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  1. #26
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    I had a similar semi-catastrophic injury in 2008, at the age of 55. I also required surgery, and a significant amount of 'retained hardware'.
    All I can say now is that PT rehab, and strengthening exercises are absolutely necessary, and likel will be, for the remainder of your lives. I had rehabbed' mine quite well. I twas painful at times, but I was able to just about regain full stength and ROM.
    Then last year I was knocked on my ass by another medical condition, and was unable to do my maintenance work out for over 6 months.. no pain issues arose to signal any changes, but when I went back to the gym in the last month, I found I cannot even do pushups without all kinds of ominous popping and grinding noises. All other motions are progressing back to pre-layoff levels, but the pushup-bench press area is clearly compromised.

    My feeling is, that if I had not ceased working out for that half-year, this would not have happened.

    So, following your rehab, be absolutely certain to commit yourself to regularly maintaining your rotator cuff and shoulder strength. Surgery can fix a lot, but we have to do our part, and some of that part involves a life-long effort, unfortunately.
    Re-Cycled Person who rides a mountain bicycle.

  2. #27
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    I know the drill. Crashed skiing back in February that resulted in a displaced greater tuberosity fracture (upper arm/humerus) and rotator cuff tears. Had a couple pins installed and the tears stitched. It's been a long road to recovery and very frustrating/painful at times. Did PT, followed instructions and have almost full range of motion 10 weeks after surgery. Got my first ride yesterday on a flat rail trail. Felt good and I'll slowly work up.
    Last edited by mvray; 05-12-2013 at 10:20 AM. Reason: Spelling

  3. #28
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    Just got my MRI results back and I have a large/massive tear of the supraspinatus tendon that will require open (non scope) surgery. Not sure what to expect here. Some great info in here, can I have some long term updates. Anyone regret having the surgery?

  4. #29
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    Quote Originally Posted by socalMX View Post
    Just got my MRI results back and I have a large/massive tear of the supraspinatus tendon that will require open (non scope) surgery. Not sure what to expect here. Some great info in here, can I have some long term updates. Anyone regret having the surgery?
    I don't regret the surgery, but there are problems. First off I will once again not lie here: that surgery was the most painful surgery I have had to date in terms of post-op pain, and I have had quite a few trauma-related surgeries.
    I'm no fan of surgery, but thank god for surgeons when there are multiple fractures, bullet fragments and shrapnel-related damage that simply must be removed/repaired.

    My supraspinatus was fully ruptured and had retract6ed into a ball that had begun to turn towards fatty atrophy. Not an ideal scenario. Much drilling and tugging later, it was re-attached, along with extensive repairs to my infrascapularis as well as an osteotomy on a type 3 acromion.

    So, the post-op pain was intense for a length of time that I did not believe would be possible. This resulted in the ingestion of more opioid analgesics than I was comfortable with, or rather a bit TOO comfortable with.

    The good news....I rehabbed it to 90% of perfect.

    The bad news ; without constant effort to maintain that re-hab, it regresses. I had one year where I was affected by an old trauma-related inner ear condition; severe vertigo bouts, tinnitus, and an amazing amount of fatigue literally kept me from maintaining the muscle mass and RC strength that I had slowly rebuilt, and the sloppiness in the joint returned, full force.

    So now, inner ear under control, I have regained first the cardio fitness I had taken for granted for the last 3 decades. Now, I am set to once again drag myself into the gym 4 days a week and resume the shoulder rehab/strengthening routine from ground zero, so to speak, and try to see how much I can regain.

    I'm no spring chicken anymore....been 60 for some time now, and I know that recovery and strength gains are not as easy to come by, so to speak, as when I was younger.

    But what else is a guy gonna do? I've been riding the fat tire FS 29er on a combo of roads/trails for over a month now, at least 5 days/nights a week, minimum of 20 miles per ride, more like 30 or more on average.
    The fact that I can now do that is in itself encouraging. Tells me no major arteries are blocked, etc.

    So, on to phase 2, fully cognizant that this is a long-haul proposition, one that I'll need to stick to for life.

    Good luck to you with yours. If you are younger than me, and have no other complicating factors, like I do, you should do fairly well if you are methodical and consistent in your rehab efforts.
    Re-Cycled Person who rides a mountain bicycle.

  5. #30
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    socalMX, how old are you, what do you do for a living, what chance do you have to take time to rehabilitate, can you spend, 6-12 weeks in a sling etc. RC repair (open is really the best IMO), plus acromioplasty, plus associated surgery to other issues is not to be taken lightly surgery. It's painful, expensive and recovery is and has to be slow.

    More important is how you will measure your recovery. This is a professional medical opinion (limited as expected online), qualified by saying that I have not torn a RC. At 53 and (think ping pong) after 3 clavicle #'s, one GT of humerus avulsion, one torn coracoclavicular ligament and partial AC joint tear, one fractured scapula and many other upper body injuries, I can give some personal perspective on shoulder rehab.

    Re acute management:

    First - a young person with an acute tear is not the same as my age or older, with a lesser injury on chronic degeneration causing a massive RC tear
    Next - instability due to associated glenohumoral joint injury, whether labral (the cartilage rim of the joint) or just ligament tearing changes immediate treatment options
    Then - what you are expecting as the outcome is a big thing

    Weigh up your rehab. Home mortgage, family responsibilities and inescapable work commitments may change your decisions. Can you drive with a sling - nup. If you can't have surgery now, when will you be able to and can you drive anyway in the meantime etc etc etc. You know your wife is going to hate you for getting hurt no matter what, so at least that isn't another option!

    It's not about whether you can bench press more weight than before you got a cold. Sorry!

    For me it is about whether I can keep sleeping, working, paying the bills, riding my bike, swinging a pick at trailwork, having fun, skiing at times and it's probably in that order. What I can say is that despite the apparent stupidity of it, digging trail has been the single best rehab program I could have used (many times). No goals in terms of power, just technique. No commitment to performing a certain task to some schedule - if it feels odd on the mattock, get a rake, or a shovel, change hands or get a drink, or review the trail contours you have built, take photos or get some test dummy to try the new berm to off-camber to hip and have a chat.

    I guess sometimes I measure callouses to assess progress, but what I am really saying is that the capacity to do many things, including those most important to you allows enough variation in your rehab to make your shoulder handle changes in routine. Also, unless you have significant posteroinferior (low and back parts of the glenohumoral joint) instability, riding is not too risky for a hurt shoulder, which has been great for me.

    So, after you choose your immediate (surgical) options, then you have to go with your gut about how it feels over time, whether it is getting better, feels secure and stronger and whether it really is time to smash that berm to off camber to hip.........

  6. #31
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    I'm coming up on the 1.5 year mark for my labrum repairs and 2 year mark for the larger of the two tears (the little one is about 6.5 years old and was fairly asymptomatic until the crash). Not quite apples to apples compared to other posters in the thread but its still shoulder work with a long, slow rehab and a massive pile of restrictions.

    Looking back at it, the first week really sucked pain management wise. I've had 7 knee surgeries hogging out cartilage (the same day surgical center staff and I trade x-mas cards...) and dealt with the "joys" that are kidney stones and frankly- I'd rather have the stones than do another round of shoulder work. I like to think I'm tough and can handle pain but damn that hurt. Especially when the nerve block wore off at 2am and i came wide awake in agony through the big damn percocets i was taking. Took me over 3 weeks to be free of the Rx meds completely during the day, longer for the night. For comparison, with all the knee work I never felt a need nor took the prescription painkillers for more than a day.

    I was able to drive pretty fast, my ortho cleared me at my post-op follow up along with a return to work part-time, providing i followed some strict restrictions on what I was doing and taking Rx wise. I organized most of my operations (i run a laser welder making Li-Ion batteries, some of which are scampering on Mars) to allow for one handed operations. I also trained up a tech i called "my left arm" for the jobs that required two free hands and some skill to complete. That worked out pretty well for the 8 weeks i was locked in the immobilizer sling. Day to day stuff was pretty interesting while i was one handed. Being a lefty with a damaged left arm meant trying to relearn basic things like bathroom functions, eating with the wrong hand and opening doors. I got pretty good at a lot of it by the time my 8 weeks were up.

    Rehab- what a long, arduous adventure that's never quite ended. I spent 4 months in formal pt and got regular massages on the shoulder and back to help loosen things up. When pt ended I had about 95% of my range of motion back and could put on a jacket correctly, which was no small feet compared to the year prior. Long term, what I've found mimics Ridnparadise's experience- if you stop the rehab/exercises everything tightens right the hell back up and what a pain it is to get back to where you were before.

    Timing- I planned mine around my company's move to another state. The idea was to be able to be out on short term disability while the old facility was shut down and shuffled north, sparing me the problems the move would bring and allowing time for my particular option to get put back together. Needless to say, the move failed to happen on time and the best laid plans got shot all to hell. We finally moved 5 months after my surgery and I got layed off since the new place was barely functional and would take months to get going. Spent a day unemployed, got recalled the next morning to help clear the rest of the old facility- ended up moving roughly ~10 tons of haz-waste around on barrel carts, grabbing whatever the folks in the new facility asked for (a lot of stuff was left behind in the hurry to go do nothing) and destroying unwanted desks and other office furniture with my 16lb brass sledge hammer. Definitely not the best thing for the shoulder and likely caused a tear in my rt knee's meniscus (surgery #7, happened in Nov of 2013. almost allowed outside again...). But it was that or stay unemployed and collect 2/3rds of paycheck and still have to pay for my health insurance.

    I also had plans already laid out for the summer on the bike and wasn't all that willing to trade the down time. I was told by my Ortho that "when we do the repair is a matter of how long you can handle the pain" and i got 4 months out of the shoulder. Completed multiple Centuries, played in the woods a bit and managed to go DH'ing a few times (including a trip to Highland the day before surgery. that got some looks in the OR). I probably could've delayed a little longer but the pain was getting to me and starting to interfere with my enjoyment on the bike.

    Any regrets doing the surgery? Nope, my Ortho & PT were honest about the length of time it would take to rehab and just how much pain i was going to be in. My shoulder is just about as strong as it was moments before the accident, the ROM is right up there and I'm no longer in pain from the shoulder constantly dislocating.

    Would I do it again? Only if there was no way around it and more conservative measures had failed.
    Alea Jacta Est

  7. #32
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    Thanks for the updates everyone. Some interesting stories there. I like this paragraph most- "Any regrets doing the surgery? Nope, my Ortho & PT were honest about the length of time it would take to rehab and just how much pain i was going to be in. My shoulder is just about as strong as it was moments before the accident, the ROM is right up there and I'm no longer in pain from the shoulder constantly dislocating.'

    Most everything else is pretty discouraging. I am searching the interwebs for alternate non-op solutions but it doesn't look promising. If I didn't ride bikes, lift weights, work in the construction industry or do any other outdoor activities I suppose I could skip surgery and risk loss of my ROM and let it heal as is. Not an option...I am 41 and hope to have many more years left on the bike, I simply need to get better and not crash so much, that in conjunction with becoming a more mild XC type rider I guess!?

  8. #33
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    Full-Thickness Tear of Rotator Cuff

    Hey all...I'm the thread starter! Saw some activity, so I figured I'd provide an update.

    I'm 14 months post-surgery, and have been fully recovered for a while. Was back to full speed probably six months after surgery. Just did a 24-hour race solo SS...did 170 miles. I've been back in the gym for a while, at full strength and 95-99% ROM. The shoulder can be a bit "crunchy", and feels stiff deep into certain exercises, but no big deal. I do everything I did pre-injury. Riding is a non-issue, though I haven't crashed on it again.

    The surgery went really well for me, and my shoulder was torn up (see above). I was off pain meds within a week. The key, in my opinion, is the surgeon. The better he is; the better the outcome, recovery and pain.

    Good luck, and make sure to be an excellent and obedient PT and rehab patient. You don't want to shortcut that!!


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  9. #34
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    I'll second that with a caveat that massive tears are difficult to repair and the outcomes are fair. Make sure your therapist has some experience with these things. Not just full thickness but massive. Usually you are restricted quite a bit initially post op, then minimal movement or isometrics, then at around 12 weeks you're able to start pushing. Take a look at insurance benefits for therapy and see how many visits you have annually. If you have something like 20 be prepared to pay cash for additional therapy. Discuss this with the therapist because it is a long recovery that needs god rehab to be successful. Good surgeon+good therapy = likely good outcome.

  10. #35
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    Quote Originally Posted by waltaz View Post
    Hey all...I'm the thread starter! Saw some activity, so I figured I'd provide an update.

    I'm 14 months post-surgery, and have been fully recovered for a while. Was back to full speed probably six months after surgery. Just did a 24-hour race solo SS...did 170 miles. I've been back in the gym for a while, at full strength and 95-99% ROM. The shoulder can be a bit "crunchy", and feels stiff deep into certain exercises, but no big deal. I do everything I did pre-injury. Riding is a non-issue, though I haven't crashed on it again.

    The surgery went really well for me, and my shoulder was torn up (see above). I was off pain meds within a week. The key, in my opinion, is the surgeon. The better he is; the better the outcome, recovery and pain.

    Good luck, and make sure to be an excellent and obedient PT and rehab patient. You don't want to shortcut that!!


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    That is encouraging, I just have to stop doing so much research and let it happen, I am driving myself nuts with it. I cant wait to get it over with & start my recovery.

  11. #36
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    Full-Thickness Tear of Rotator Cuff

    Quote Originally Posted by socalMX View Post
    That is encouraging, I just have to stop doing so much research and let it happen, I am driving myself nuts with it. I cant wait to get it over with & start my recovery.
    ^^Totally agree! I was pretty nervous about my surgery, after reading about how painful, etc, that shoulders can be, particularly given that mine was a big tear with other stuff going on, but it turned out far better than expected, on all counts. Make sure your surgeon is a good one, and if possible, find one that works with pro sports teams...they're the best. My guy is one of the orthopedic surgeons for the Arizona Cardinals and Phoenix Coyotes.


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  12. #37
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    Well, I am scheduled for Surgery a week from tomorrow, March the 7th. My surgeons (it will be a team) have several decades of experience between them and have great reviews but they are old, one is 82 and his partner is 62, wow... I guess I would trust them over a rookie! I am such a big wimp, how the hell am I going to sleep this week???

  13. #38
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    Quote Originally Posted by socalMX View Post
    Well, I am scheduled for Surgery a week from tomorrow, March the 7th. My surgeons (it will be a team) have several decades of experience between them and have great reviews but they are old, one is 82 and his partner is 62, wow... I guess I would trust them over a rookie! I am such a big wimp, how the hell am I going to sleep this week???
    That's good.....for a full RC rupture you need two guys....one to pull the muscle out from the retracted ball-shape it assumes when it ruptures, usually with some kind of surgical-level vice-grips, and the other to screw it into the bone, back in place.

    Depending on the degree of damage they have to clean up, your sleep quality will vary that first week.....I sure hope for your sake that your shoulder is not as screwed up as mine was. I had decades worth of successive injuries to it before it gave on me. The supraspinatus was retracted into a ball for so long that 'fatty atrophy' of the muscle part had begun to set in. That's a long time that I was swinging away with no supraspinatus whatsoever. The PT said the movements I was accomplishing before the surgery were mechanically impossible. Where there's a will, there's a way, I guess....
    Re-Cycled Person who rides a mountain bicycle.

  14. #39
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    Glad to hear positive recovery stories! I injured my shoulder years ago wrestling with my son(They get stronger than you think. lol) Therapy and exercise wasn't working any longer and it was hurting when I rode also so I found a time in my schedule that worked, timing it after ski season and in the spring so that I would be able to ride at the end of the summer.

    I had Bicep tendosis and RC repair along with a bone spur removal last week. Started PT yesterday and the pain level isn't too bad with just sharp pain that subsides during movement/exercises. The Ice machine is great as was the Norco after surgery.
    My Wife had Labrum and RC repair 6 years ago so she is telling me what to expect.
    I realize PT and is the most important and keeping up with exercise in the future will be key to keeping the shoulder strong.
    Bummed out about not being able to ride for 3-4 months but I know in the end I will be pain free and able to resume other activities that I couldn't do on account of weakness and pain.

    A question I have is how long until you guys hit the trail on your bikes?

  15. #40
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    Full-Thickness Tear of Rotator Cuff

    3 1/2 months til the easy trail


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  16. #41
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    Thanks Walt. That's what I figured and what everyone had said.
    I hope to start on a stationary bike soon to keep my cardio up so that I'm at least not starting from scratch in 3 months. I'm 54 so getting back into shape is a bit harder than a youngster.

  17. #42
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    Thanks for starting this thread Waltaz. I am having an MRI today (hope if I can sneak it in) and am worried I am going to find out I have a Rotator Cuff tear. Took fall week ago and can't really move arm away from body at all now.

    What worries me the most is that I can't be off work for 8 weeks as can't afford it. I am hoping that I will be able to work one handed but I worry that will be hard if I do need surgery. Just about the worst timing for this to have happened
    Originally Posted by XC62701
    Agreed...make it longer. I want to know death is an option

  18. #43
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    Disability helps while your off. I'd be in big trouble without it.
    Good luck!

  19. #44
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    I am about 10 weeks out of my full open surgery. My incision was just under 4" and there were 4 plastic anchors installed to hold the threading in place. My tear was unique in that it went with the grain of the muscle, splitting open. From the time I went into surgery to today I would be happy to inform anyone going in, it is not half as bad as what I was reading on the interwebs. In fact I took the Norco they gave me for only 2 days and only about half of what was prescribed...

  20. #45
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    Quote Originally Posted by Okie Dokie View Post
    Thanks for starting this thread Waltaz. I am having an MRI today (hope if I can sneak it in) and am worried I am going to find out I have a Rotator Cuff tear. Took fall week ago and can't really move arm away from body at all now.

    What worries me the most is that I can't be off work for 8 weeks as can't afford it. I am hoping that I will be able to work one handed but I worry that will be hard if I do need surgery. Just about the worst timing for this to have happened
    I found that I could work with my arm in a sling.....I found I could have 1-1/2 arms, so to speak. Since my bicep tendon was unaffected, I could extend/flex my affected arm without abducting it at all, and my forearm flexors, etc. were all good to go. So I could hold a heavy tool, like a weedeater, in my right arm and guide it with my sling arm. Just had to shift my weight, and turn from the waist, keep the elbow in close, which is a basic principle of body mechanics that most athletes learn about. I knew all about it from my martial art training. lt's nice to know those skills are useful for more than just breaking legs!
    Re-Cycled Person who rides a mountain bicycle.

  21. #46
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    Quote Originally Posted by pwrtrainer View Post
    I'll second that with a caveat that massive tears are difficult to repair and the outcomes are fair. Make sure your therapist has some experience with these things. Not just full thickness but massive. Usually you are restricted quite a bit initially post op, then minimal movement or isometrics, then at around 12 weeks you're able to start pushing. Take a look at insurance benefits for therapy and see how many visits you have annually. If you have something like 20 be prepared to pay cash for additional therapy. Discuss this with the therapist because it is a long recovery that needs god rehab to be successful. Good surgeon+good therapy = likely good outcome.
    ^^^ This is good advice!
    Re-Cycled Person who rides a mountain bicycle.

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