LM - injured/damaged rotator cuff

So it appears I've managed to damage the rotator cuff in my right shoulder. As a typical specimen of the male of the species I didn't get my posterior to the doctor until it got so bad that I nearly threw up from the pain after making a wrong move when taking a motorcycle off the center stand.

Finally ended up seeing a specialist earlier in the week and we're now on what I understand is the standard regimen of 1-2 steroid shots over the next month or two, potentially followed by an MRI if the problem persists and in the worst case, surgery.

Has anybody on the forum dealt with this before? I appreciate it takes time for the inflammation to heal, so I'm not expecting this to be fixed overnight. My bigger concern is if everything goes back to normal or if it'll end up affecting my ability to handle heavier items. Heck, at the moment it even impacts my enjoyment of driving (fortunately not my ability to) so I'd be happy if things would go back to normal-ish.

I tore mine a few years ago. Lots of shoulder mobility work and time fixed it. But i had to sleep with my arm hanging off the side of the bed for over a year.

I've never had the injury, but my Aunt did.  If there is one thing that I can recommend, it's DO THE REHAB/EXERCISES.  She was reluctant because she was afraid of pain, but she ended up worse after the surgery than she was before.

Find a good doctor, trust them, and do what they say.  Best of luck.

I had the surgery 13 years ago.  Went with a high end reputable surgeon.  Did the rehab.  Had a bit of the dreaded "frozen shoulder" afterwards.  Worked through that.   

End result.  Total recovery.  Went back to using the big Paslode nail gun that probably caused it in the first place.  I would definitely do the surgery again if needed.

One thing they don't tell you before the surgery...  The pain the first week after is really severe.  

In reply to BoxheadTim :

Physical Therapy has been surprisingly effective for my shoulder pain, without injections or surgery.  1-2 PT sessions per week and a daily home exercise program.

I'm a few weeks away from graduating with my Physical Therapy degree, so I'm obviously a believer, but please give physical therapy a chance before doing injections. Shoulders can be unbelievably painful and feel like they will never get better, and get amazing results with a few days a week of therapy and exercises at home.

In reply to MrJoshua :

I didn't want to recount the whole sorry story - I've had a bunch of PT already, which helped with the range of movement, but if anything made the pain worse. That is why I ended up seeing the specialist.

I'm not fond of the idea of getting surgery as anything but the last resort, so right now we'll see if the injections help and I'm doing the exercises sanctioned by my orthopedic surgeon. I also held off on the steroid injection (the PT folks had been suggesting already) without getting a second opionion.

I tore the supraspinatus tendon that helps lift the arm to the side. 

When I first saw my doc, he wanted me to do PT since I could still move it sort of OK, even though it kept me awake at night.  After a couple of months of no improvement, finally got an MRI.  Radiologist diagnosed a 75% tear. 

When I saw the surgeon after the repair, he said it was 100% torn.  Had to reposition the tendon that anchors the biceps in the process.  The whole thing was arthroscopic.

Was able to function OK after a couple of months - no lifting.  Absolutely do the PT and whatever exercises the therapist gives you.  

It has been 18 months now.  I have full motion back with no restrictions and don't even think about it.

Good luck with yours.

I would push to get the MRI sooner rather than later, so you know what you're dealing with (fully aware insurance may want the PT first). Then you can work through a plan of attack.

I had some shoulder pain over the past two years, did a lot of PT and that was a game changer.  But (thankfully), I wasn't starting out with a tear, just impingement and overuse.

In reply to dj06482 (Forum Supporter) :

Already had the inswearance deny an MRI, that's how I ended up with the first round of PT. I'm certainly not opposed to more PT, but right now the orthopedic surgeon isn't too keen on it outside a couple of very specific exercises I'm doing at home. It's the same doctor who was monitoring progress on my broken clavicle in the other shoulder and following his advice there worked out OK.

I'd listen to the surgeon. PT does make sense in a lot of cases, but I've been burned by only having an x-ray (and not an MRI). Knee not feeling good became a torn meniscus, and a whole bunch of other stuff I could have lived without, based on a diagnosis from an x-ray. Had I known what I was dealing with up-front, it never would have gotten that bad (but may have still required surgery). My lesson learned is that I would be *very* careful with it until you have an MRI result to know what you're really dealing with.

I, my brothers and nephews are ex rugby players . So I've had both shoulders done and each one of them has had at least one done. My advise is if you have surgery do the pt despite the pain. And most importantly make sure post surgery you have the ice water pump thing. Do that even if you have to rent it yourself. It pumps ice water from a cooler to a contraption around your shoulder l had it on one surgery and it made recovery faster. Good luck

I'm willing to bet that there's labrum damage, likely a slap tear, in addition to the capsule shift. 

I'd take a pair of ACLs in both knees at the same time and an Achilles over going through the shoulder again. 

Also fire your orthopedist now and start over with a new one. There is zero reason to start doing physical therapy without getting MRI first. That's the same as throwing parts at a car and seeing if it fixes the problem as opposed to scanning it and properly diagnosing it. The only difference between those two hacks is one pays big money to the snap-on truck on the other has six figures of medical school debt. But your vehicle and certainly not your body should be trusted in either's hands. 

The Captain is right on many counts.  The pain of surgery is terrible, but I've been able to live happily for 13 more years because I endured it.

In reply to Captdownshift (Forum Supporter) :

The PT didn't have anything to do with the orthopedist and everything to do with my "deny everything that's more expensive than half a generic Aspirin pill" health insurance of mine that of course denied the initial request for the MRI. They insisted on PT first and it took a while to get an appointment with the orthopedic surgeon. He wasn't very pleased with the PT approach either.

And yes, I realize that medicine seems to be one profession in this country where a gatekeeper (the insurance) insists on a fix first, diagnose later approach.

I'm not a professional, but I have enough plates, screws, and replacement parts to offer an opinion.  It's never wise to "push through" bad joint pain. Ask me how I know.  Insurance Companies in general suck eggs.  But...  Get as many 2nd, 3rd medical opinions as you feel necessary.   PT does work, follow their guidelines.  Surgery can help, but never quite cures, unless the damage is too far gone.  And lastly, sad to say, arthritis will lurk around.  Prepare as best you can, and you'll make the right decision.  Best of luck.

In reply to Dirtydog (Forum Supporter) :

I'm very much pro PT, but you have to have the diagnosis confirmation before going that direction. Sticking with the automotive analogy. It's a bit like having a front end clunk after installing coilovers on a vehicle. It could be the spring settling, It could be the top hats, especially if you've eliminated the rubber bushings. But you better make sure it's not the ball joint before you tell a client to drive on it for a week or so to allow it to settle. 

I'm also unfortunately aware that it's the insurance company that requires hoops to jump through. There are methods that medical care providers can communicate to the insurance companies, such as threatening to not take them and lawsuits, that seemed to clear those hurdles rather quickly. I can say with 100% confidence that if my medical care providers did what insurance companies required before acting, that I would have been dead a decade ago. 

The injuries vary greatly, as do the surgeries and the recoveries.

For me, the surgery wasn't very painful, and the initial recovery was very quick.  Which let to terrible mistakes on my part.  Instead of giving things a long time to heal, I engaged in stupid activity, like timbering with the chainsaws and such.  Believe it or not, I did not heal up, the pain did not go away, etc.  

Only when I finally gave up and quit doing stupid stuff did it start to actually heal.  So a good year of being stupid, and probably at least another year or two of not using it.  Probably would have healed earlier and better if I wouldn't have been so stupid and stubborn.

It did heal though.

So now it's many years out, and it's pretty good.  I have to be careful when working out, especially overhead press type things.  Sometimes I can do them just fine, many times I cannot.  If I ignore that burn, I'll regret it for weeks.  I carefully work on strength, and can do things these days I couldn't do even when I was kid (always was prone to bursitis in my shoulders).  

I do have limited mobility.  It doesn't generally bother me, but I can't actually stand at parade rest and handcuffs would hurt like hell.  It's also quite noisy, as in snap/crackle/pop.  It doesn't generally though.  So otherwise, I'm good to go.  

I'd really want an MRI to assess the damage.  Now that you've seen the orthopedic surgeon, he can't recommend an MRI and get insurance to cover it?

docwyte said:

I'd really want an MRI to assess the damage.  Now that you've seen the orthopedic surgeon, he can't recommend an MRI and get insurance to cover it?

That's the plan based on the outcome of the next visit.

Right, visit taken care of and we're making another attempt at the MRI, this time with a referral from the orthopedic surgeon. 

Mine has been bad for 30 years. This is what happens when you catch a sleeper sofa that is tumbling off of a truck and aimed for a mud puddle.  Exercise, stretching, and not doing anything stupid usually keep it in a pain free functional shape.  I managed to do it in back in October planing a square wood stock into two round spars and a mast for my newest boat. It's only starting to feel better now.

Had the MRI yesterday - shoulder is grumpy today as it didn't appreciate the combination of driving and the fixed position it needed to be held in for the MRI by means of a couple of mechanical implements.

The letter stating that the health insurance approved the MRI, arrived today...

Talked to the orthopedic surgeon on Monday to get his feedback on the MRI.

As expected, I have a partial tear of the rotator cuff (plus some "age appropriate" arthritis'n'E36 M3 in several of the joints), but according to the doctor it's not really a candidate for full-on surgery. He recommended a consultation with one of his colleagues who basically does minimally invasive clean outs to see if that would be an appropriate path to take or not.

In reply to BoxheadTim :

I had rotator cuff / torn labrum / detatched bicep surgery two years ago. If you have the opportunity to have the arthritis cleaned up while they're in there, I'd highly recommend it. I didn't even know that I had arthritis both of my shoulders until they fixed the bad one. Now the repaired shoulder usually feels better than the "good" one.