Shoulder injury

[Mark Gibney]

I'm looking for feedback from any of you who have or had shoulder issues.

For a year I've had a bad left shoulder. Grew worse over the summer. Would wake me up a lot at night.

Got to the point it was difficult to put on a shirt or jacket. And certain movements would cause a lot of pain for 30 seconds - 1 minute.

Physical therapy for 8 weeks didn't help. In fact my wife thinks it made it worse.

So last week the orthopedic surgeon sent me for an MRI. I have a SLAP tear. Seems they are very common. (a tendon that comes up off the bicep has partially detached from the labrum)

The surgeon gave me a cortisone injection today and I'll do another stint of PT.

Anyone successfully avoid surgery?

My primary form of exercising is on a road bike. When I google this all the forums talk about recovering from surgery.
My question is - does riding a road bike tend to aggravate this injury? or is riding in fact perhaps good for the healing?

This injury has me worried to be honest. I need to have good physicality for work, and I'm now mid-50s, so recovery is not what it would have been 20 years ago, but I'm hoping for a successful outcome.

thanks, Mark

[Larry Frank]

My advice is to find the best orthopedic surgeon and get another opinion. Do your research about your doctors to find the best one. I had to have my wrists rebuilt and found a well respected surgeon with many papers and awards who did miraculous work on my wrists.

I would also ask your PT about the effects of riding the bike.

If you have a tear, you likely need surgery. The risk of course, if you do not get surgery is that you get a complete tear. In addition, you may cause other problems by favoring the injured shoulder.

If it were me, I would get it fixed as soon as possible.

Note: my shoulders are one part of men not falling apart. It is just hips, back, wrists and others.

[Bruce Wrenn]

The longer you delay surgery, the longer recovery will be.

[Chris Parks]

My experience

Cortisone injections give temorary relief and prevent for surgery for some time after the injection

Find a really switched on physio and have him assess whether the issue is actually in th shoulder or Thoracic neck/upper back issues as this can often be confused, DAMHIKT.

If an xray/CT scan/MRI do not show evidence of injury I would have a really hard look at back/neck issues

I had two ops on my left, the first was to repair the Rotator cuff injury and the second was not necessary as the problem was in my neck. I had a very robust discussion with the surgeon who want to give me Cortisone shot and then he admitted that it had only a small chance of working for any length of time.

[Roger Nair]

Mark I have no authority on the subject of riding but since riding places the muscles, back and shoulders in a constrained state for extended time with a limited range of motion then I would be dubious of road biking as proper rehab.

[Mike Cutler]

Don't be afraid of the surgery. I lived in pain for almost two years with both shoulders. Adhesive Capsulitis, arthritis, and bone impingement. I could barely dress myself prior to the first surgery.
Oh yes, and Orthopedic will know you've been engaged in cycling. I was a USCF CatII rider and the doc said it was obvious based on muscle development and density.
Don't buy that "Low Impact" label they put on bike racing. You are going to have some very developed anterior shoulder muscles.;)

[glenn bradley]

Therapy has always done it for me. I get certain "injuries" when I slack on my exercise routine. One tends to keep doing things as if he does exercise when he doesn't and sooner or later something gets ticked off. If the PT is being done religiously and is not helping, it is time for the next step. I too vote for second opinions on anything that involves the knife. I have avoided surgery that was recommended on three different body parts.

[Brian Henderson]

I had a shoulder injury years ago, everyone thought it was a torn rotator cuff, but it turns out that, for some reason, my bones just seized. I couldn't lift my arm at all, physical therapy didn't help, the MRI and xrays showed no muscle damage. Wound up going in for surgery, they just wrenched the bones apart and broke out the seize. Works great today. Nobody has any idea what happened.

[Roy Petersen]

Adhesive Capsulitis
Had that also. First one arm, then the other, and I can only say I never want it again. Was living with it for quite a while until one day I was waiting for the school bus with my son, and slipped on some ice. Reached out quickly to grab something to stop a fall, and just about blacked out from the pain. It was blinding.
Fix for me was cortisone then lots of working the arm(s) to get it to stay gone. One shot was enough to allow movement, so I got lucky and avoided surgery.

[Ron Citerone]

Had torn rotator cup surgery and had a great result. It got to a point I had no other choice. 4 years out and it feels great. Downside,it put me out of commission for 3 months. Not crazy pain during recovery, but long recovery. Your injury sounds like an easier fix perhaps than a rotator cuff.

[Mark Gibney]

What I get from your replies is that if it can go wrong, it will, but there's a way to repair that.
I'll give the physical therapy another go but I'm encouraged that surgery helped a lot of you too.

My dad used to sing that song if the left one don't get you the right one will.
Don't know how the song ended exactly but let's hope it was happy :p

[John K Jordan]

I developed severe shoulder pain in the late 90s, got to where I couldn't raise or lower my right arm without assistance from my left. I got the cortisone injections and lots of PT which didn't help and may have actually made it worse. In my case it was a severe tear (near separation) requiring rotator cuff surgury and a stainless steel pin. Months of PT. That was 18 years ago. Today I still have pain but have plenty of strength and can lift and stack bales of hay and muscle slabs off the sawmill.

I'd also get a second opinion. If there is a tear that's not too bad yet, they may be able to fix it with orthoscopic surgury. I think the problem with cortisone is it might make you feel better then you use it and tear it more. I'm certainly no MD but I got the impression that some cortisone might be ok to treat pain from inflammation but not useful for a tear.

JKJ

[Jerome Stanek]

I have a bad shoulder also Never heard of Slap tear until I just looked it up. My symptoms are exactly as the they describe. I did go to a orthopedic doctor and he gave me a cortisone shot that did not work. I will be going to a different doc after Christmas.

[Bill Dufour]

Since you live in LA I would check around University research hospitals to find the best doctors for this kind of stuff. Here I would recommend Stanford for most stuff. I would assume LA has. at least one world class university research hospital in this field
I know it does not really apply but everyone I know who had a joint replaced says they should have done it 5-10 years earlier.
Alieve is your friend, naproxin sodium is the generic.
Bil lD

[Ole Anderson]

I'm following this as I injured my left shoulder two months ago and have been doing PT. Some improvement, but still not right. My ortho guy specializes in shoulders. Initial X-ray didn't show anything. I go back Thursday for a re-evaluation. Initially he said he would do an MRI if PT didn't do the trick. We will see. Not looking forward to 3 months of recovery if I need surgery.

[david mcnamara]

I had the same injury, slap tear, and ended up eventually going with surgery for a resolution. Six months of therapy and pain prior to surgery. I will caution you that recovery is a long process that limits you for a long period of time before back to “normal”. Since I was injured at work, my employer required 100% release from doctors care before I was able to return to work. I work as a electrician and there is no “light duty.” It was a six and a half month recovery for me, with the last three months, of four hours a day of therapy.
I am currently two years post surgery, and doing much better. Pain and discomfort is manageable, and I am able to return to work without any restrictions. 28 years of work in the trades is hard on your body, so thereÂ’s going to be aches and pains.
I am glad that I got the repair, that being said, the recovery in one word, “sucked.” I am capable now of sleeping without waking every 1.5 hours due to shoulder pain.
Good luck with your recovery. If you have any other questions, let us know.

[Mark Rainey]

Shoulder pain is very common. So many shoulder surgeries in aging people have no scientific evidence that they improve outcomes. The zeal of the surgeon and the desperation of the patient result in a surgical procedure that may help, may do nothing or may hurt. Go slow, give your body a chance to heal. Frequently it does.

[Chris Parks]

I'm following this as I injured my left shoulder two months ago and have been doing PT. Some improvement, but still not right. My ortho guy specializes in shoulders. Initial X-ray didn't show anything. I go back Thursday for a re-evaluation. Initially he said he would do an MRI if PT didn't do the trick. We will see. Not looking forward to 3 months of recovery if I need surgery.

Recovery depends on your job, a desk only guy could say 3 months, a painter could need 12 months, mine took at least twelve months because of my job and then the doctor put permanent restrictions on me. It was work related so they had to wear it for my last years of work.

[Jerome Stanek]

I had the same injury, slap tear, and ended up eventually going with surgery for a resolution. Six months of therapy and pain prior to surgery. I will caution you that recovery is a long process that limits you for a long period of time before back to “normal”. Since I was injured at work, my employer required 100% release from doctors care before I was able to return to work. I work as a electrician and there is no “light duty.” It was a six and a half month recovery for me, with the last three months, of four hours a day of therapy.
I am currently two years post surgery, and doing much better. Pain and discomfort is manageable, and I am able to return to work without any restrictions. 28 years of work in the trades is hard on your body, so thereÂ’s going to be aches and pains.
I am glad that I got the repair, that being said, the recovery in one word, “sucked.” I am capable now of sleeping without waking every 1.5 hours due to shoulder pain.
Good luck with your recovery. If you have any other questions, let us know.

I think I have the same thing my wife wants to know how was your diagnosed what was the surgery like did you have to stay in the hospital. She bugs me about stuff like this as she is a planner and I am not I will just jump into something and get it done. She will plan for days and then decide not to do it.

[Patrick Grady]

I imaging most of us have experienced shoulder injuries of various types and degrees. 14 months ago I endured on of my most stubborn protracted pain fests (the usual - clothes dressing accompanied by the sharpest of red-zone pains). I started to lose hope that it would heal itself. I wore a shoulder sling-heater at night and tried to keep arm levels low during the day. Somehow, someway the pain started to lessen and the healing, though slow at first, continued till I could sense that it would be ok. Emerging from that tunnel of pain makes one want to just hug that sweet healing shoulder. Wanted to write to say to not sleep on nutrition requirements for our aging bodies and joints. I hope you find a recovery.

[Chris Parks]

Both my Rotor cuff injuries had periods where they did not cause any injuries but gradually the left got to the point where it to be repaired. The right ceased to cause me problems becuase as the xray technician said to his mate...there wasn't enough tendon left to cause impingement so i have never seen the necessity to have the op.

[david mcnamara]

I think I have the same thing my wife wants to know how was your diagnosed what was the surgery like did you have to stay in the hospital. She bugs me about stuff like this as she is a planner and I am not I will just jump into something and get it done. She will plan for days and then decide not to do it.

With the doctors recommendation an MRI was used for the diagnosis, xrays were tried in the beginning. Trouble is that xrays have difficultly showing soft tissue injuries.
Surgery was outpatient, about three hours, no hospital stay. They cut my bicep off and re attrached in a different location, then extensive debridement. I had a spinal block for pain that lasted about three days, which helped. I also used a ice/compression shoulder wrap post surgery for two weeks. It circulates ice water in the wrap and provides squeeze/compression to reduce swelling and promote healing.
A powered electric recliner/chair in my opinion is a must, it’s going to be your bed for a while and getting in and out of it and reclining helps a lot. You can’t get in and out of bed, even if you could, you can’t lay down comfortably.
Let me know if you have more questions.

[Chris Parks]

I remember that now, laying down on bed was the hardest thing to do so I slept semi reclining. I was lucky in that as long as my arm was immobile in a sling (six weeks) I had very little pain apart when I started Physio a few days after the op. They gave me bottles of pills and I threw them away IIRC.

[Mark Gibney]

I have some good news about my slap tear injury that might interest some of you.

I went to see a different physical therapist on Friday. He gave me some insights and do and don't that has helped reduce the pain enormously.

Long story short he had me stand with my arms by my side and breathe in as I straighten up and roll my hand outwards a little, relaxing and straightening my shoulders.

Then breathe out as I slump / relax.

And do this about 10 times.

Next he pressed on (deep massaged?) the muscle that covers my left shoulder blade.
This was very sensitive and unpleasant.
Next he showed me how to do this myself with a tennis ball up against a wall. He prefers a lacrosse ball as they are harder.

I do all this four or five times a day. It has made a world of difference. Over the weekend I had to do a rush job that had me working 6 am til 11 pm on Sunday, with stress levels that would normally exacerbate physical issues, but I took the time to do my shoulder rolls and massaging with a tennis ball and it kept me able to work. Sleep has also improved.

What is interesting also to me here is that I had done 8 weeks of physical therapy during October and November and the pain had worsened. This first therapist did not address the muscle that covers my shoulder blade.
My surgeon then gave me a cortisone shot, but that only marginally improved my comfort. She suggested I try therapy again, and said they will now be able to work on the injury in a way they couldn't before I had the shot.

I decided not to go back to the first physical therapist. She is very professional and thorough, but she is young. A buddy insisted a therapist he goes to is very good and encouraged me to go.
I went, not expecting much, and it's a long drive which is never ideal.
Glad I went. His experience and talent really matters.

So I hope my experience will be useful to some of you. I know everyone's case is different, and if my friend had not know of this new therapist to recommend to me I may well have opted for surgery, with all the recovery problems.

The new therapist used just his insight, his fingers and a tennis ball. No fancy equipment.
If you have shoulder issues or other physical ailments no matter where you live hopefully you can find a talented therapist to help you.

[Kevin Beitz]

Been there ...Done that... After 3 years I still feel the pain...

[John K Jordan]

Been there ...Done that... After 3 years I still feel the pain...

Kevin, hang in there! The pain goes away for most people I've compared notes with.

18 years after my rotator cuff surgery I still have some pain but no limits on motion or strength. Not a bad trade off.

[Todd Zucker]

I just saw this thread. I had a torn labrum last year (but the doctor didn't call it a SLAP tear). One day I suddenly could not put my shirt on or use my mouse at the computer without extreme pain.

The doctor said that surgery would fix it but the recovery time would be long. He said that about 50% of his patients stop having pain without the surgery and suggested physical therapy. With my work, the surgery and immobility afterwards would have been difficult.

While deciding what to do, I read a lot of stuff on the Internet, and there was a doctor in New York who said that most people in their 50s who suddenly get pain like that without a specific incident might just have irritated a prior shoulder injury, so that time and physical therapy might allow a return to normal, even though the injury doesn't actually get "healed." I had had trouble with push ups and the like for several years, and I came to the conclusion that going "all in" for a few months at one of the cycling classes that involves repetitive lifting of weights overhead during the class must have exacerbated a prior injury.

Anyway, I did the physical therapy route for about a month and a half. Lots of stretching of the shoulder joint. Pain gradually went away, even after stopping the physical therapy. After about 3 months, the pain was basically gone, and it has fortunately stayed gone. I have about the same mobility as I did beforehand, and I am just careful now about doing anything that involves lifting heavy things above my head.

Hope your recovery goes well.

[Jerome Stanek]

My MIR came back and I have a torn rotator cuff sugary is set for next month. pain wakes me up 2 to 3 times a night. I have pain all day but not as bad when the shoulder pops.

[Wade Lippman]

Totally different injury, but....

Surgeon wanted to schedule me, but a therapist said he could get me through it. That was 17 years ago.
Your surgeon was probably right. Mine wasn't.

[Jerome Stanek]

Surgeon said it would never get better but may get worse. He said therapy may work to relive some pain but the pain at night would be the problem. I have lived with this pain for a year now and it seems to be just as bad as when it started. During the summer it wasn't as bad so I thought it was getting better.

[Chris Parks]

Surgeon said it would never get better but may get worse. He said therapy may work to relive some pain but the pain at night would be the problem. I have lived with this pain for a year now and it seems to be just as bad as when it started. During the summer it wasn't as bad so I thought it was getting better.

Depending on the thickness of the tear as to the pain level. A full thickness tear such as mine tends to become less of a problem or mine certainly has but the shoulder that got operated on had a smaller tear and I had no choice and had to have the op. My right was torn 30 years ago and as I have gotten older it is to the point now where it gives me nil problems at all.

[Jerome Stanek]

Well tomorrow I go in for rotator cuff surgery My right shoulder. I have been in a lot of pain lately. I think I am ready I did a bunch of stuff so to get ready for it. My worry is the weather now since I live out in the country. I tried teaching my wife how to run the tractor but if worse comes to worse I guess I could do it as it has a shuttle shift and power steering also she can use the snow blower. I ended up getting a different bed that is a recliner. I have a lazy boy but I tried sleeping in it and I get real stiff. What I will miss most about the bed is we have a water bed and it is so nice to get in a warm bed.

[Chris Parks]

My approach after the op was to start physio ASAP because the shoulder is basically unused for 6 weeks or was in my case. The op is a nothing event, the recovery is the issue. They insisted I would have major pain afterwards but that only occurred when trying to sleep laying down. Semi reclining sounds like a good idea.

[John Goodin]

Not to scare you but my father had a shoulder issue and he delayed replacement surgery. All went well and the recovery was textbook. The only problem was that he had delayed surgery so long that his limited, pre-surgery range of motion caused his shoulder muscles to entropy. He never really regained his full range of motion which causes him issues activity-wise to this day. While his an extreme case, be cognizant that sometimes delaying what may or may not be inevitable can have more serious unintended consequences.

[Jerome Stanek]

just got home and everything went well. fingers are numb but that is do to a nerve block that they said would wear off in a day.

[Nathan Johnson]

Ice will be your best friend. It's better than any pain med, honestly.
And if you are taking pain meds, make sure you're taking a stool softener and drinking pear juice.

I've had two surgeries on my right shoulder and it sucks. No way around it. Be diligent about PT.

[Jerome Stanek]

I have a chiller that someone here recommended here. they told me to use it all the time . My wife got some stool softeners and I think I am good. it sucks doing everything with my left hand. my wife and I joked about me getting a cnc cut job after surgery and guess what. I got home and what was in my email but a cnc cut job. luckily I set up the table with the most use material and cut down the other hat they use a lot so I can handle it.

[Jerome Stanek]

I'm just over 2 weeks out and start PT next week does anyone know what exercises that will help and how long did you go to PT

[Chris Parks]

Don't overthink it the physio will asign the exercises. I started two days after the op and the physio went on for months from memory.

[Nathan Johnson]

I think I did 12 weeks with the physical therapist after my last surgery. Different injury/condition, but I'd imagine many similar exercises.
Range of motion focus to start...raising your arms at certain angles in front, to the side, and behind. Internal and external rotation. Possibly wall pushups with an extension to force your scapula back. Wall circles with an exercise ball. Bicep curls. Strengthening will start with soup cans and light bands. Holding a few ounces out in front of you and making little circles.

Having said all that, your PT will dictate your program. Follow it to a T, and do all the at home exercises. But don't go crazy and do extra. It's baby steps, and doing it methodically and on schedule is key.
You're going to get frustrated and bored. It's going to seem slow. But suddenly, you'll be six weeks in and doing three times what you started out being able to do. Play the long game.

[Bill Jobe]

Wall circles with a ball caused me to become concerned should my shoulder become overpowered by rotating too wide and having to catch myself falling forward.

Both of my shoulders had massive tears and were longterm. The muscles had atrophied and the tendon had dried up. The tendon was cut, the stretched very hard to where they could be screwed to the bone.
Post surgery beyond 15 years, I have very little pain but absolutely no strenght in either arm or shoulder.

As others have pointed out, follow your doctor 's orders to the T.
Over do it and you may not get a second chance.

[Bill Jobe]

Oh, and if the next morning the pain is beyond the reach of the pain meds, don't be shy about asking to have a nerve in the side of your neck deadend. It is instantaneous relief.

[andy bessette]

...since riding places the muscles, back and shoulders in a constrained state for extended time with a limited range of motion then I would be dubious of road biking as proper rehab.

Surely this.

Recommend finding a different form of exercise, like swimming, for awhile, to confirm. Also a regular regimen of deep tissue massage (shiatsu); just work through the initial pain.

[Kevin Beitz]

I for one gotta say the physical therapy did not help.
I hated it but I had to do it for insurance reasons.
I really think it did more harm than anything.
I'm OK today and I'm glad I had it done but I
sure hope I don't ever have to do it again.

[Brice Rogers]

I completely tore/separated two tendons on my rotator cuff. They put in eight expensive little anchors. My surgeon had done well over 2000 shoulder surgeries and this was the second time that they used that many anchors ($800 apiece). My doctor told me that it would take a year for my shoulder to 100% recover. I didn't believe him. I went through extensive therapy. Initially 3 days a week (all passive motion controlled by a second person moving my arm) then 2 days a week. In between visits I did the same therapy at home. I made all of the various contraptions that they used at the PT (physical Terrorism) place. Sometimes my therapist pushed a little too hard and I would get a set back. So we fine tuned the PT to the point that it was always helping. So my PT routine changed weekly. I think that after about 5 or 6 months that my insurance stopped paying for the PT. I continued on my own dime for about 2 or 3 months. At this point I am 100% recovered. I have full range-of-motion.

At the same time, my SIL had rotator cuff surgery and her company (Mayo Clinic, Rochester) only paid for two PT visits. I don't know how dedicated she was in her independent PT. But today she cannot comb her hair or put in ear rings with that arm and can no longer golf.

So, my "message" is to focus on the PT. Duplicate their equipment and gadgets and on the "off days" do the same PT at home. But don't push yourself to the point that your progress goes backwards.

[Jerome Stanek]

Well today it has been 26 weeks 1/2 year since I had my surgery and I have pretty much full movement but still have pain more like a tightness but if I try to lift anything over 10 LBs it hurts. Still doing the exercises that they gave me and that does seem to help a little. The pain is nowhere near what it was before the surgery but i did have more strength back then. The doc did say with my age and as bad as it was that it may be over a year before I feel better.