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Ksolem
Trad climber
Monrovia, California
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Dec 12, 2014 - 09:59pm PT
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Just really not looking forward to being out of commission for such a long time.
Beats the heck out of being out of commission forever.
Take advantage of the PT as a time to learn about your body from professionals, and challenge them to teach you.
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Pete Hill
Social climber
Squamish
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Dec 13, 2014 - 01:52pm PT
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I feel for you. I had a supraspinatus reattached a couple of years ago. Be diligent on the PT to get range of motion back. I was 3 weeks of 3 times a week being pushed to my pain threshold. But I got full range back. Don't settle for anything less.
All the mind numbing boring pt exercises with a rubber band, keep up on them.
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JonA
Trad climber
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Dec 13, 2014 - 04:01pm PT
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Ruptured subscap and just about everything else at least partial thickness tear. Notice the lack of inflammation. Clean livin' pays off. The outer bicep went to the humerus. Works great, better than the other one.
Lack of inflammation is thought to possibly be part of the problem for some folks. Traumatic cuff tears are certainly possible, but it's more likely that the shoulder experienced many years of impingement or tendinitis beforehand. Chronic tendinitis can create very unhealthy, poorly nourished tissue that lacks a healing response and won't really get inflamed. Some nonsurgical techniques to treat tendinitis actually try to induce inflammation.
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Ksolem
Trad climber
Monrovia, California
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Dec 13, 2014 - 07:53pm PT
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You raise an interesting point. In my particular case Dr. El'Atrache told me that the lack of inflammation in the case of my particular injury was a benefit and a sign of a lack of degeneration in my shoulder. I trust him - he is among the very best in the field.
The point you raise regarding inflammation and it's various mechanisms, beneficial and detrimental, is way out of my scope.
I will never forget what Dr. El'Atrache said to his Fellow when he saw my MRI: "Look here, this guy tried to tear his arm off but his skin held it on."
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east side underground
climber
Hilton crk,ca
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Dec 13, 2014 - 08:44pm PT
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eight weeks out from severed upper bicep tendon and rotor cuff repair. motion is coming along but im not cleared for weight till end of december, six weeks in a sling played havoc on my elbow and wrist, im still having some nerve issuse but everyday it gets alittle better....painful rehab .......good luck..... not sure when I'll be climbing and surfing but hopefully back to work soon!
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LilaBiene
Trad climber
Technically...the spawning grounds of Yosemite
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Dec 13, 2014 - 09:56pm PT
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Thanks for thought-provoking input.
Am diligent about PT, so I've got that going for me, which is nice. ")
The inflammation issue is an intriguing one -- I've never broken a bone (but should have more times than I can count -- think aggressive New England ice skiing) -- but have had joint stability issues since elementary school. Never tore anything, either. For a little over 3 years, have lived mostly without the chronic inflammation I had for 40+ years, since being diagnosed with celiac disease.
Will have to noodle the effects of having eliminated chronic inflammation...
And so true -- I'm grateful that surgery is an option, rather than being put out to pasture.
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phylp
Trad climber
Upland, CA
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Dec 14, 2014 - 07:59am PT
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LilaBiene , your surgery sounds like the one I had a year ago. They decided not to pin the bicep, only trimmed 1/2 of it off. They did have to cut and pin another tendon. Bone trimming, rotator cuff repair etc.
Don't expect to get a good night's sleep for 3 months more.
After 3 weeks of post surgery non-sleep due to the pain at night, what worked well for me was insisting that they give me both a muscle relaxer and ambien. The pain killers and nsaids did nothing for that night pain. I didn't take those drugs every night, but the nights that I did were the only ones when I got some sleep. It may be different for you.
I was climbing low angle after 3 months and back to steeper after 6 months.
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LilaBiene
Trad climber
Technically...the spawning grounds of Yosemite
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Dec 17, 2014 - 07:30pm PT
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Thanks for the insights, phylp! I'm grateful.
I haven't had a good night's sleep in about 3 months, and in the last month the pain at night has just gotten progressively worse -- I wake up every morning counting the days until surgery like many kids are counting the days until Christmas.
Thanks, also, for the info on your recovery time -- it's given me back some hope!
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Lorenzo
Trad climber
Oregon
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Dec 17, 2014 - 09:57pm PT
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In my case it was pretty massive also, and in 1990. Things with arthroscopy weren't as evolved as now.
Torn subscap, torn labrum, ruptured synovial sheath, torn acromio-clavicular Ligament, and the end of the humerus that did all that was punched in like a ping pong ball, as the surgeon described. Lots of crud in the joint as a result. And a tendon was reattached to the front, which one I was never really clear about.
The surgery took much longer as a result and what they thought was outpatient turned into a two day stay. I got written up in a journal as patient X.
I think the key was then the rehab, about 1500 hours worth over a couple -3 years, starting three days after surgery. I lived in a rehab center. Fortunately most of that was free. They took me on as a project long after insurance ran out. Lots of that was range of motion stuff. The pain wasn't all that bad except for the first couple weeks. It might be that I have a high pain threshold. I rarely used prescribed pain drugs.
Climbing came back slow. I can show you lots of one armed projects in the DC area ( right arm only). For about seven months there was none with two arms. Then I could climb reaching high only with the right and the left tucked to my side. It took 18 months before I could reach high with my left with confidence. But recovery was total. Even now it seems stronger than my right. It doesn't appear I lost any range.
The failures were prediagnosis and pain management early. This was before MRI was very common ( don't recall it was even mentioned) and I don't think they had a clue as to the full extent of it until they went in. As to the pain, I had surgery on a Friday which meant the attending surgeons weren't around much and the weekend folks weren't attuned to the issue. When they fill your joint with gas (insufflation) it hurts a LOT until it is absorbed - usually 2 or so days. That also was never mentioned. I'd talk to your surgeon about how they would handle early pain.
I do now have a little arthritis in the joint, but I was a carpenter. That was probably inevitable.
Good luck. Joint surgery has come a long way.
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phylp
Trad climber
Upland, CA
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Dec 17, 2014 - 10:18pm PT
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Yeah, so I should add that my post surgery pain may have been related to my very aggressive immediate PT routine. My surgeon is a sports med doc who works with a lot of pro athletes. So he's used to client's whose main goal to get strong again, fast. The PT is what got me back fast, but you pay the price.
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Lorenzo
Trad climber
Oregon
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Dec 17, 2014 - 10:32pm PT
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Yeah, I was pretty shocked when they started three days later. My guy was a sports med guy who did tennis players ( Stan Smith, Capriotti) and several climbers I know. I scheduled the surgery in January so I could still go to the valley that summer. It was both our goals. Reality set in when all that stuff was done, so the emphasis was range as well as strength, especially early. Maybe that doesn't hurt as much...I don't know. There was pain, but like I said, it didn't generally bother me much after sessions. They said it reduced scarring.
But I was able to do two-a days pretty early. It just became daily routine.
You still gotta do it. It's as important as the surgery, I think.
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LilaBiene
Trad climber
Technically...the spawning grounds of Yosemite
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Dec 22, 2014 - 02:13pm PT
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Hey, thanks very much for your insights. Surgery is tomorrow morning -- I feel a mixture of pure elation and creeping dread. ")
I've promised repeatedly to take the pain medication as prescribed for at least 24 hours -- beyond that I typically can't stand the meds and switch over to Advil. It'll probably take about a day and a half before I'm stircrazy... lol
Lorenzo, great to know that you have already explored this area from a right-arm-only perspective!!! I was signed up for a self-rescue course just a few days after I was diagnosed and was so far into denial that reality didn't sink in until the morning of -- thankfully I came to my senses and didn't go.
I'm hoping I'll be able to get back to easy swimming fairly quickly -- even if it's just treading water -- the lack of having a physical outlet is torture. I'm very diligent about PT -- I've done enough of it for knees, back & SI joint to know that it's imperative. When I had knee surgery about 10 years ago I had full range of motion back before the PTs had taken any range measurements -- they were a little surprised. :D This surgery is far more complicated, though.
Thanks, again, for sharing all of the valuable insights -- I have a much more realistic perspective going in, which should make the rehab process a lot more tolerable.
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couchmaster
climber
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Dec 22, 2014 - 02:44pm PT
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I learned not to wait and try self-rehab. Atrophy and age can affect all of these little muscles and tendons, rendering them irreparable. Did mine in a non-climbing accident, but I got lucky, perhaps because I kept trying to climb through the pain. Or not, who can say. Both of my shoulders were screwed fairly seriously up. Went to the valley in the spring, 3 years after the last of several injuries to the shoulders and living in daily pain. Did some half way OK climbs considering raising either arm was a painful effort. One day we camp to camp the Arches Crest jewel link up in 8 hours. Next jumped on the Prow and they hurt so bad (probably from biking over on the trail with the haul bag on in addition to working different and long unused things in there) couldn't sleep all night, next day arms didn't really want to move. Told my buddy, "hey man, I screwed up my arms even more, if you want, I can follow you and jug by keeping my arms low, but I'm in some big pain". He let me off the hook and we bailed.
Went to the Dr when I got back. They MRI'ed the left one first and shocked me by letting me know that for the last 3 years my Infraspinatus was torn almost all the way through and was hanging by a thread, the supraspinatus was half way ripped, the Labrum was torn, there was a bunch of artritus stuff they cut out (tissue showed white on the MRI, I didn't know they could cut that stuff out, ....Bonus!), and the bicep tendon was also screwed up and needed to be stitched back somehow. Then they said they'd grind down my collarbone when they got in there just in case of potential impingement. So they did. Open surgery. It hurt more than Lorenzos although I skipped the plentiful pain pills they gave me. I'm 1 year in and that shoulder is 90 percent back, and I've been religious on the PT. Got back on rock 5 months in.
At 6 mo of hard rehab on the left one, and because I was starting to climb at about month 5, indicating I was doing better, they then did the right one. The pain decreases over time, but I'm 7 months in on this one to this day and it still hurts some. The Dr was adamant that I shouldn't climb on the right one until 6 months - so except for a few very easy footwork bouldering seshs, I've stayed true to that. I watched the calender ticking off the days of 6 months and now I've done a few easy laps of favorite climbs now and it's empowering not to screw them up again...yet.
What I've learned is 3 fold.
1st) Get thee to the Dr early.
2nd) Early professionally directed PT may (Not in my case as I was so screwed up) help you avoid being cut.
3rd) As Lorenzo says, stick to the PT, no more no less. I over did it 2nd go-round and backslid into more pain, irritating it worse and then having to take days off from PT to avoid injuring it more.
Lastly, I think diet is not addressed by the Dr's and PT folks considering the healing path, for you this will be a critical component, don't hesitate to share your issues with your team, and seek outside expertise if you feel you need it.
I'm glad I was pushed into seeing a Dr by my wife and the shame of having to back off a fairly easy route. It shouldn't have come to that. Anyway, it's gonna hurt like hell, but it will get better...slowly. Good luck Lil Brianne.
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SC seagoat
Trad climber
In What Time Zone Am I?
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Dec 22, 2014 - 03:16pm PT
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Good luck Audrey. Been there, done that. It's not a pleasant rehab but that shoulder has never been stronger! No regrets on this end.
Happy Holidays to you and you family.
Susan
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guyman
Social climber
Moorpark, CA.
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Dec 22, 2014 - 03:50pm PT
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Good Luck .....
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SC seagoat
Trad climber
In What Time Zone Am I?
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Dec 23, 2014 - 07:31pm PT
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Hoping all went well with your surgery!
Susan
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LilaBiene
Trad climber
Technically...the spawning grounds of Yosemite
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Dec 24, 2014 - 06:45pm PT
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Well, as it turned out, my shoulder was actually frozen, so that was added to the list...but the good news is my bicep tendon is intact, so the surgeon only had to grind away some of the inflammation there.
This morning had initial follow-up appointment, and wouldn't you know, PT started less than 24 hours post-surgery!!! Thanks, everyone, for setting my expectations - I think I would have otherwise run screaming.
Thanks for the well-wishes! ")
Edit:
Stupid pain meds - switched to Advil before 48 hours was up - didn't even understand what the surgeon did!!! Yesterday he told me that my shoulder was completely frozen & he had to release it, as well as do some major clean-up. Then he had to weave back together a half-way torn bicep to the tendon & anchor my rotator cuff. Grateful to have had a very determined and talented surgeon, and a physical therapist that doesn't give in when I sob. ")
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LilaBiene
Trad climber
Technically...the spawning grounds of Yosemite
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Begging for advice on how to gain some level of control over the muscle spasms that keep popping (literally) up in my arm pit, bicep, under my scapula, neck, etc.! (Pain medication & muscle relaxants don't work thanks to my biology.)
Has anyone had luck with any alternative treatments? I'm grateful for your input!!!
P.S. I'm being diligent with my PT!
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Lorenzo
Trad climber
Oregon
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Keep with the PT. The first couple months are the worst.
Here are a few things to try:
Just use a sling for a few hours a day to rest the muscle groups, the spazzing sounds like it might be fatigue. You will know in a day or two. What part of the day doesn't really matter, so driving(safely) or watching TV is as good as anytime.
See a chiropractor. ( not the pop your neck kind, the gentle realignment kind. There are guys who use very gentle methods for realignment with adjusting instruments.) he might have to do it over the course of your healing. I had sub scapula pain that my guy helped a lot with.
Some people think acupuncture helps. Never tried it.
Likewise a tens unit. I have one and think it's great for my back when it starts spazzing. Some doctors don't want you using them around your head or heart.
Your health plan might cover those things if pain meds don't work. Mine does.( I still do a copay)
Drink a really hoppy beer or some single malt. It will still hurt. You won't care.
As it happens, I just started PT on my knee today. Hurts like hell. I'm starting with method five.
( just joking. I assume your doctor has counselled you on alcohol inhibiting healing.)
But since this is the new Taco....
Juice!
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phylp
Trad climber
Upland, CA
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Jan 10, 2015 - 07:51am PT
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Lila, so sorry to hear, this was what I was warning you about. For me, the pain from the rock hard spasmed muscle after the surgery was unrelenting for months. Sorry the muscle relaxers aren't working for you. That's the only thing that gave me relief.
After some time had passed I had my massage person do some direct work in the area, which did help. I was reluctant to do that when all the sewing was still fresh. Your doc may be able to advise when you could do that...
Phyl
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