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Old 08-21-2017
Hscovern Hscovern is offline
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Join Date: Jun 2009
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Hscovern
Default Recovery from rotator cuff surgery - success through persistence

Thanks Sojomojo, I just got back to this thread and will be trying Stew Smith's workout, just not sure about the military presses which my surgeon advised against. Maybe with 0-5lb though..

In the hope that it might help someone else in this situation I wanted to fill the gap since ~2/2016 when I first posted about upcoming rotator cuff surgery. The rotator cuff is complex, consisting of 4 distinct muscles, and it can sustain varying levels of damage. One's age and general conditioning come into play wrt recovery as well. I was 66 at the time, in reasonable but not superb condition, and surgery on 3/10/16 showed large, complete tears of the supraspinatus and infraspinatus muscles, which were also retracted (meaning shrunken so the torn ends were separated by an inch or more) and partial tear of the subscapularis. The teres minor was intact, but that one rarely is damaged anyway. There was a lot of inflammation in the joint as the injury occurred 6-7 weeks earlier and the joint was attempting repair as best it could, though there was 0 chance of active range of motion recovery without surgery. Surgery with repair of all damaged structures including insertion of posts that the damaged tendons were attached to was not terrible. Postop was not terrible except for sleep (lack of, need to sleep on a recliner) for the 5 weeks that I needed to wear a Donjoy sling 24-7 except for showering, and no movement of the shoulder was allowed during showering. I actually needed very little pain medicine except for sleep, and only a small amount then for a week or so. So 5 weeks later the sling came off revealing a bone and some skin. All musculature from the scapula (shoulder blade) to the elbow was AWOL. Range of motion was nil and painful. Then slow reconditioning started with PT, which was necessary but not enjoyable, gradually establishing passive range of motion, e.g., by pulling the arm up with the other arm using an overhead pulley and scapular stabilization, then slow rebuilding of active motion using stretch bands and ongoing scapular stabilization and various other tricks of the physical therapy trade. At around 11 weeks postop I got into a pool for the first time figuring the water would be useful as a continuously variable resistance mode but it simply did not work for swimming in any way, shape or form, with partial arm recovery (all the shoulder would do) or even no recovery or simply standing and applying gentle shoulder pressure by rotating the torso with the arm in the water. I did not try formal aquatic therapy, but perhaps that would have worked better. At about 13 weeks I was able to start doing some laps, awkwardly and largely one-armed with an underwater slow, incomplete recovery for the affected arm which would still not extend fully overhead. By 20 weeks I was able to get the affected arm out of the water (mostly, with a lot of body roll, some finger drag) during freestyle recovery for 25 meters at a time. The stroke remained VERY slow and VERY deliberate. I got a lot better at balance. Breast stroke was possible, though, because less shoulder abduction is required during arm recovery. Skipping forward, passive and active range of motion did not fully recover until >12 months postop, and while I have a real shoulder again and can do comfortable freestyle and some butterfly it is still not overly flexible. But I am not 30 years old and the injury was severe and a lot of inflammation was seen at surgery, so "actual mileage may vary." My surgeon was careful to explain to me that the shoulder was "refurbished," not like-new, so I (my words) shouldn't be a jerk with it.

What was most surprising to me about the recovery phase was that there was no change in linear slope of the recovery line. With other injuries and surgery after a certain period of misery the time comes when function starts to recover more rapidly. Following this surgery it was a daily grind-it-out recovery of function from the day the sling came off until now, nearly 18 months later when I am still doing shoulder exercises and scapular stabilization at least several times per week. Think 1/3 of a percent or less improvement per day, for the first 12 months or maybe longer. Progress was fairly steady but it was impossible to see except by comparing function to that of 4-6 weeks earlier.

Would I do it again? re: injuring the shoulder I would much rather not!! ;>). So I am trying not to be a jerk with the shoulder, as advised. re: surgery and inherent postop travails, a definite yes!! There was really no choice, I was unable to elevate the arm from my side at all, either in a forward direction or to the side. I would have been forever unable to swim or do anything else useful with my dominant arm.

Hope this is of some help.
Hank

Last edited by Hscovern : 08-21-2017 at 01:32 PM.
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