major contributing factor for most patients. Although, some patients had a visibly reduced subacromial space seen on x-rays. Overuse injuries can also cause impingement. Impingement occurs when the area in the subacromial space that typically allows for normal movement of the supraspinatus tendon becomes greatly diminished due to inflammation. Impingement causes additional pain and loss of normal range of motion secondary to the initial injury. If surgery was to be performed to repair the supraspinatus, in some cases, a subacromial decompression was performed at the same time to help prevent future problems with impingement.

In conservative treatment, it seemed obvious to me that shoulder (glenohumeral) stability and inflammation management should be the primary goal of physical therapy. Typical physical therapy would work on internal and external rotation and abduction exercises with some stretching. Completely missing the scapular stabilizing exercises.

After spending time reviewing the biomechanics of the whole shoulder complex, I realized that strengthening the muscles that retracted and depressed the scapula (middle and lower trapezius and rhomboids), strengthening the external rotators (infraspinatus and teres minor), and very cautious exercise of the effected the supraspinatus would probably work quite well.

I also realized that managing inflammation was imperative. Immediate R.I.C.E. after all physical modalities on the effected shoulder to manage inflammation. N.S.A.I.D.’s could also be beneficial in conjunction with R.I.C.E.

I know this conservative approach worked quite well due to fact that I had to use it on my own partial supraspinatus tear!

After about one year I was stronger then I was pre-injury! I attribute my recovery to better stability, better muscular proprioception and better form when lifting heavy loads.

Either way you decide to go, take your time to avoid re-injury. Manage it well and you will be better then before!

I hope this sheds some light!

Brent D.

 

[muscle96ss]

Guys, about 6 weeks ago had a rotator cuff tear, got MRI and consult last week said was 30% tear in supersp. and said maybe 50-50 chance that I could re-hab and come back with out surgury.
Now, scince I dont want to rehab and then get back to pupmin the big wheels and have another blow out just to have surgury, would rather just have it cut now.
Any one have this % of tear and come back all the way..I have rehabed a lesser tear on the other side but this one is worse.
any ideas thanks LEX

LEX: I see that you are in the AZ area; I am curious who your ortho doc is? I am a physical therapist and see pts every day with rotator cuff injuries and would not advise anyone to have surgery with a 30% tear without trying therapy first. There are way too many surgeons out there that are way too quick to do surgeries. Most of the top docs will not perform surgery unless absolutely necessary; even when working on pro athletes.

Rotator cuff surgery can be quite detailed depending on whether they can get it through arthroscopic or if they have to go open. The rehab process after surgery is long and hard.

My advice would be to first find out what caused the tear to begin with as there may be some underlying factors such as the shape of your acromion, impingement, etc.. that need to be addressed first otherwise you will just reinjure it again following surgery.

I would also seek out another opinion before having surgery done as well as research the doc fully. There is a huge difference in the outcomes of a good surgeon compared to a bad surgeon. I am not sure if you are in the Phoexnix area but if you are and you need the name of a good doc, I would go with Thomas Carter from TOCA. he is one of the best surgeons in the country and will give you an honest opinion on whether he feels surgery is necessary.