Ok, so here's the situation,

I fucked up my shoulder playing racquetball about 2 years ago, I had an MRI done in Korea and one done in Italy. Both are indicative of a type II slap tear. I've done a year of physical therapy (3x a week) and it's only gotten worse. I can't throw a ball more than 5 times without being in pain, I sometimes have to take a muscle relaxant to sleep soundly through the night. I had been seeing an ortho up at another base and he was ready to scope my shoulder. However, he PCSed and got replaced with another doctor who wanted a consult with me before he did anything.

This doctor said he wanted to try 6-12 weeks of doing physical therapy 3x a day, every day of the week. (just a quick 10 min session I can do at home. And if that doesn't work, he will scope my shoulder and see what's up. This is the option he recommends.

However, he said I could opt to go ahead and forgo the physical therapy and get scoped within 2-3 weeks. I like this option because I will separating from the military 28 Nov. This options gives me the chance to do physical therapy at my base clinic with a physical therapist if need be (if something is wrong in my shoulder, and repairs are required, I would need it) If I wait, I might be put on administrative hold or have to deal with the VA in Durham. The reason why the doctor doesn't want this option because he has high hopes for the higher tempo PT and says that he doesn't want me to get the surgery, go through post surgery PT and not be healed and be back at Square 1. However, he is giving me the option.

Thoughts?

7/20/2011 10:09:43 AM

I know a few people who hard rotator cuff surgery after a tear, and they still cannot raise their arms above their head. Not to mention the recovery time is really really long.

I have really bad rotator cuff tendinitis and I've basically given up on throwing sports. I can't sleep on my left side anymore. That keeps me from being in pain. Like you, about 5 throws of a football costs me a couple of weeks of agony and ibuprofen addiction.

I've seen multiple doctors, and they all say pretty much the same thing.. surgery is an option, but i'm likely better off not doing it.

Obviously your situation is different with a tear rather than tendinitis... but shoulder surgery seems like one of those things that has an equal chance of making shit worse.

7/20/2011 10:16:11 AM

Do the physical therapy first. Better to go with the least invasive option and work your way up.

7/20/2011 10:17:01 AM

I appreciate the advice. I mean I had been doing PT for a solid year, and I've been doing it 3x a week at a pretty good tempo too, I just feel like it's not doing anything

7/21/2011 9:26:57 AM

I have this pain in the left back side of my neck that lingers and is aggravated sometimes when I move my head forward/back or move my shoulder/arm forward. I don't feel any shoulder pain but the pain worsens when I move my shoulder/neck the wrong way.

Is this similar to any of you?



[Edited on July 21, 2011 at 9:44 AM. Reason : x]

7/21/2011 9:31:49 AM

^^ My mother had a similar surgery done and not only did it make things worse, she had to get 9 additional surgeries to try and fix the first surgery and they never really fixed anything. Now she's unable to walk or stand for long periods of time and has to take morphine.

So yeah, I'd stick with more aggressive physical therapy first

7/21/2011 9:35:29 AM

^^sounds like maybe a pinched nerve to me.

Quote :

"I know a few people who hard rotator cuff surgery after a tear, and they still cannot raise their arms above their head. Not to mention the recovery time is really really long."

Torn rotator cuff =/ torn labrum cartilage.

GET THE SURGERY

I had a very similar injury to you that bothered me off and on for years and had the slap procedure done last September. Rehab was slow at first and being in a sling for 8 weeks sucked however I now have zero pain in my shoulder and full range of motion. You're young, you're in shape, you'll recover quickly.

As someone who has been there, GET THE SURGERY!

7/21/2011 9:44:54 AM

^^^ Not similar at all, sorry.

^ Awesome.

7/21/2011 9:58:46 AM

You've been doing PT for a year. Have you had any substantial improvement? My girlfriend likely has a similar problem and she keeps up with PT but still cannot fully use her shoulder. At a certain point, PT becomes pointless due to damage in the joint and there's only so much that strengthening the surrounding muscles will do.

I would get the surgery. I tore my ACL and I had the option of going PT only and getting no surgery, which with intensive PT I likely could've been able to walk around fine, but I would never run or do any type of physical fitness to the level I'd want again. I got the surgery and while it isn't 100% yet, its still loads better than what it would've been.

Hell, it almost sounds like your doc doesn't want to do the surgery. Any chance you can get a different one? He might not know what he's doing in there (hence why he's advocating PT until you get out of his jurisdiction) and could fuck your shit up even more.

Quote :

"You're young, you're in shape, you'll recover quickly."

This. With the PT you've been doing, the surrounding muscles are in good shape and will help with the recovery process.

[Edited on July 21, 2011 at 10:08 AM. Reason : lkj]

7/21/2011 10:07:53 AM

I have no reason to doubt this surgeon (He is a Colonel Orthopedic surgeon, which means he has a lot of experience), my previous doctor told me "Hey, I'm going to give you a cortisone shot, and if it doesn't work, I'm going to scope your shoulder and see what the damage is"..he had to move though.

My current doc, said that it'll be a scope for diagnostic purposes and the very minimum he'll just clean up the join a little bit, but if he sees significant tearing, he'll fix it.

As far as my PT goes, I feel it hasn't really helped as far as pain wise. I mean, I can do more with my shoulder (I've moved up in resistance band tension) however, I can do more than 20 pushups, I can't do a pull up, can't throw a football, can't swim, etc

7/21/2011 10:17:15 AM

I hate to be the bearer of bad news but it sounds to me like you have some major tears in there. Your condition sounds worse than mine. I couldn't do pull ups either, but I could swim pain free no problem. My MRI showed a decent sized tear, but when they went in for the surgery it turned out that over 180 degrees (out of 360) of the labrum cartilage around the joint was torn. My surgeon had been expecting to use 3 anchor screws and ended up needing 5.

On the flip side you could just be more sensitive to pain or maybe whatever tear you have is bothering the nerves more than mine did.

7/21/2011 10:24:45 AM

I would do everything in my power to get it fixed. No one wants to be a 40 year old gimp who can't even play catch with their kid.

7/21/2011 10:26:06 AM

^^ It has something to do with the way my humerus is, the top of it is more rounded than normal so the labrum has stretch farther to the joint.

^ That's my rationale of thinking, I'd rather have an aggressive treatment and deal with extended PT then to have the joint just shit out and die on me in 25 years.

[Edited on July 21, 2011 at 10:32 AM. Reason : a]

7/21/2011 10:32:19 AM

^Oh that's good. The recovery from the surgery (for me) was very painful at first, I was gobbling percocets like candy. Recovery is also slow at first b/c the fix is fragile so physical activity with the joint is very limited. But once you get about 1 month out from surgery the pain is very minimal, really just the stiffness you have to deal with.

In comparison to recovery from my ACL reconstruction, which was initially less painful (go figure) but more painful in the long run and harder to get the joint back to normal function. That surgery was over 3 years ago and the knee feels "different". Whereas my shoulder feels 100% normal, just like the other one.

Good luck, if you do surgery let us know when you schedule it

7/21/2011 10:37:12 AM

Thanks, I'm going to email the doc tomorrow at work and tell him that I decided to go with the surgery.

7/21/2011 12:22:24 PM

I think if a year hasn't helped three weeks won't help. I also think dealing with the VA is going to suck, not from personal experience but from the experience of a friend. I'd get the surgery while you're still in and can take care of it with the least disruption to your life.

7/21/2011 12:23:24 PM

Yeah, I've heard nothing but bad things about the VA

7/23/2011 11:58:12 AM

Get it fixed now while you are still in. I did that, had similar shoulder issues, now I don't.

7/23/2011 2:47:20 PM

Absolutely get it while you're still in.

7/23/2011 3:29:23 PM

Well I sent the doc an email requesting the surgery, he responded back with something along the lines 'Well, it's not an unreasonable request, but I'd still like to try the conservative approach and do more PT, are you sure I can't talk you out of this?'...responded back 'Nope, mind is made up, surgery time.'

So now I await a date.

7/25/2011 2:58:29 PM

I think you made the right decision. Good luck with your surgery.

7/25/2011 5:36:45 PM

Surgery on the 4th (in Italy)

7/29/2011 9:33:14 AM

Done, injury was worse than expected. Will require 6 weeks in a big ass sling/pillow contraption and months of formal rehab.

8/4/2011 11:53:24 AM

Welcome to my life, circa 11 months ago. Glad you had it done, considering the injury was worse than thought.

8/5/2011 2:03:50 PM

Some pictures!

8/5/2011 2:13:03 PM

lol, holy crap that looks exactly like mine. (I, too, have pics).

They give you videos as well?

8/5/2011 2:14:09 PM

Nah, no video

8/5/2011 2:16:52 PM

Had my first appointment with the main physical therapist today (she is at another base, not the base that I'm at, or the base I had my surgery at...but another one) ROM and Pain level are right where they need to be, strength is looking pretty good to.

9/14/2011 10:12:12 AM

So shoulder pain was pretty much non-existent for a while, now, I'm about 3 months post surgery, and the pain is coming back with a quickness.

10/30/2011 2:43:08 PM