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  1. #1
    Registered User tk1434's Avatar
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    shoulder impingement - surgery

    Hey guys,

    Last October I ****ed up my shoulder and turned out it was a pretty serious case of shoulder impingement. I have tried cortisone shots, and physical therapy, but I am still unable to lift over a year later. I am thinking about asking my doc for arthroscopic surgery.

    For those of you who have experienced surgery like this, what is the rehab like? How long until able to live daily life normally? Lift again?

    Any tips for going in?
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    Registered User orthodoc's Avatar
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    You can lift legs/cardio right away. Lifts not involving raising your shoulders out to the side (e.g. triceps/biceps) are OK when you're comfortable (usually a couple weeks. I wouldn't let you do overhead lifts for at least 3 months post-op, but that's up to your doc.

    If you end up with a rotator cuff tear repaired then the rehab is a lot slower to allow it to heal . . .
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    Any one else?

    Surgery in May = lifting again in the fall?
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    Physiotherapist Fresch's Avatar
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    Originally Posted by tk1434 View Post
    Hey guys,

    Last October I ****ed up my shoulder and turned out it was a pretty serious case of shoulder impingement. I have tried cortisone shots, and physical therapy, but I am still unable to lift over a year later. I am thinking about asking my doc for arthroscopic surgery.

    For those of you who have experienced surgery like this, what is the rehab like? How long until able to live daily life normally? Lift again?

    Any tips for going in?
    Explain what happened to your shoulder in October please.
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    Registered User TAPPER_II's Avatar
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    I went in for arthroscopic surgery for an impingement and possible rotator cuff tear ten days ago. Since the tear only appeared in a couple of the MRI images and was on the small side the plan was to do the subacromial decompression (for the impingement) and evaluate/repair the rotator cuff once inside. Luckily, the "tear" was an only an artifact on the MRI but the Dr found/shaved a bone spur on my clavicle.

    As far as recovery, the first two days after the surgery were typical. Mostly sleep and pain meds but I was instructed to do some limited movement (pendulum swing, circles, etc) a couple times per day. By the third day I was off pain meds during the day but nights were brutal. The only solace I found was in a Lay-Z-Boy rotating the sling for support pillows.

    My first appointment was 1 week after the surgery. I was cleared to use my arm and ease back into things. As far as returning to lifting, I was told to "listen" to my body. At this point I was still sleeping on the Lay-Z-Boy but not taking pain meds.

    Since then I have probably been overdoing it. With X-Mas approaching I ended up shoveling snow, carrying, lifting, etc and ended up with a constant ache/pain in my shoulder. By noon, just the weight of my arm was enough to get me to call in for meds. (the initial pain meds would have been WAY to potent and I couldn?t deal with the constipation again)The lightweight pain meds are just enough to let me know when I have moved my arm too far, but still reduce the constant ache/pain.

    That brings us up to today. The constant ache/pain has subsided so I have not taken any pain meds and almost have a full range of motion without pain. Any free movement above my arm parallel to the floor still hurts a little, but I can get a full range of movement if assisted. I would bet by the two week point the pain associated with free movement will be gone. Once that happens I?ll work back into lifting.

    The Dr didn?t feel physical therapy was necessary. I didn?t ask why but seeing is my surgery was limited to shaving bone I?m assuming the only thing holding me back is pain and inflammation.
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  6. #6
    Registered User tk1434's Avatar
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    Originally Posted by TAPPER_II View Post
    I went in for arthroscopic surgery for an impingement and possible rotator cuff tear ten days ago. Since the tear only appeared in a couple of the MRI images and was on the small side the plan was to do the subacromial decompression (for the impingement) and evaluate/repair the rotator cuff once inside. Luckily, the "tear" was an only an artifact on the MRI but the Dr found/shaved a bone spur on my clavicle.

    As far as recovery, the first two days after the surgery were typical. Mostly sleep and pain meds but I was instructed to do some limited movement (pendulum swing, circles, etc) a couple times per day. By the third day I was off pain meds during the day but nights were brutal. The only solace I found was in a Lay-Z-Boy rotating the sling for support pillows.

    My first appointment was 1 week after the surgery. I was cleared to use my arm and ease back into things. As far as returning to lifting, I was told to "listen" to my body. At this point I was still sleeping on the Lay-Z-Boy but not taking pain meds.

    Since then I have probably been overdoing it. With X-Mas approaching I ended up shoveling snow, carrying, lifting, etc and ended up with a constant ache/pain in my shoulder. By noon, just the weight of my arm was enough to get me to call in for meds. (the initial pain meds would have been WAY to potent and I couldn?t deal with the constipation again)The lightweight pain meds are just enough to let me know when I have moved my arm too far, but still reduce the constant ache/pain.

    That brings us up to today. The constant ache/pain has subsided so I have not taken any pain meds and almost have a full range of motion without pain. Any free movement above my arm parallel to the floor still hurts a little, but I can get a full range of movement if assisted. I would bet by the two week point the pain associated with free movement will be gone. Once that happens I?ll work back into lifting.

    The Dr didn?t feel physical therapy was necessary. I didn?t ask why but seeing is my surgery was limited to shaving bone I?m assuming the only thing holding me back is pain and inflammation.
    That doesn't seem too bad if it is a couple of weeks. Had you tried prolonged physical therapy before the surgery but it didn't really work? PT has seemed to flatline in my recovery. Minimal scars with the arthroscope right?



    Originally Posted by Fresch View Post
    Explain what happened to your shoulder in October please.
    Well I had been seriously lifting for over a year, and I had pulled a muscle in my back, so I wasn't doing back exercises for a couple weeks. Like an idiot, I upped my chest/tri day to 2x a week with the same intensity, while still doing a shoulder day as well, just to have the same amount of lifting days a week. Even though it was only for like 3 weeks, the imbalance in my routine led to impingement. It was gradual onset, but I didn't think much of it at first, until it really blew up one day and my arm killed me after lifting one day.
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  7. #7
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    Originally posted by: tk1434
    Had you tried prolonged physical therapy before the surgery but it didn't really work?
    I went to PT for about 6 weeks. The stretching helped a lot but they offered me nothing useful beyond that. Looking back, the impingement was getting better with stretching and they were treating the rotator cuff which ended up not being an issue.


    Originally posted by: tk1434
    Minimal scars with the arthroscope right?
    I doubt there will be any highly visible scars which surprises me because I tend to have bad keloid scarring. Right now they look like two small cuts/scratches.
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  8. #8
    Physiotherapist Fresch's Avatar
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    Originally Posted by TAPPER_II View Post
    I went in for arthroscopic surgery for an impingement and possible rotator cuff tear ten days ago. Since the tear only appeared in a couple of the MRI images and was on the small side the plan was to do the subacromial decompression (for the impingement) and evaluate/repair the rotator cuff once inside. Luckily, the "tear" was an only an artifact on the MRI but the Dr found/shaved a bone spur on my clavicle.

    As far as recovery, the first two days after the surgery were typical. Mostly sleep and pain meds but I was instructed to do some limited movement (pendulum swing, circles, etc) a couple times per day. By the third day I was off pain meds during the day but nights were brutal. The only solace I found was in a Lay-Z-Boy rotating the sling for support pillows.

    My first appointment was 1 week after the surgery. I was cleared to use my arm and ease back into things. As far as returning to lifting, I was told to "listen" to my body. At this point I was still sleeping on the Lay-Z-Boy but not taking pain meds.

    Since then I have probably been overdoing it. With X-Mas approaching I ended up shoveling snow, carrying, lifting, etc and ended up with a constant ache/pain in my shoulder. By noon, just the weight of my arm was enough to get me to call in for meds. (the initial pain meds would have been WAY to potent and I couldn?t deal with the constipation again)The lightweight pain meds are just enough to let me know when I have moved my arm too far, but still reduce the constant ache/pain.

    That brings us up to today. The constant ache/pain has subsided so I have not taken any pain meds and almost have a full range of motion without pain. Any free movement above my arm parallel to the floor still hurts a little, but I can get a full range of movement if assisted. I would bet by the two week point the pain associated with free movement will be gone. Once that happens I?ll work back into lifting.

    The Dr didn?t feel physical therapy was necessary. I didn?t ask why but seeing is my surgery was limited to shaving bone I?m assuming the only thing holding me back is pain and inflammation.
    The doctor obviously feels that he will perform the whole cure himself with the surgery. Too much of an ego. If you had impingement before the surgery, what has done to correct the biomechanical problem? Shaving the acromion only relieves a symptom.

    Shoulder surgery should have a guided rehab program, as the results without it are frequently poor.
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  9. #9
    Physiotherapist Fresch's Avatar
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    OP: 3 weeks of unbalanced lifting should not be the cause of sustained problems. And what would the surgery be "fixing"?

    Sounds like your rehab has been ineffectual, did it include work on stabilising your scapula and posture work?
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    Originally posted by: Fresch
    The doctor obviously feels that he will perform the whole cure himself with the surgery. Too much of an ego. If you had impingement before the surgery, what has done to correct the biomechanical problem? Shaving the acromion only relieves a symptom.

    I can?t speak for the Dr, however, IMO the biomechanical problem before the surgery was poor form combined with heavy weights. Since I know when the injury occurred and what most likely caused it, relieving the symptom was exactly what I required.

    As far as the ego, I have several Dr?s in the family and know many more. They all have ego issues and the more talented the Dr, the larger the ego.
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  11. #11
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    Originally Posted by Fresch View Post
    OP: 3 weeks of unbalanced lifting should not be the cause of sustained problems. And what would the surgery be "fixing"?

    Sounds like your rehab has been ineffectual, did it include work on stabilising your scapula and posture work?
    Yeah that's what I was thinking, I see people week in and week out just doing chest and biceps on end... so I wasn't sure whether the few weeks could have done it.

    The rehab was focused on stretching my chest, and tightening/working my upper back and scapular muscles. It helped to a degree, but it started to flatline after awhile and it still hurts when under too much stress and I can't lift at all.

    I assume the surgery would be to shave some bone off the acromion, get rid of any spurs, and fix up any partial tears if they are there. I have my appointment on Monday.
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    I doubt that 3 weeks of poor lifting would cause that much damage.

    It is most likely an impingement due to inflexibility and poor posture, and the training period mentioned just finaly tipped the scales.

    The rehab sounds like it was on the right path, hard to say why it did not succeed. I would not imagine you have any structural damage.
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    In case your interested TK, I was able to lift for the first time last night. I worked back & bi?s @ about 50% of the normal intensity. Although sore overall today, my shoulder feels great and I hope to ease into benching tomorrow night.
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    Had my appt today. Will be getting arthroscopic surgery mid-May when I am home from college for the summer. If he finds a labral tear, month in a sling and then rehab. If not, he said sling at my own discretion and rehab.

    Did not mention about finding tendon tears in my cuff, but I guess its understood that any partial tears will be repaired while in there?
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