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Rotator Cuff Tear

 Poster: A snowHead
Poster: A snowHead
Hello all!

I am a seasonaire who has recently found out that I have torn my rotator cuff from a fall I had off piste last March. I am about to undergo surgery next week and I was wondering if anyone else has experienced a similar injury from skiing and what their recovery time was after surgery?

All being well its me intension to get back on the slopes at the start of December for my next season. However am I being unrealistic?
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
You don't ski predominantly with your shoulder do you? Rehab rehab rehab. IANAD.
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daveg481,
Hi , I did that in Feb. 2009. also dislocation of shoulder and 17 fractures of upper arm . Had surgery in Austria where I had a shoulder replacement .(inserted a steel ball and socket)
it took me 12 months to get over it , but did ski a little this past winter. (2 days,But very nervous and slow) I bought a book which I found very good from Amazon "Treat your own rotator cuff" by Jim Johnson
did the exercises in the book for a year. Now 18 months ater and feeling good. I will be back skiing again this winter.
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Surgery? Don't do it... Or maybe, I don't know. Seriously, have you looked at all the alternatives? Who's the surgeon?

fatbob, said it rehab = skiing will be no issue this year.

FWIW my brother-in-law has had the surgery and play rugby with no issue. It's not game over.
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 Anyway, snowHeads is much more fun if you do.
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Many Thanks for your feedback guys.

Byron Gates, That sounds horrendous. Sorry to hear you had such a horrific injury Sad ! Glad to hear that you have recovered though Smile

Thankfully I have only completly torn a tendon in the Rotator cuff (no dislocation or fractures) but hence why i need surgery. However id like to think my rehab will not be as long as yours.

parlor, I am told that with a complete tear there is no alternative other than surgery. My surgeon is through my local NHS, I have to say I have been impressed with the timespan: 4 weeks from my first visit to my surgery date with an MRI scan carried out in between (which you can wait ages for!) Smile.

I did hear that you cannot play contact sports until at least 5 months after the surgery. Skiing is obviously not a contact sport unless you stack it like I did! Embarassed My worry will be is if iI stack it again and land on the shoulder! But that’s the risk we all take I guess.
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Hi Dave, I've had my rotator cuff repaired and, although you shouldn't underestimate the op, if you follow the physio instructions/exercises and go carefully you shoud manage to be skiing by December. If it's done with keyhole surgery the recovery time is shorter as the scars are tiny, if through a full incision (mine was about 4" long) it takes a while to heal. It's worth having done as it is the only way to get relief from the constant pain. Just be really careful not to fall on it - fling yourself in another direction! Best of luck and stock up on co-codamol!
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daveg481, I think you can learn to adapt your 'stack technique' to protect your shoulder. Like learning to roll with your shoulder / arm tucked nicely in. IMO sometimes people with this sort of injury are more prone to re-injuring it because they are so aware of it they bring it on themselves (envisaging it happening etc).

Rehab, get stronger than before and find that balance between recovering / self-executed 'survival stack' which protects your weaker shoulder.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
I did mine pretty badly in 2007. Not from skiing, I landed a microlight on Wells Next the Sea beach and rolled it on soft sand.

Your rotator cuff joins the bone by an average of 35mm in a typical adult, I had 5mm left attached. I was lucky in that we have always had the top level of health insurance. I had an arthrogram which is very painful. They inject a magnetic fluid into your shoulder joint to get a better picture in the scanner. They cannot anaesthetise your should joint for getting in a 'horse injection' sized needle!

1 week later I was in for the op and fortunately had one of the best shoulder specialists in the UK.

They cut in through the top of my shoulder and then through the deltoid muscle. They also put a camera in through the back of my shoulder. They screwed 4 fixings into my arm, cut a slot in bone, pushed the tendon end into the slot and then wired it in place to the 4 screws. It was a 3 hour op.

Recovery was having my arm strapped to my body for 6 weeks. They stressed that there should be no movement and I should forget I had a left arm. after six weeks, my arm was in a sling but I was still not allowed to move it with its muscles. After 3 months, I started physio which consisted of stretching by creeping my hand up the wall with my finger tips. I had laser treatment on the tendon to help increase its blood flow and had what was basically a very powerful vibrator run over the muscles. This went on for another three months. In this time I was not allowed to drive. I stopped drinking and concentrated on eating masses of protein rich foods and fruit.

After six months had passed and I was allowed to go back to the gym, while still set for another 3 months of physio. At the gym I wasn't allowed to lift anything more than 1kg so I did hundreds of reps every night. The muscle wastage on my shoulder was terrible and I looked lob sided. Each night I would do 1500 reps with my 1kg, split between forward, backwards and sideways. Sideways used the full pull on the tendon and even 50 reps was difficult in the first few weeks, lifting my arm sideways.

After another this last 3 months of physio 3 times a week and gym work every day I was doing 5 sets of 50 lateral raises with 8kg. This is better than an average healthy person can do, but I had always been fit so was determined to push all I safely could.

All in all, it took a year to fully recover. It was stressed to me that if I pushed more than I was allowed, my tendon would be ripped through the fixing and would look like a silk tie that had been through a paper shredder... unrepairable.

In the early days after the op, sleeping was a nightmare.

My recovery was as good as it was because I had a brilliant surgeon, a truly brilliant physio lady (head of the hospital dept) and I was determined to follow their advise to the letter. Now my left shoulder is the stronger of the two and I was back to full health in a year.

The main problem is that the couple of veins through the tendon are the diameter of a human hair and those veins may be damaged making recovery even slower. My advise is be resigned to doing virtually nothing for quite a while after the op and then build up slowly. Were I having the op now, I wouldn't risk skiing in December.
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bar shaker, blimey thats certainly put me in the picture. I should emphasise that i have actually torn just one of my tendons not all of them as i might have made out in my previous postings (i believe theres four of them) I am assuming that you torn all of your rotator cuff tendons seeing as you had 4 fixings inserted into your bone?

Hope all is well now with your shoulder!
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Yipes, am I gald I got my shoulder repaired BEFORE the tendon went - 18months after the fall that brought it on. According to the surgeon the tendon was being abraded like sand-paper. It would have eventually pinged - ouch

Repair was done 5 weeks ago - I now have 3 staple size scars (front, side and back of shoulder) and reasonable movement. Still not got full movement especially behind the back - that can apparently take about a year. Physio has now started me on strengthening exercises using "therma" bands (stretchy plastic things).

I don't expect to have any problems going back ski-ing - at least thats what the surgeon said. He should know he's a boarder!!

Lessons learnt - If you have problem with your shoulder see a quack, get further investigation if it's not responding to physio and do the physio exercises!
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A useful interactive diagram

I did my Supraspinatus and Infraspinatus. Both were barely attached and I couldn't lift my arm out sideways (abduct) to more than 45 degrees.

It's perfect now.

The recovery time and success is all down to good physio and doing all the exercises exactly as instructed, now matter how pathetic the movements may seem. It is also about doing no more than the movement you are allowed, with the force you are allowed.

Go very slowly as its almost impossible to repair a damaged repair.
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And love to help out and answer questions and of course, read each other's snow reports.
A very useful diagram - explains why I've been feeling like I've "pulled" a muscle just at the bottom of my ribs on the same side of the body as the repair. The physio excercises must be utilising the Latissimus Dorsi muscle group. They are also probably atrophied from not really using them properly for 18 months

And "Latissimus Dorsi muscle group" isn't a phrase I expected to get into evryday conversation wink
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Muscle shrinkage of the 'Lats' is a big problem. Once I started physio it took me nearly four weeks to be able to get my arm truly vertical, due to shrinkage of my unused Lats on the damaged side. That was by walking my fingers up the wall. Doing this in the shower every morning was best as the muscles were relaxed from sleeping.
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bar shaker,

Can do vertical - as you said took about 4 weeks. Sort of working on the beyond vertical by lying on my back on the bed and trying to get my arm as straight and as flat as possible. Thats and the arm behind the back are still going ouch after nearly 6 weeks post op.

The other problem is the complete lack of strength - hence those lacky bands. Also the reason I'm still not back at work full time Sad or is that Very Happy It gets boring after a while
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bar shaker, Great diagram that certainly explains a few things! From the diagram it would suggest that ive torn the Supraspinatus tendon as I cannot aduct my arm in a stable manner. I can abduct my arm above 45 degrees but i have to use quite a bit of power which i am guessing is coming from my deltiod which makes it uncontrolled. However I can do all of the movements that the Infraspinatus does in complete control so i am guessing i am ok with that one.

I am seeing my surgon on Friday, so I should get a full picture then from the results that the MRI has brought up! Fingers crossed!
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 Poster: A snowHead
Poster: A snowHead
I don’t know if this adds much as there are plenty of detailed replies, but I had a similar op on the 24th June last year.

I’d done it in St. Anton in Feb, but got the season finished before seeing a sports specialist surgeon. At the end of the day I had a large Labral Tear and had arthroscopic surgery. To fix it I had a Bankart Procedure, which was lucky as the recovery time is shorter than some other options.

Arm strapped in sling to waist for six weeks, then physio. Take the Physio seriously if you want to ski in December. The thing that shocked me the most was the amount of muscle wastage and how tight the rotator cuff becomes. It was very painful stretching it back into shape.

With the help of a great surgeon and physio I managed to get to Ischgl on the 12th Dec for a week and then on to St. Anton for a fortnight. Ischgl was a great start as the pistes were so well groomed I was soon hooning it around and feeling like a hero and soon forgot the shoulder as it was it was -17c. Been to La Tania and Val since and managed to get some good powder in Val, but was a little cautious.

To give myself a little boost during the recovery period I had a gentle play on the indoor pistes, I felt it helped but my physio gave me a b*llocking.

I discussed skiing in December with my surgeon and how easy I should take it last season and his advice was to just carry on as normal once I was back to fitness.

He works on a lot of professional sportsmen particularly rugby players, as he is a shoulder specialist. Apparently the stats work out something like this.

One year post op - Out of the pool of people who have had the Bankart procedure any weakness attributed to the procedure will mean that 1 out of 4 further injuries may not have happened if the shoulder had never been operated on.

After two years post op - the injury rate returns to the normal population. His summary of the stats, just forget it and go for it!
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
All I can advise, people, is that if you have such an injury, get it seen to asap. These injuries do not fix themselves.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Cheers Mt, your story has really cheered me up! Very Happy Very Happy Very Happy

Sounds like your situation from last year is identical to mine this year. Hopefully I will be able to have arthroscopic surgery too (i am guessing this is key now to my recovery time); i find out that tomorrow! I know the Physio is going to be a challenge but ill do what ever it takes to get back ready for December if it is realisticly possible!
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bar shaker wrote:
All I can advise, people, is that if you have such an injury, get it seen to asap. These injuries do not fix themselves.


Actually, you are not correct I injured mine fairly badly - to the point where putting on a shirt was painful and swimming freestyle was out of the question In the end, after about 6 months of pain, I saw a doctor and he recommended a technique in which salt water is injected into the joint. Cannot remember the name. Anyway, I had booked in for it, but out of curiosity I did some web research and found a lot heal themselves. I cancelled the appointment and started some mild shoulder-freeing exercises. After about 2 or 3 months, I could swim 50 metres freestyle, with only a little discomfort. After another 3 months, I was back swimming 2000m, with no discomfort.

The moral of this story - do seek medical help, in case you really do need surgery, but don't think that is the only solution.
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ulmerhutte,

This just seems to me to show the danger of a little knowledge. A quick search showed that the salt water treatment is for a frozen shoulder. The normal physio for this would be - light exercise/stretching.

You were lucky that a) you haven't damaged the tendons and b) you found the right regime to sort out your injury.

Everyone else should get expert advice

Skitrack
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Couldn't agree more with getting expert advice!

After seeing my consultant my scans show my I have completely ruptured my Supraspinatus and Infraspinatus Shock . I now need open surgery to repair this on Wednesday. I was told if had left this I would have developed Arthritis in a few years followed by the need to having shoulder replacement which would have be a "disaster for someone my age" being the words of my surgeon.

Because i have left this for a while; he has told me that i will not get 100% normal abduction back into my shoulder, however my surgeon tells me that I should make a near complete recovery in 4 months. Which surprised me given the scale of damage done. Luckily I'm told I have got youth on my side !

Lesson learned for me: no matter what you think you may have done when you pick up an injury - get it checked out! Because this is the first sports injury ive ever had in my life, i thought had just bad bruising, not two complete tears of a joint!
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daveg481,

Good luck for the op - the shoulder will hurt like . . . . for a while (as you may have gathered from the info above). It'll be worth it in the end

Skitrack
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After all it is free Go on u know u want to!
Yep, good luck Dave.

Ulmerhutte, that is really poor advice. I hope no one follows it.
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