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  #1  
Old 30 October 2017, 22:54
Tango Chaser Tango Chaser is offline
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Rotator Cuff Permanent?

Had a rotator cuff tear over a year ago. MRI shows 30% tear and some arthritis (big surprise). Finally got to see ortho and he tells me he won't operate with less than 50% tear and it won't heal on it's own. Two options, PT and PT with steroid shots.

PT has reduced the pain and is helping build up my atrophied shoulder muscles. Only one shot so far. Not anticipating any more.

Am I stuck with dealing with a permanent injury?
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Old 30 October 2017, 23:12
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Expatmedic Expatmedic is offline
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Nope. Get a second opinion. Outside of that particular ortho group.

I am dealing with shoulder stuff now. My quality of life is diminished. 3 injections posterior, now we have moved to injections in the anterior portion.

PT did nothing. The injection today lasted long enough for the Lidocaine to wear off, then back to pain. But know I know we're part of the injury is.

So, like I said, 2nd opinion.
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Old 31 October 2017, 03:17
Chucko Chucko is offline
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I just went to see a specialist this afternoon with mucho pain in the right shoulder when moving the arm laterally front ward or backward or up and sometimes down. Quite a bit of clicking in the joint when moved certain ways.

Took two exrays and saw arthritis on both sides of the joint and gave me a shot of steroids mixed with something to make me smile a lot and get dizzy. I act like a 12 year old drunk but feel no pain.

Getting an MRI Wednesday then to decide if that is it, cut and ream out, or if anything else is going on in there.

That is why I am on this damn computer at 2:30 in the morning. Can't sleep.

No pullups with ruck today.
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Old 31 October 2017, 05:56
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I have seen so many Rotator Cuff injuries in my job, that its almost normal. Even with operations, nobody has come back 100%. We do route sales with heavily lifting 40 to 60 hours a week. In 25 years so many joint injuries. I am no Dr or do ortho. Just saying dozens of injuries as such, all have had to find another line of work.
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Old 31 October 2017, 06:44
AustinPT AustinPT is offline
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I get a lot of patients with a script that says "partial rotator cuff tear". That's usually anything under 50%, or in the 1cm or less range (1.5 cm is usually the "surgery is indicated" size, or if more than one tendon is involved). Most patients do well with PT and go back to normal function. However, a lot of that depends on what "normal" is for you. Pull ups with a ruck, or route sales with frequent heavy lifting require a much longer rehab period. I typically only see patients for about 10-12 visits unless it's post surgical, so we end therapy with a long discussion about what to continue doing for home exercise program and/or gym program, and what to avoid doing for the next 6-12 months. Without specifics, I would say a 30 percent tear has a good chance of healing w/ conservative treatment. As stated above, a second (or third) opinion is always a good route. Also, don't go nuts with steroid injections. Those types of steroids are catabolic, not anabolic, meaning that while they are powerful anti inflammatories, they also can cause tissue to break down w/ chronic use. General guideline is no more than 3 injections per year into the same area.
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Old 31 October 2017, 11:32
Tango Chaser Tango Chaser is offline
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PT has reduced the pain considerably but I still have stabbing pain when reaching or trying to push open a heavy door. Been through 2 sessions of PT already and just started a third. First 2 were a joke. This PT session is more intense and focuses on strengthening the shoulder muscles.

I had to change jobs within the same company immediately after the injury. New job requires very little shoulder activity. Good shoulder is starting to have same type of pain but I've been able to adjust my shoulder use and it's manageable.

I filed workman's comp at work but I'll give it a go through Tricare for a second opinion. I've had numerous injections in my knee while on active duty. I stopped when it looked like it was eating my flesh under the skin, leaving depressions at the injection site.

Last edited by Tango Chaser; 31 October 2017 at 11:35. Reason: Added info.
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Old 31 October 2017, 15:58
labman2 labman2 is offline
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Get another doc. MRI's can't always show the full extent of RT and labral tears. My doc said degeneration (decreased rom and strength) of the affected shoulder will worsen with time due to pain as the body/mind will often subconsciously avoid movement that causes pain. I had 30% decreased mobility without realizing it prior to surgery. The testing was an eye opener for me.

Workman's comp will try to avoid the surgical route if at all possible due to expense. If you're semi close to the Dallas Ft. Worth area, I highly recommend the Carrell clinic in Dallas. Dr.s Burkhead or Cooper for a second opinion.

I wouldn't hesitate to have surgery again. Mine was 12/2106 and I have zero issues with ROM, strength, mobility.
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Old 1 November 2017, 19:34
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Oxy 10-325's, Motrin, TENS unit, bag of frozen peas. So far, zero relief.

My Orthopod says all of my chondral defect stuff is age appropriate. And he did not seem to impressed with it all. He did not say much when I reminded him I was symptomatic. Sigh.
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Last edited by Expatmedic; 1 November 2017 at 19:39.
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Old 1 November 2017, 20:02
Dangerous Dangerous is offline
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Oxy 10-325's, .... Sigh.
Be careful with that shit.
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Old 13 November 2017, 12:53
Tango Chaser Tango Chaser is offline
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Current round of PT has the pain considerably and been pain free for the last 2 days. Some tightness at extreme articulation but no real pain. We will see how long it lasts.
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Old 13 November 2017, 13:22
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Be careful with that shit.
For sure. I try and make a 30 tab supply last a few months.

Quote:
Originally Posted by Tango Chaser View Post
Current round of PT has the pain considerably and been pain free for the last 2 days. Some tightness at extreme articulation but no real pain. We will see how long it lasts.
I am pain free as well. I just don't throw, reload, swim, live life etc.
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Old 13 November 2017, 13:47
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Last year I had something the doc called "Frozen Shoulder". ROM kept getting less and less and pain increased the closer my movements got to the max ROM. I thought I had a tear of some sort and would need surgery but as it turned out all I needed was physical therapy. The "cure" was essentially stretching the shoulder muscles back out to the normal ROM. Hurt like a bitch, but it worked. No shots and no surgery.
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Old 13 November 2017, 17:42
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chokeu2 chokeu2 is offline
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Stem Cell treatment brother.
I had it on a rotator that got trashed from a lot of Jiu-jitsu and volleyball without warming up. I'm talking years worth of abuse, to the point of pain just raising my arm. It was useless, and after the treatment, I have absolutely zero issues.

I don't think that most insurance covers it yet, but $3k ain't a lot for not only repair, but rejuvenation, to no issues any longer.

Also, I broke my back last year in a car accident. L1 and L2 were evaporated. By the middle of December I was back on the Jiu-jitsu mats with no physical issue aside from shitty cardio. Again, stem cell rejuvenation.

I abuse the hell out of this 47 year old bag of meat via BJJ, Muay Thai and Crossfit('ish) about 5 days a week. No limitations.
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Old 14 November 2017, 10:22
notdeadyet notdeadyet is offline
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Quote:
Originally Posted by Tango Chaser View Post
Current round of PT has the pain considerably and been pain free for the last 2 days. Some tightness at extreme articulation but no real pain. We will see how long it lasts.
Congrats for this, TC.

Hearing surgeon's hesitant to operate on a rotator cuff is actually a good thing. If anything, they can be too quick to pull the trigger on this. You only have so many shots at operating on the RC and since the injuries often return, all attempts at PT should be given an honest try (if recommended) prior to going under the knife.

Hope you continue to have good progress.
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Old 14 November 2017, 14:14
Just Another Guy Just Another Guy is offline
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Absolutely right about non-surgery can be good news. I'm proof of that. Also, advice to, if you get a second opinion, make sure you go to another group (personal experience, too).
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Old Today, 01:47
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Quote:
Originally Posted by AustinPT View Post
I get a lot of patients with a script that says "partial rotator cuff tear"......
This is me. 6-7 months of pain and reduced ROM before I saw a physio. 2-3 visits later, primarily with dry-needling and deep massage, combined with at-home exercise, and the pain decreased while ROM increased.

Now 95% pain-free, with me only needing to see the physio once a month for that, and tennis elbow in my opposite arm.

Yes, I masturbate waaaay too much.
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