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Rotator Cuff Recovery

 Poster: A snowHead
Poster: A snowHead
Hello Snowheads,

After 18 weeks on snow I picked up my first injury annoyingly indoors up at MK 3 weeks ago. Fell onto an outstretched arm and had pain straight away, a+e reckoned a grade 2 ac joint injury and the doctor at the fracture clinic thinks it's rotator cuff injury. Been referred for physio for the time being to see how it goes. Have any of you got any experience recovering with this type of injury conservatively?
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 Obviously A snowHead isn't a real person
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My very non medical advice would be to keep it moving as much as you feel you can. I fractured the humeral head and tore my rotator cuff last December. It resulted in a frozen shoulder and i still have limited mobility with it.

I did manage to ski last season with the help of a couple of steroid injections.... but we warned, they hurt like hell!
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@mooreski,
I suppose it depends on just how the rotator cuff is damaged. I have Slap tears in both shoulders as a result of climbing. I could not face the surgery normally associated with repairing this. I am old.

Good physio exercises got me back to climbing. I learned from shoulder 1 where my following my GP advice of rest, I suffered severe muscle wastage. Shoulder 2 and I was straight into physio. Gradual increase in range of movement of the joint, followed by increasing theraband exercises produced a pretty good outcome.

My shoulders sound like a bowl of rice crispies, but so long as I am gradual in my approach to strength and mobility improvements things remain manageable. I still can't get beyond 8 pull ups/chins without breaking down though!
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@mooreski, Go and see a good physio, even if it's private and costly. I did similar a few years ago, suffered for a couple of months, then went to a great physio, about 3 sessions, huge improvement, and probably another month later no issues.
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Thanks for all your advice so far @RichClark, @HammondR, @srobbo.

The extent of the tear is all but unknown, doc has said try for physio and if that is no good further tests (assuming mri/ultrasound). Iíll be looking up some physio first thing in that case, NHS wait is a bit longer than I had imagined. I couldnít do chin ups before so Iím not too fussed...
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When I had a Rotator Cuff injury, which wasn't very serious, I did specific exercises like:

- External shoulder rotation

http://youtube.com/v/tijDtTzNdu8

- Internal rotation

http://youtube.com/v/HgRgAioWb2E

Upright rotation

http://youtube.com/v/jQ4TKUEVDoc


Check out other rotator cuff exercises and stretches as well.
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@mooreski, one word of caution. If you are nails, disregard this post.

Having a shoulder scan isn't like knees and such like. Because the shoulder is such a complex joint, huge amounts of discomfort/searing pain must be inflicted on the patient. A gigantic needle is stuck right into the joint and some fluid is injected in which makes the scan result clearer.

In spite of being 100% unreconstructed Northern, I am not having that again.
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@mooreski, before I start, I am not a physio or doctor or anything like that. It will probably take about 3 months to get from your GP, through triage and to an actual physio. Donít wait this long to start using your arm, or it will seize up. Try and keep it moving, lifting small things, whatever you can manage.

@HammondR, that does not sound like fun Shocked
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Hello @mooreski, snowHead

There are 3 key steps to rotater cuff recovery:

1. Stretching
2. Stretching
3. Stretching

These are my top 3 stretches - worked for me... (same geezer as above but I much prefer cable machines for these types of things)


http://youtube.com/v/I1DtikA6KGw


http://youtube.com/v/N4b4KIPUpeo


http://youtube.com/v/T_WCU7wjn4Y
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Just to add to what @red 27, said....I found Trigger Point/Myofascial Release with a tennis ball, also helped. A bit of Googling will point you in the right direction. If in doubt a good physical therapist who uses it, will show you.
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@mooreski, I've had both and the symptoms are very different. I'm surprised you have got two conflicting diagnoses. An AC joint sprain is primarily a skeletal injury (ligament) whilst a rotator cuff injury is muscular (tendon).

Therefore if it's AC, you will have no loss of strength in the joint but it will click/pop/grind in certain (most) movement planes and may well be excruciatingly painful if you do the 'wrong thing'. You almost certainly will not be able to lie on it without pain.

A rotator cuff injury (if not completely torn) will ache but will not grind or click. Moving your arm will feel specifically weak in one plane of movement but fine in other planes depending on which rotator is damaged. If it's completely torn you will have no more than a few inches of movement and it needs surgery.

An AC joint responds well to stretching (which reduces the strain on the ligament) followed by a gradual increase in load bearing exercises. Be careful not to aggravate the weakest plane of movement.

A rotator cuff needs to be rested initially (2 weeks) to be sure that you don't tear it completely followed by isometric exercises and then a fairly rapid increase in load bearing exercises. After 3-4 weeks you should work it to fatigue 2-3 times a day.

I would expect to fix a rotator cuff completely in 6 weeks but a Grade 2-3 AC joint is 6-12 weeks depending on the severity.

Disclaimer: Not qualified to offer advice except through experience. 34 dislocations and 3 reconstructions.
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@red 27, 2 out of the 3 videos you've posted are not stretches, they're load bearing strength training. They're also specific external rotator exercises for the infraspinatus. That's fine if that's the rotator cuff part that's injured but no use at all if the injury is to the supraspinatus or subscapularis.

I'm not trying to be clever, just making the point that for a rotator cuff injury, the exercise must address the specific movement weakness - internal, external or lateral.

For rehab, it's best to do a series of reps that address all three planes of movement as it will soon become clear which is the weak point. Same as anywhere else on the body, shoulder injuries are often caused/aggravated by an imbalance between the muscles. Focus on the weak point and when all three planes have similar strength levels, the rehab is finished.


Last edited by And love to help out and answer questions and of course, read each other's snow reports. on Sun 22-10-17 22:37; edited 1 time in total
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i"m a postman and after 30 years of carrying a sack on one shoulder it finally succombed to a rotator cuff injury, royal mail sent me to a very good physiopherapist, in fact he looks after a very well known golfer, and all he gave me was a popped balloon and showed me a few stretching exercises with it, after the six week course was up he was quite happy to send me back to work, although this happened 8 years ago i have recently been diagnosed with osteoarthritus in the same shoulder joint.
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Thanks for the videos @old Fartbag and @red 27 I'll certainty give them a go once I've seen the physio! @HammonR maybe I won't request a scan in that case 😂

@scarlet Pretty much spot on with your estimate 12 weeks from injury day is my first physio but in the meantime will be going through work and if not private! Can't wait that long till I'm active again! A popped ballon @composter glad to see they've not gone to high tech.

Not the best to get to conflicting opinions @raceplate although the doc thinks the AC joint was a old injury which I never noticed about! Although I'm sure the bump on ,y shoulder wasn't quite as large before...
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Moorski I can only reiterate the advice to get some physio asap. On March 16th I fell skiing and dislocated my shoulder. To cut a long story short it was diagnosed and put back within a couple of hours without too much pain. I was recommended to see an orthopaedic surgeon on my return to the uk. Went to my GP immediately (mistake should have gone to A&E), 3 weeks to get appointment at hospital, 6weeks to get MRI, (not a painful process) eventually saw Consultant on 6th June which was nearly 12 weeks later. In all of this time i lost nearly all range of movement and strength in my shoulder. Consultant wanted RoM back before any operation so arranged physio. Three weeks later I got NHS physio appointment!!!
I didnít wait and arranged private physio through my insurance and wish i had done it straight away. It took another 12 weeks to regain 95% RoM. The physio excercises were painful but she said ďits good painĒ and I agree. Even now when my shoulder hurts I do some strengthening exercises and the pain eases. Iím still waiting for surgery to repair the shoulder.
As an aside. When I fell off my bike three years ago into the other shoulder it took 18 months to recover pain free without help.
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 Poster: A snowHead
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@mooreski, I suspect that the popped balloon was actually a theraband - they're worth having, start with red and then work up to green.



I had to work though these initially, because of the fracture there was very little that I can do.





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@kevinraine, Fairly similar story. I was knocked over in Les Arcs and fairly quickly x rayed and the shoulder put back in. The doctor in Les Arcs reccomended that I see a surgeon in Grenoble because he suspected the rotor cuff rupture. I delayed and saw my GP when I got back home. He referred me immediately to the local hospital and I got an appointment in a couple of days and booked in for surgery a week later to reattach the 2 torn tendons. Apparently it was classed as trauma so went straight to the top of the queue; no doubt pushing a couple hip replacements further back. Physio started 6 weeks later with a weekly visit to the local hospital. The next 6 months were incredibly painfull but now the shoulder has full range of movement and back completely normal.

When I went through a similar procedure a couple years later for a grade IV AC seperation on the other shoulder the surgeon couldn't restrain his laughter when he saw the screws fromthe rotor cuff repair while trying to compare shoulders. This time they waited 6 months to see what function was recoverd without operating. In the end the operation was less painful that the rotator cuff repair and though it still doesn't feel "right" I have full range of movement and strength.

The physios at the hospital were good and I just followed their instructions.
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I've had a slap repair on one shoulder and a rotator cuff on the other. You can do all the stretching you like and its important you do but your body wont release the shoulder fully and properly until its ready. Don't rush any recovery because no matter how tight your shoulder feels after surgery if you stretch like your physio tells you it'll come back to near perfect. Patience is a virtue with shoulders!
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Thanks for all the info! As a bit of an update the DR's have diagnosed a non-tender prominence to the ac joint and weakness of supraspinatus and subscapularis in the rotator cuff. Pretty much full range of motion and just working on building up strength. Back skiing and maybe racing soon (I'll try and stay upright next time Very Happy ).
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mooreski wrote:
weakness of supraspinatus and subscapularis in the rotator cuff. Pretty much full range of motion and just working on building up strength. Back skiing and maybe racing soon
You can fix that extremely quickly just by doing overhead lifts and lateral raises with adjustable dumbells 2-3 times/day. Build up to 3 sets of 10 reps at 5kg and you're done. 20 reps even better. No reason not to ski now - rotator cuff strain isn't going to affect anything except your subconscious.
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@mooreski,

Sorry to hear of your injury.

How certain are you that the diagnosis is correct?

Did you see a shoulder specialist, a junior doctor or did they scan you?

Cuff tears may take months to settle. So you want to be sure they are correct. Did they scan you ( ultrasound or possibly mri)
A lot of time ( and money) can be wasted on a treatment if the diagnosis is incorrect.

Jonathan Bell
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Damaged my left rotator cuff in March this year. Partial tear as I could pass the drop test. Some physio but mostly gentle exercise and lots of swimming.

November and I am about 90 % recovered. Full movement but still some pain.

70 year old living full time on a boat.
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