Shoulder Issues -- Therapies, Surgeries, Etc.

Discussion in 'Health & Fitness' started by Spittle, Feb 3, 2008.

  1. ab70

    ab70 New User

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    Gzim,

    just wanted to re-iterate my early point about SLAP ( had it done 14 month ago and have continued problemd with bicep tendon)... There are studies and experience of several people (all 4.5 level players) that have an issue with reoccuring bicep tendonitis weakness post isolated SLAP repairs... tenodesis seems to have better outcomes...

    This is not meant to scare you but something that would be useful to talk to your surgeon...

    Good luck!

    FastFreedy,

    Such a high cost out of pocker with PPO, I had 2 surgeries done at Scripps over the past year on both shoulders and out of pocker was ~ 500-700 with PPO insurance. Probably depends on insurance.
     
  2. FastFreddy

    FastFreddy Semi-Pro

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    Cost

    500-700 sounds right with me. I have Bluecross PPO insurance last two times I had United Health Care PPO. I talked with my insurance and they said it's different with every city and surgery center. I priced and was going with Sharp Rees-Stealy Medical centers in SoCal. My first two I paided only 400 each. Can you tell me your Doctors name and which Scripps did you use?
     
  3. ab70

    ab70 New User

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    I would recomend Dr. Hoenecke (he works with Padres) and see patients in Carmel Valley and Torrey Pines (my guess you are in SD). Very experienced... I did have UHC PPO. Good luck!
     
  4. GZim

    GZim Rookie

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    ab70, thank you for the concern, and we did talk about that ... my surgeon said he was going to re-attach my bicep instead of dealing with the Labrum, if that is what you mean.
    He said it would heal quicker than the Superspinatus so it should not effect my healing or PT.
    That site Slaptear.com sure made me anxious, but one cannot account for how many people with lesser outcome have had the procedure done by someone less practiced at it.
     
  5. FastFreddy

    FastFreddy Semi-Pro

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    New Date for Surgery

    I called Dr Alberton's office to find out the next surgery opening I hope it will bethe end of this month. April is really busy for me then I will have to wait for May or early June. I am really sick of the dull pain in my shoulder and not lifting heavy. How did your surgery go?
     
  6. GZim

    GZim Rookie

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    my surgery was on tuesday. typing this lefty.....
    ab70 I did discuss the SLAP tear with my surgeon b4 and he said if the labrum was bad he would do tenodesis .... like you said.

    Good new was my Labrum just needed to be "cleaned up" and he did not need to do the bicept at all. I did need 4 anchors to reattach and repair the superspinatus. Next week he will show me all of the pictures of exactly what was done... on the previous 2 visits since the procedure it was more about getting started doing pendulums and straightening my arm without firing any shoulder muscles (which is not always so easy) etc.
    I also had 2 bone spurs dremmeled out (not sure of the proper term).
    Pain the first night after the nerve block wore off was intense, and each night has gotten better since. Felt much better on thursday nite after removing the brace, ice pack bag etc and took a shower and did my first very careful pendulum.

    i have been hooked up to a game ready ice machine (auto cycling on and off) much of the time since. today went for a little walk. Getting better, tho nights are a bit tuff....not used to sleeping sitting up. when we went out today it was to buy a bed wedge...scheduled to start PT on tuesday

    Gary
     
  7. kaiserkai

    kaiserkai New User

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    This is a very interesting thread.

    I have recently come down with severe shoulder pain generally coming on when playing tennis.

    I have played Tennis on and off for about 2 years.
    Initially I played with a very large and light $50 racquet and never had much problems. I was playing 1-2 times a week back then.
    About 9 month ago I started getting serious about the game, took a lot of lessons and migrated to a 12oz Volkl racquet. Now I am playing 6-10 hours daily.

    Most likely the shoulder pain is brought about by the additional playtime, rather than the heavier racquet.

    The pain is pretty much everything overhead, I can hit forehands and backhands just fine, but serves and overhead volleys can ache severely.

    When the pain subsides and I do the first movement overhead, it feels like something is crunching in my rotator cuff.

    It does feel like tendonitis, having had tendonitis before.

    I am going to the doctor to get it checked out, but was wondering what others have done in similar cases, and what the ultimate outcome was.

    Thanks in advance
     
  8. FastFreddy

    FastFreddy Semi-Pro

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    Cost

    I called up Dr Hoenecke to find out the cost I was looking at 3500.00 out of pocket. It must be my insurance I use to have UHC PPO like you and paided 400.00 out of pocket for my first two. Now I have BCBS PPO. So I am going ahead with the surgery with Dr Alberton my out of pocket will be around 1300.00 Thanks for the info to compare price so this is a deal compared to 3500.00
     
  9. GZim

    GZim Rookie

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    7 days post op, pain is getting better, still have this deep deep bone ache. For reference I had 4 anchors and 2 bone spurs, which I think is why I have this pain.
    Today was my first day of PT (does that stand for Pain and Torture?) The script from the surgeon said they want me to be at 90 degrees in front at 2 weeks out... today was very painful, she lifted my arm 10 times, then a few more just to make sure I could not bear it any more, and measured.. I was at 70 degrees. I will have 2 more sessions this week. Also was the first time I layed flat, which does not feel good on my shoulder.
    The pain when she was lifting my arm was so bad you sort of have to laugh....

    Sleep is still terrible for me. I basically only sleep 1 hour at a time a few times a day - so last night I took 1/2 ambien an hour after 1/2 vicodan and I was able to sleep for 3 solid hours... first time in a week. could not go back to sleep after... woke up with pain, got on the ice machine (Game Ready), and was just able to be dozy.. (maybe 5 minutes of sleep at a time)

    I am exhausted.
     
  10. FastFreddy

    FastFreddy Semi-Pro

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    Sounds like you are having a little rough time of it. When I had my first two I didn't need any pain meds just ice. Then again when I torn the tendon off the bone it was pure pain for 72 hrs. I did not sleep well those three nights so compared to that after surgery was like pie for me.
     
  11. GZim

    GZim Rookie

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    Freddy,

    did they have to use anchors to reattach your RC? was it the superspinatus?
     
  12. FastFreddy

    FastFreddy Semi-Pro

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    Shoulder

    I looked at my two op reports and it did not say they used anchors. I had surgery in 1996 and 1999 they might do things different now. Ask your Doctor if the anchors were used for the tendon to attach the bone. Yes it was the superspinatus all three times. The other three cuff muscles are not in the way of bone. The superspinatus is right under the collar bone. The inner part is called the clavicle then move outward to the ac joint then the acromion.

    My next up coming surgery procedure right shoulder arthroscopy with rotator cuf repair( large full thickness recurrent tear) acromioplasty, excision of the distal clavicle; possible repair augmentation with Graft Jacket(allograft dermal martix) Well in plain english he will sew up the hole in my tendon. He might need the Graft Jacket which will become apart of the tendon since it is a living martix. He will cut 1cm off the end of my collar bone since it has arthritis, plus it will give the tendon more room. Also get rid of 2-3 bone spurs deburr them. He might use the Graft Jacket Wright Medical, arthrex anchors/ scorpion. He will start with a scope job and might have to do a mini open if I need the Gaft Jacket I think.

    My first two were full open I wanted that type since the retear rates were lower at the time 5 years out. I did not want to get a scope job then come back a few years later and get a mini open or full open. Turns out 12 years later I ripped the tendon only due to the fact the bone spurs regrew and cut the tendon again. Not my fault since I always did my pt and not my Docors fault. The only thing I could have done is to get an mri every year on both shoulders to check if the bone spurs were growing again. Good luck with your pt it is very up and down experience just keep doing it.
     
  13. GZim

    GZim Rookie

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    Yes Freddy, he said he needed to use 4 anchors to reattach my superspinatus tendon.
    When are you scheduled for your next surgery?

    Today I am 9 days Post Op, and it was my second day of PT.
    She got my arm up to 82 degrees,,,,, also it was a bit easier than the first time. I had less trouble keeping the shoulder muscles from firing, and when she was massaging and moving my shoulder blades around, it seeme to improve my mobility.

    If only I got get a decent nights sleep... I am really exhauseted from not being able to. An hour or two at a time doesnt really do it, but that is all I can do right now.

    PT again tomorrow.

    Gary
     
  14. STP

    STP New User

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    Hey GZim. I am 9 weeks post op for rotator cuff tear, bicep tendon tear, and bone spur removal. You wrote that you are having a hard time sleeping. Don't know if this will help or not. What I did to sleep was put a folded blanket under my pillow for my head. It gave me a gradual decline so my shoulders had something to rest on.

    Also I placed a pillow at my surgery side to rest my arm on. I slept on my back, which was not a problem because I always end up in that position anyway.

    I slept like that for about 5 weeks until the Doc said that I didn't have to sleep with the sling any longer. Then I went to head pillow only.

    I hope this helps. Good rest is important in the recovery process.
     
  15. FastFreddy

    FastFreddy Semi-Pro

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    New Date

    All set for May 11, 2010 I never had a problem sleeping. Are you still in your arm sling, I wore mine for one week only since keeping your arm like that makes it stiff. I remember just being on a table and having two sometimes three pt people work my rom. Sometimes I would leave pt and my arm would be sore. Later move up to finger walks up the wall. Next using a ube machine and ski machine. Then light weights and ultra sound the whole time and electric stim machine. Are you doing pt 3 times a week for 5 weeks then 2 times a week for 5 weeks then 1 a week for 5 weeks. That's what I did the first two times.
     
  16. GZim

    GZim Rookie

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    Thanks STP, yes I have tried many different ways of creating an incline but just cant seem to get really comfortable.

    Freddy,
    Yes I am still in the sling, though I take if off often, and it seems I can be out of it for more and more time before it gets sore, but they said I definately have to sleep with it. Today was day 3 for PT. I am doing 3 days a week for 4 weeks to start.
    I am going back to see my Dr. on Wednesday and will see the pictures of the work they did.

    Gary
     
  17. larry10s

    larry10s Hall of Fame

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    GZim keep up the good work and posting.as much as i cringe hearing of your pain, lack of sleep etc your courage to get thru this is inspiring
     
  18. FastFreddy

    FastFreddy Semi-Pro

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    Shoulder

    I don't remember wearing it to sleep. When will you get out of the sling for good? Can't wait to see the pics. I love going to PT since my PT women was so hot. I use to stay for 1.5hrs and took a long lunch. My PT appointment was only 40mins long but my friend worked there and I would get more PT time. I finished my PT in 10 weeks instead of 15 weeks.
     
  19. GZim

    GZim Rookie

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    Thanks much Larry. Today in PT we were really able to move my shoulder around more, and get my arm a little higher (85 degrees), it hurts but its easy to see the progress.

    I am going to have one of the PT Therapists give me a massage as it really feels great to get all the stuff around my shoulder worked on and loosed up a bit.

    Gary
     
  20. GZim

    GZim Rookie

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    Day 13 post op. 4th day in PT. Today she was able to get me to 90 degrees with less of a struggle, and was able to do it 10 times. Then we started working on internal and external rotation, doesnt hrt as badly and I'm making progress there too.
    Still cannot be pain free. The deep bone ache is still present, and keeps me from sleeping. Even with an Ambien I can only sleep like 3 hours. Going to the doctor on Wednesday, I really want to know when I will be able to lie down to sleep, cause this sleeping sitting up is a real pain. I am making good progress in my recovery (and watching some great tennis at Indian Wells - thx Tennis Channel)

    Gary
     
  21. larry10s

    larry10s Hall of Fame

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    heres to sweet dreams as soon as you are able:)
     
  22. GZim

    GZim Rookie

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    Day 17 post op

    I am 17 days into my recovery, and I have had 6 PT sessions. The pain is still very much there, but is declining as time passes. I continue doing my pendulums.

    For me PT is tough. The first day I was at 70 degrees (arm raised straight in front), and my doc said he wanted me at 90 by 2 weeks post op, I made it to 95. Yesterday she took my arm up to 115 which really killed me. I thought it would get easier, but the pain during PT is intense. We also started internal and external rotation which is a bit easier. I got to 30 external and 50 internal, when she is pushing these they do not hurt as much.

    I still cannot lay down for more than a little while, and am sleeping 3-4 hours at a time in a recliner. Still using the Game Ready ice machine often, but starting to use the gooey type ice packs as well, as the ice machine is supposed to go back next Wednesday.

    I would like to hear how some others have done going thru this. I know everyone experience is different, but would like to hear from someone who also had a full tear of the supraspinatus.
     
  23. danix

    danix Semi-Pro

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    Gzim, I've got a spare ice machine if you want it. Email is in my profile.
     
  24. GZim

    GZim Rookie

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    Danix, Did you get the email I sent thru this site?

    Its 3 weeks since my surgery today.

    In PT we got my arm up to 110 degrees, it is really a killer, still, but at least it goes up to 90 pretty easily. Starting to sleep propped up in bed, but still only getting 3-4 hours, then back to the recliner for another hour or 2, so I guess this is an improvement. I am generally feeling like my shoulder is loosening up, but progress seems slow. I am used to healing and getting over stuff much quicker.

    Gary
     
  25. larry10s

    larry10s Hall of Fame

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    keep pushing. you are making progress.:) (hope the smiley face gives you a smile)
     
  26. GZim

    GZim Rookie

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    Last night was the first night I was able to sleep laying down on my side. I slept for 5 hours with is the most sleep I have gotten since my surgery on March 2. I woke up with my shoulder being very stiff, even thought I slept on my good side, my healing shoulder seems to have bunched up and was pretty stiff all day.
    today was day 9 for PT, and we got my arm up to 115 degrees, but it hurt like hell! Internal rotation got to 50 and external to 30 and she was able to move my elbow further out from my body making it more difficult. These do not seem to cause as much pain for me.
    Its hard for me to believe how much the PT hurts when raising my arm (and we are only doing the arm raises where I am on my back and the therapist is lifting my arm straight in front.

    at least there is progress, however slow.

    Gary
     
  27. FastFreddy

    FastFreddy Semi-Pro

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    PT Light at the end of the tunnel

    I look forward to my surgery on May 11, 2010 but not the PT. It's a long 4 months plus another 4 months to build up your strength. My PT should be a little better this time since I am getting a scope or mini open. I had to open surgery already both time it took me 8 months to get back to full power. Gary PT is very up and down day to day just look ahead to 8 months and the results you will get It will be worth it in the end.
     
  28. GZim

    GZim Rookie

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    Thanks Freddy. I am confident I will be better off in a few months... Just tuff getting there. Still can't sleep more than 4 hours and that's with pharma help. just always wake up in pain. Tomorrow is 4 weeks post op. Today in PT she was able to get my arm up to 120 degrees so yes there is marked progress, however slow and painful. I am sharing my situation not to complain, but to share the process with other who will go thru it. This thread was very helpful for me in hearing what others have gone thru. I do believe I made the right choice, and my shoulder is getting looser and moving better, the only really painful part of PT is the passive arm raises, MAN THEY HURT!
    so I should only have 2 more weeks in the sling which will be great to get rid of. I see the Dr on Wednesday.

    Gary
     
  29. larry10s

    larry10s Hall of Fame

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    met someone yesterday 8 weeks post op after open repair.sounded like he had an accute complete tear.(he wasnt specific on his problem) he was in no pain and moving his arm around without a sling or support.of course his range of motion was limited.
     
  30. GZim

    GZim Rookie

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    Larry,

    Today I am at 4 weeks and think I too should be moving my arm well at the 8 week mark, and am looking forward to it.

    Overall my shoulder is getting looser, just hurts like hell with they raise it to stretch the ROM.

    Gary
     
  31. drak

    drak Professional

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    That's how I was, everyone is different and some have more issues than others. My pain was not bad from the get go, I took no meds after I got home except Tylenol and iced like hell for 2 weeks with that machine. I feel very fortunate given some of the other stories I have heard here. It's been about 16 months and I have been playing full bore with no issues for 5-6 months.

    Drak
     
  32. FastFreddy

    FastFreddy Semi-Pro

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    4 weeks to go

    May 11 2010 shoulder surgery #3 comin up soon:)
     
  33. GZim

    GZim Rookie

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    Yesterday I hit the 6 week mark. I am out of the sling and it feels really weird. My arm is so weak and so much atrophy. I have some big adhesion's in the back of my capsule (near the back of my shoulder blade) I hope they break up soon. I went to a physiatrist who worked on breaking them up which hurt like hell.
    Next week I will try trigger point acupuncture to help drain the lactic acid.
    what was it like for you guys when you first got out of the sling? I am hoping I will start to improve soon as I get use of my arm back and start to rebuild some muscle back just from simple easy use and the weight of my arm. Right now I can barely even lift it.
    Sleep on some nights is getting a little better (tho last night was terrible after my first day out of the sling)

    Gary
     
  34. FastFreddy

    FastFreddy Semi-Pro

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    Sling off

    Sounds like the slap guys are having more problems with pt recovering than people like me just a cuff tear. I only wore my sling for one week and it made my arm stiff. It felt so nice to remove it and hang my arm very comfy. Six weeks in a sling sounds too long to me maybe different so slap tear. Sorry to hear Gary you are having so a rough time 6 weeks out. My first two I finished pt in only 10 weeks instead of the normal 15 weeks. I hope my next upcoming surgery and pt goes as well as my first two times.
     
  35. larry10s

    larry10s Hall of Fame

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    gary at least you are out of the sling. thats progress:)
    went to another ortho for another opinion.he said main reason for surgery is pain or limitations in your activities. i have minimal pain and minimal restriction with what i do . have gained strength since being consistenet with the shoulder exercices. so for me for now no surgery
     
  36. GZim

    GZim Rookie

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    Larry that is great. Stay strong as it will help you not further your injuries. I am happy to out of the sling as you could imagine.
    Freddy, i did not have a slap tear. he only had to "clean up and trim" my labrum. Its just that my rotator cuff tear needed 4 anchors to reattach. I agree that 6 weeks in a sling is a long time, but as my surgeon says, it takes that long for the tendon to heal and reattach. I am now dealing with the effect of the sling, not the tear in my supraspinatus.

    Good luck on your upcoming surgery.

    Gary
     
  37. FastFreddy

    FastFreddy Semi-Pro

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    Time

    Got it no slap tear, how big was your cuff tear cm x cm? I can't image being in a sling for 6 weeks can u take it off for sleeping aleast.



    Well I was told the tendon will fully heal in 7 months low blood flow. The first time(right shoulder) I was in the sling the Doctor or pt guy was like why are you still in the sling. I was like you did not tell me to take it off yet. I might of had it on 2-3 weeks the first time 4x5cm tear supraspinatus full retraction with exposed humeral head and two large bone suprs(osteophyte).

    The 2nd one now my left shoulder was 2x2 cm not retracted( supraspinatus) but irregularity and degenerative changes within the cuff plus two large bone spurs. As soon as I was allowed I took off the sling(one week) it feels way better to have the weight of your arm stretch the tendon(traction)

    First two were both full open my upcoming surgery will be scope or scope with a mini open. This time retear of the right shoulder(supraspinatus) 2.8x3.5cm and two bone spurs and arthritis on my collar. So he will remove 1cm of my collar which will give the tendon more room.

    The funny thing was my doctor could not believe I was playing tennis and serving 105mph for 5 years without my supraspinatus attached to the bone. Once I was fully recovered I was serving in the 120's self taught if I grewup playing tennis and was taught how to serve by a pro use my big frame I am sure I could hit 130's maybe 140's
     
  38. larry10s

    larry10s Hall of Fame

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    it must keep you up at night that you only serve at 120 mph with bad technique,:) i should be so lucky.lol its like tiger saying i played really bad . i shot minus 11 over four rounds
     
  39. GZim

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    I am not sure the size of the tear in my supraspinatus but it was a full tear. My surgeon was pretty into the sling for 4-6 weeks... At the 4 week mark he said I could be out of it at home. Its much different being completely out of it, and now after a few days I am starting to be able to lift my arm, reach for things etc. I hope this helps my recovery speed up. Still have pain but it is getting better. Sleep is still pretty tuff for me.
    I too was still serving big right up until my surgery, but I have only been clocked once ( in a booth at the US Open). How do you know how fast you serve?
     
  40. FastFreddy

    FastFreddy Semi-Pro

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    serve

    Well I have more of a arm serve than learning the proper way to use my legs. Then again 120 was fast 10-15 years ago. Today 130's is the norm and Roddick can hit 150's. Well all the d-1 guys I have hit with over the past few years all bomb 130's hard to return.
     
  41. FastFreddy

    FastFreddy Semi-Pro

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    serve speed

    My friend would bring his radar gun to the courts he worked in law enforcement. Also have checked it at the US open a few times too.
     
  42. FastFreddy

    FastFreddy Semi-Pro

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    Surgery #3

    One more week to go until my surgery, I will let you guys know how it goes day of surgery that afternoon.
     
  43. GZim

    GZim Rookie

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    Good luck Freddy.... I'll be pullin' for ya (now that I have finally been cleared for some active PT). I am doing much better finally, in the 3 weeks since I have been out of the sling, its really starting to become less frozen. I still have some trouble sleeping, but life is almost normal, and pain is only at night and in the morning (usually wakes me). Can't wait until I can sleep on my side again.

    Gary
     
  44. FastFreddy

    FastFreddy Semi-Pro

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    Surgery

    Thanks, I just hope I wake up from the gas if I don't I guess I will never know:wink:
     
  45. charliefedererer

    charliefedererer Legend

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    Good luck!
     
  46. FastFreddy

    FastFreddy Semi-Pro

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    Surgery

    Thanks for the best wishes
     
  47. FastFreddy

    FastFreddy Semi-Pro

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    Did my preop visit with my doctor all systems go!!
     
  48. larry10s

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    good luck fastfreddy hope you get a fastrecovery:)
    gary glad to hear positive progress:)
     
  49. FastFreddy

    FastFreddy Semi-Pro

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    Happy Mother's Day

    Thanks, looking forward to getting this done and over with the PT is long and hard work and time. I met with my Doctor for my preop he said he would start with a scope job. I might need a mini open if my tendon looks in bad shape then it will need a graftjacket.

    He will get rid on two bone spurs and chop off one cm of the end of my collar bone. Last thing is to knock down the bump on the top of my ac joint. Lookng at three hrs plus 1-2 in the recovery room.

    My surgery is at 700am so be out by noon. I talked to my doc about having to wear that retarted sling for 6 weeks. I told him my arm and shoulder gets super stiff wearing that. He told me I don't have to wear it as long as I don't lift my anything or my elbow above my shoulder or outward. He said I can type which is cool. This makes me happy not to wear that thing just ice no pain meds. Plus I would take it off to sleep and that sling gets gross from getting so much sweat on it. I am not even going to lift my arm at all just let it hang it feels so good. The weight of my arm with pull a little on my shoulder and relax it (traction). The PT place is only one mile from my house cool!!

    The surgery center and doctor we shocked when I told them I did not take any pain meds for my first two shoulder ops. I was like it hurt like hell for 3 days when I tore the tendon off the bone then just dull pain after that The last two tears it poped and I could not really lift my arm nothing like the pain of the first time. So fixing it was pain free the ice is to help speed up my recovery.
     
  50. FastFreddy

    FastFreddy Semi-Pro

    Joined:
    Aug 8, 2008
    Messages:
    755
    Made it 3 for 3

    well the surgery went great, it took 3hrs and I did not need the graftjacket so no mini open oh yeah. had a scope job three little holes, stayed in the recovery room for 3 hrs then went home. no need for pain pills just like my first two times just ice.

    will see my doctor on the 21st for a follow up and let me know when to start my pt. pt is only one mile from my house sweet. no sling for me just let it hang and iam allowed to bend my elbow and move my fingers and hang my arm and do small circles.

    just no lifting my arm above my shoulder and no lifting. the tendon needs 16 weeks of pt within 7 months for the tendon to heal before lifting med to heavy weights. it took me one year the last two times to get my full strength back after the first 7 months.

    my doctor gave me 5 pages color pics from the scope step by step what he did inside my shoulder cool what a mess it was. he said the tear got bigger since the mri last year. how big i will find out on the 21st. the worst part is the gas for 3hrs and the metal taste on my tongue yuck from the tube.

    hope this is my last time don't want a 2nd on my left like my right.
     

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