Getting ready to Fix the Rotator Cuff

[Guest]

I need surgery on my rotator cuff as determined by two different orthopedic doctors. I don't know if it's been building up from work, swimming or waterskiing but I want the surgery as soon as possible so that I can get back in and on the water. I'm wondering how long from surgery to ski did it take some on you. Has anyone had this surgery and used stem cells to increase the healing rate?

I'm a small 67 year old woman who refuses to give in.

[Rednucleus]

Welcome to BOS. I have not had rotator, but have had a torn labrum repair and a biceps tenodesis 13 years apart. Both required 8 wks in a sling; was skiing again in about 4 months. Lots of PT will be your friend! Re stem cells - no proven science out there that says it will improve healing - plus it will not be covered by insurance.

[Bruce_Butterfield]

I'm 59 and in recovery on my second rotator cuff. The first was 6 wks in a sling, then PT and 6 months to semi-normal activity (skiing). Slow and easy to start, about 9 months to feeling pretty "normal" and a year to full strength. After 3 months, the second shoulder seems to be pretty much on the same pace.

 

The surgery and recovery does suck, but the long term result is well worth it.

[skiinxs]

I have had rotator cuff and Labrum repair surgery twice on each shoulder several years apart. Find the best surgeon you can, make sure they scope. Many times the physical therapists know who the good surgeons are because they see the results of many. Your PT will be at least as important as the surgeon. If you don't work really hard, it will never come back 100%. Each of mine was a great success until I tore them up again years later. Right now both shoulders are 100% from the second surgeries. I was skiing at 6 months on each, really solid at 9 months, and 100% at 12 months. Although I have had over 20 PRP's and am a strong advocate I have never added stem cell, which should be even better. They can add PRP during the surgery directly where needed, but I never had it done due to the surgeries being done at a hospital. PRP at my surgeons office is $600, but with the absurd hospital markup would have been around$10,000. A little out of reason due to being out of pocket.

[OTF]

I just had Rotator Cuff, Labrum, biceps tendonesis and my collar bones re-attached to my shoulder blade.

My surgery was June 9th.

8 weeks in an immobilizer

Pain wasn’t too bad but barely sleeping for 10-11 weeks as im a side/ stomach sleeper and there was not a way to do that for almost 12 weeks really took a toll

on my attitude.

Lots and lots of ice and massaging.

Luckily I’m Self employed and always put myself first in terms of recovery, work often had to wait.

As @Rednucleus said lots of PT will be your only way to a positive other side. I did mine religiously 2 times a day at home for about 35 minutes a session and 1 60 minute session a week with a physical therapist.

It took about 3-3-1/2 months to get back to 100% range of motion and flexibility and that was often more painful than the surgery. At the 6mo mark I’m at about 60% of my previous strength. I’ve been cleared to go back to regular workouts but that last 40% of strength will likely take 6 more months.

I have a skiing trip planned for the end of March 2022. I don’t expect it to be very good skiing as I missed all last season pre surgery.

 

Best Wishes and Good luck.

[lsmisko]

Thank you, we'll see how it goes but I was hoping to be on the water by next summer so maybe I will!

 

[Rednucleus]

@lsmisko I hope to see you posting pics this fall when you are back on the water! Keep us posted on your post op journey.

[ctorthopa13]

First off sorry you have to go through surgery.

 

I cannot only tell you as someone who had gone through rotator cuff repair surgery I am also a PA who specializes in orthopedic surgery.

 

Couple of things to keep in mind usually there are two approaches to doing a rotator cuff repair. One totally arthroscopically and mini open repair.

 

Typically if you have a bone spur present those will be shaved down and then repair of the rotator cuff tendon. If it is a full thickness tear typically you will require suture anchors to place that tendon back in the position on to the Proximal humerus.

 

There are a lot of factors how many rotator cuff tendons are torn? Remember there are a total of four rotator cuff tendons in the shoulder. The most commonly torn tendon is the supraspinatus which allows for forward flexion and lateral elevation.

 

Depending on your surgeons approach to recovery you are typically in a sling from 4 to 6 weeks with passive range of motion only during that period of time.

 

Then active assist to active range of motion proceeds with formal physical therapy. Followed by strengthening.

 

I can tell you from personal experience I had a rotator cuff repair done three years ago towards the end of October and I was back on the water by mid April.

 

As far as stem cells go there’s no significant literature that it will speed recovery. However regeneten grafting is an option for retracted rotator cuff tears. For which we use in our practice.

 

https://www.smith-nephew.com/professional/products/all-products/regeneten-/

 

(please note the above content is not as medical advice it is merely editorial)

 

Good luck! And a speedy recovery.

 

Brian

 

 

[MrJones]

Okay. I'm a PT who has not seen you in person. Take this with for what it's worth.

 

Your healing time will depend on several things. Numbers one and two being how large the tear is and how long it's been there. Your doc should have a reasonable feel for this from your MRI and physical exam.

 

You are not going to heal nearly as well at 67 as at 27. Not that it won't, but you will need to be patient. Being super active helps. Hopefully your overall health is good, don't smoke, etc.

 

As for the stem cells, I do not seen them used in RC repair in my practice setting. I'm sure they are in certain situations, but in my opinion they might make a low single digit difference in your healing. If you don't mind the cost it's not going to hurt.

 

You will be better after the repair in the long run. It's also better to fix it sooner than to wait until it's really gone and it might not be able to have it fixed at all.

 

Good luck

 

[lsmisko]

Thank you PT's for your insight. I really appreciate the details and the confirmation of what I've been told and read about. I actually have a torn Labroligamentous and not the subscapularis (if I'm reading all of this correctly). It does need suture anchors. I am very happy with my fitness and level of health which is why this is so disheartening, at my age I feel like I'll have to crawl back up the hill to get to the spot where I left off. I don't want to wait another minute, summer is coming. Again, thank you for your insight, it's really very helpful.

[lsmisko]

Again, thank you all for sharing your experiences. Looks like I'm in for a rough couple of months. I'll get there.

 

[Rednucleus]

Probably more annoying than rough - both times I was back to work in 2 wks but hassle of the sling for 8 weeks made my veterinary work a bit of a challenge. Pretty comfortable after a week except for sleeping.

[skierjp]

8 weeks in a Sling and oh by the way, don’t plan on sleeping in your flat bed until roughly 8 weeks. Find a good chair or get a adjustable bed. Lots and lots of PT on your own time. 3 times a day. Along with PT visits.

Make sure you get the ice pump / shoulder wrap to get you off the pain killers. After the first week you will be good.

My ruptured Achilles was way worse. In fact if I new I would rupture it again I’d quit skiing.

[skierjp]

Also, take a video of your skiing or of someone else or even YouTube and maybe even a good crash. The DR probably thinks you’re riding along on 2 skis. Also show the same videos to you PT.

[DangerBoy]

Please take a look at this thread:

I had a bona fide torn supraspinatus rotator cuff tendon/muscle. Could see the tear plain as day on the ultrasound and could certainly feel it every time I engaged the muscle in any type of movement. Conventional forms of physiotherapy don't work very well on that type of injury because they all work by trying to stimulate more blood flow to the injury site in order to bring the proteins and other things needed for healing to the injury site. That doesn't work for the Supraspinatus and probably other rotator cuff injuries because it/they have very, very low/restricted blood flow. That's why they never seem to heal on their own and why most forms of physiotherapy are largely ineffective on those types of injuries.The thread will tell you what type of therapy I received and explains why it was successful in completely healing the injury in a very short period of time. That information may help you avoid having to get surgery in the first place, or, if surgery is absolutely necessary, it will help you recover much faster from it.P.S. I have since sent several friends who have lived for years with nagging, seemingly unhealable rotator cuff injuries to get the same treatment. No one had quite the amazingly quick results I had (I was an exceptional case apparently) but they all report having far more and better results much quicker than they ever had with literally years conventional physiotherapy. I got that treatment back in 2012 or 13 when I was 51 or 52 and have never had a problem with that muscle/tendon or any other rotator cuff muscle since.

 

[boscoman]

Interesting study of all kinds of orthopedic surgery including rotator cuff in the British Medical Journal.

https://www.bmj.com/content/374/bmj.n1511

 

 

[drmadd]

Yikes - Good information here and really interesting. My question is, what the heck were you folks doing to trash your shoulders? Give me a tip how not to do so. Best of luck .

 

[DangerBoy]

Rotator cuff tears and injuries are super common in folks over 40. Throw a ball when your arm's not warmed up enough, whatever. It just happens. I think I hurt mine doing a little weight lifting.I'm sure happy the Class IV laser fixed my injury and I've never had another rotator cuff injury since. If it ever happens again I'll immediately get over to see that guy and get him to zap me with that Class IV heal-o-matic gun of his again.

 

 

[jeblanc]

@

lsmisko

- Best of luck to you. I broke my ankle on July 4th and had to have two screws put in to repair it. By the time I was cleared to ski we had to winterize the boat ): I definitely second what @

Rednucleus

said, PT is your friend.

 

[DFWskier]

January 24, 2020 operation, June 26 on the water. No tournaments, no 34 gates. Back into 34 -28 in 2021. I was very conservative and i highly recommend it to you.