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Rotator cuff shoulder injury - how long to come right?

 Poster: A snowHead
Poster: A snowHead
Any advice on rotator cuff injury hugely appreciated.

As is the case I suspect, for many of my vintage (59) who suffer this injury, it came out of nowhere and for no decent reason or event. Just wear and tear and age as far as I can make out. It can be gawdawful painful if I hold my arm up the wrong way.

I want to do a week's touring in the Monte Rosa in mid-March 2016 and another out of Arolla in early April (already booked and deposit paid along with flights).
Worryingly, the April one involves crevasse rescue training etc and at the moment at times I can barely lift my arm above my head.

I've checked the Net for physio exercises etc but would also like the reassurance of consulting the collective sH's Brain to hear of any first hand experience of recovery exercises and time taken to get back full use.
I was doing a lot of Pilates and Yoga before this problem came along and have continued with them as best I can. However, they aren't having much effect on it and in fact, I think yoga might be making it worse.

Many thanks.
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@Big Paua, sorry to hear about the injury. My Mum tore her rotator cuff tripping on a stair in April. She did lots of exercises, but when referred to the surgeon he said there was no alternative but surgery. She had the op 6 weeks ago and is attending regular physio. She has just been allowed to remove the sling this week. I think a consultation with a physiotherapist at the very least would be a good idea. He/SHe will asses the damage and give you appropriate exercises.
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@Big Paua, I had surgery after trying to treat it conservatively for 7 months. The surgery was in August 2014 and I was skiing again (carefully) in December 2014. It still isn't right but I'm not very conscientious about my mobility exercises due to work. I've given up paragliding as I have a noticeable lag in the ability to raise my arm above shoulder height and of course a big difference in the strength. Mine was a full tear (initially a partial one) of the Supraspinatis tendon as well as the biceps tendon. The Spuraspinatus was the one that gave way in the end and made surgery unavoidable. It was my dominant arm by the way.
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I suffer this and now tug a Theraband around for five minutes every morning. Took perhaps 6-8 weeks to notice a difference but, so long as I keep it up, this seems to keep it in check.

https://www.google.co.uk/#q=theraband+rotator+cuff+exercises
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Quote:

Mine was a full tear (initially a partial one) of the Supraspinatis tendon as well as the biceps tendon. The Spuraspinatus was the one that gave way in the end and made surgery unavoidable

@Samerberg Sue, exactly the same as my Mum, although the surgeon did have to sort out the biceps during the op too.
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Aaah - not at all the news I wanted to hear but nevertheless thanks to all for coming back so quickly. To hear of first hand experience is so helpful.
Will follow altis' example (thanks for the link) and see how long that and hope can hold off the surgery.
Here's to a great season to you all.
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Then you can post your own questions or snow reports...
Swimming?
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After all it is free Go on u know u want to!
@Big Paua, get a really good clear diagnosis and make sure you are referred to a surgeon who specialises in shoulder injuries. My guy wanted to avoid surgery, not because of my age (a wee bit older than you), but because the surgery is not always successful. As soon as the Supraspinatus went it was sadly inevitable as I was unable to raise my left arm above waist height and I'm 100% left-handed. I was off work for nearly 2 months while I had intensive physio (daily for up to 8 hours a day doing various activities and treatments) and then I worked from home for a further 2 months while doing physio 3 days a week. This was in Germany by the way and covered by my normal state health insurance.
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My Mum's surgeon was a very well-respected shoulder specialist. All done on NHS.
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@Big Paua, My brother and I have both had this injury - through old age, gym & golf combo and both took about 12 months to recover...

BUT, only 3 months after stopping trying to be 'ard about it, and doing the physio recommended stretching and gentle gym exercises.

Surgery is to be avoided
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@Big Paua, this might give you a bit of hope if you're willing to work at it...

My supraspinatus tendon is completely torn in my right shoulder, caused by an anterior impact shoulder dislocation that I relocated myself about 5 years ago. The tendon tore a couple of days later. I did all my own rehab using therabands and 5kg dumbells over 3-6 months because I was out of work with no health insurance. It was very intensive - a full set of exercises at least 4-5 times a day, every day. The object is to work it to complete fatigue level every time. As soon as the fatigue eases, do them again. The exercise caused scar tissue to form in the gap between the two ends of the supraspinatus and assume its function. I went from not being able to pull the lightest weight theraband any more than about 12 inches away from my side to snapping it in two above my head within about 12 weeks.

I had completely normal shoulder strength, mobility and stability within 6 months of the original injury. The only 'problem' is that it clicks when raising the arm in the coronal plane above 90 degrees. Apparently this is because the scar tissue is 15mm thick whereas the original tendon is only 2-3mm thick and this displaces the collarbone slightly in that movement. It's nothing.

I saw a specialist about the clicking 2 years after the original injury out of curiosity. He had already planned a complete shoulder op based on the MRI to repair the tendon until he physically examined me. He was amazed that I could even lift my arm up, let alone resist him pushing against it. He then told me that he'd never seen complete recovery before in over 20 years of shoulder surgery and asked my permission to use me as a case note when teaching his students as to why you have to, "operate on people, not MRI's" Very Happy

I suspect the real reality is he'd never seen anyone daft enough to leave it 2 years before seeing a specialist but those were my circumstances at the time. BTW, I have a bit of knowledge about shoulder rehab because my left shoulder has dislocated 30 times. That one took 15 years and 2 operations with an advance in surgery techniques to stabilize... wink

Good luck.
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And love to help out and answer questions and of course, read each other's snow reports.
First is to get it diagnosed properly. I saw a good physio and he gave me a course of exercises with bands. Plus I swim loads which helped, but it still took time and at times still aches two years later but doesn't stop me doing most things. That said, I don't play squash !

Judging by the experiences above though I think I got off quite lightly
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I would second the advice to see a good physio, and be disciplined with the regular rehab exercises and then gradually build up the strength.

I damaged my rotator cuff around 18 months ago while climbing and delayed seeing a doctor (and phyiso) for a few months to see if it would get better on its own, as seeing a doctor is generally something to be avoided if possible in my line of work. After eventually admitting defeat and getting a referral the physio was extremely helpful and the injury showed small but steady progress over about 6 months until it was barely a concern any more. Low impact but very regular physio and exercise really helped.

This summer I rather foolishly tried waterskiing for the first time; the skis came free with the speedboat we hired and common sense has never been a strong point, so after 5 minutes of boat driving instruction for my wife I gave it a go. How hard could it possibly be anyway? Wink

It turns out that it is both much harder than it looks and also quite tough on your shoulders so after the slow speed syncronised drowning exercise, my shoulder was pretty much back to square one and quite painful again.

I have since been re-doing all the physio recommended exercises and have built up to gentle weights and lots of rowing etc. I have found that as long as I keep up the very regular exercise for the joint and build up the strength slowly it has made a real difference. It now barely troubles me at all. Obviously, mine was a relatively minor injury in the first place compared to some, but I just wanted to offer some hope for the rehab! The physio may take a long time to show results but for me at least it really worked.
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You know it makes sense.
I would definitely go the proper diagnosis route first, and not necessarily just a physio. My own symptoms were remarkably similar (first world problem - couldn't lift my briefcase onto the top shelf on the train!) but after MRI was diagnosed as 'impingement' of the tendon due to bits of bone expanding and squeezing on the tendon. Incredibly painful but after diagnosis advised further exercise (squash) was not a problem but would eventually need a procedure to open the gap and make space ( not totally relevent but my consultant, as a skier, was insistent on timing this to optimise my skiing season ). He said I would be ok in 6 weeks. After 4 weeks my movement was still very limited but stuck with the physio and hit squash balls gently 6 weeks to the day. 2 weeks later playing full on (other than the slight stamina issue). 3 years later completely pain free. Don't just dismiss the knife. Physio may be the answer but if you don't know what it is ......
Ps similar vintage so share your pain!
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Big Paua, injury to the rotator cuff is potentially serious.
Like others here, i presume you have seen a shoulder specialist to properly confirm the diagnosis - if not, then organise seeing one immediately.
And then ask him/her to answer the question you pose at the top of this thread.

Please note: a shoulder specialist, preferably one with in interest in sports injuries.
Do not put up with a general orthopaedic surgeon "with an interest in shoulders". Not good enough.
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 Poster: A snowHead
Poster: A snowHead
Definitely get it looked at by a specialist. Could be a tear, could need strengthening of the surrounding muscles to hold the joint correctly.

I have always had trouble with my shoulders and they can take a while to rehabilitate, depending on what you have done to it. Sometimes surgery is a practical option. No matter what dont rush the recovery exercises and push it along or do things you shouldnt, you will just overstress the area and its back to square one, but with perseverance it will come right

Once diagnosed and you need a physio if you are in London you could try this lot http://www.bimalmedical.com/ . I used them but some years ago when run/owned by a sports physio called Alan Watson. Dont know if he is still there but the company is still around.

Good luck with it
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Would echo the shoulder specialist/sports injury specialist. Happily recommend my surgeon at New Vic in Kingston and these are both his areas of expertise. PM me if you want details.
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I had similar .... started about a year ago .... don't know how or why but I was playing a fair bit of golf but don't remember any specific event that started it. Went to doctor and physio .... both considered it likely to be partial tear of rotator cuff .... no further investigations .... lots of exercises, less golf and started doing a fair bit of swimming which definitely helped.
I do a lot of sport .... it is my left shoulder and I'm right handed so probably does suggest more likely to be caused by golf. I could still play squash and tennis ..... but in the first 3 or 4 months any sharp twisting movements jolted the shoulder and it was so painful that I had to stop playing for a few minutes to let it calm down. Serving in tennis was really hard as I couldn't toss the ball up properly.
I went skiing a couple of trips last year and it was fine - no radical stuff and fairly careful pole plants .... but not touring or climbing.
12 months on .... it's still aches a fair bit but no sharp pains now (they stopped after 6 months say) I'm playing golf regularly but not as well and squash and tennis are fine.
Planning ski trips and some touring this winter and not worrying about the shoulder at all.
Lots of stuff I read about frozen shoulder and other related similar conditions .... most suggested at least 12 months with distinct phases of a real painful period followed by aches and increasing mobility and full recovery after at least 12 months.
Good luck .... it does get better.
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Thanks all!

Lots of helpful replies and different experiences here to mull over.

I guess like some of you above (Red27), I've been trying the "wait and see and maybe it'll go away approach" otherwise known as HIS (head in sand). Summing up your collective advice, I need to stop that straight away and get some expert opinion especially if I'm to get a March tour in.


Thanks for the link ster. Looks hopeful.

@stevios, I seem to be having difficulty PMing you for your specialist's details - maybe you could try PMing me? Thanks for the offer.
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You're welcome.

It won't just go away so don't delay getting it seen to, as it really can take a while to properly recuperate.
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I have a mild rotator cuff problem due to serving a hard spinning ball in tennis . . .regularly pings with pain but I have been putting up with it. Saw a sports injury fitness specialist (for another problem, my achillies and calf) and he recommended gentle weights, starting with a tin of baked beans. Affected arm positioned outward with the elbow parallel to the shoulder - then lift arm in front of you from downward (pointing to floor) up to parallel position, hold, then from parallel to upright (ensure right angle between shoulder, elbow and arm) hold, and down again - repeat until you cry etc . . .

Absolutely killed to begin with, however slowly getting stronger . . .refuse to serve underarm!
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I believe that there are 4 different places that can be classified as rotator cuff tears. If it affects the biceps then you would have a droopy arm and would know that it needs surgical attention. The other 3 seem to be less serious- the doc and physio seem to think mine is no problem at all...........?!
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I had a lot of problems for about 10 years after a rotator cuff injury. It wasn't bad enough to justify surgery but was a constant irritation. Eventually I took the bull by the horns and started training with kettlebells. It was painful and nothing improved until one day I felt a ripping sensation. Whatever scar tissue which had been gumming things up tore loose. In the weeks that followed I kept exercising but with much smaller weights and it healed up fine. No problems since.
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@Big Paua, how's it coming on?
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@Big Paua,

I think you need a bit more clarity on a diagnosis before you get advice on treatment.

Otherwise you'll just get anecdotal advice on worked for other people's diagnosis.

Ideally see a shoulder specialist. Get a diagnosis. Work on the rehab program you are given that is tailored to your problem .
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Went skiing a few weeks ago and had a minor crash.

Felt a bit bruised the next day and thought nothing of it.

When I got home I realised the pain was not going away

I self diagnosed a very slight RC tear, based on slight pain only when raising arm up high but no loss or range of movement.

I have full range of movement and strength is good but after 6 weeks of no sport(maybe mistakenly trying to protect it?)and taking a fair few Ibroprofen it seems to have settled down.

I stopped taking the Ibruprofen and I felt the pain come back but not as bad as the first couple of weeks. Not bad during the day but a dull annoying ache and uncomfortableness at night.

Im off skiing again at the weekend and I cant see it bothering me as long as I dose myself up a bit more.

When I get back I will have to have a rethink, maybe see a specialist and a physio.

A was think it would right itself after a few weeks, but from reading some of the ^^^ I may have to be more patient. Sad
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And love to help out and answer questions and of course, read each other's snow reports.
@hedley, Stretching is the key
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@hedley, my friend had fall two weeks ago tomorrow, to be fair I wouldn't have called it a "minor crash" but he did ski some of the rest of the week and drove the hire car back to Geneva. He has just been to see the author of this paper and he has an undisplaced fracture of the greater tuberosity as described. Judging by your location you can easily get to see him as he is based in the NW.
https://www.shoulderdoc.co.uk/article/1482
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