Shoulder Surgery Tomorrow!!!

Discussion in 'Health & Fitness' started by Pacific lefty, Apr 26, 2012.

  1. Pacific lefty

    Pacific lefty Rookie

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    So this is it, I am having the arthroscopic shoulder surgery tomorrow. Hoping he's only going to take out the scar tissue and make a little space for the tendons to move around...Thanks to everybody who has given me good advice on rehab and on their own surgery experiences. Will post whatever the good surgeon finds tomorrow. It'll be weird being right handed!!!
     
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  2. mikeler

    mikeler G.O.A.T.

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    Hope you have a speedy recovery.
     
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  3. LuckyR

    LuckyR Legend

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    Good luck. What is the current injury and what symptoms are you having?
     
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  4. Pacific lefty

    Pacific lefty Rookie

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    Hi LuckyR,
    Rotator cuff tendonitis with impingement. Have had it since Oct 2010 and tried everything conservative, hasn't responded and the daily pain and compromised ROM has been getting worse and worse, so hopefully this will sort it out.

    Thanks mikeler.
     
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  5. LuckyR

    LuckyR Legend

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    Is the pain at the edge of your lowered ROM or in neutral positions or is it during strain, perhaps also in a neutral position?
     
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  6. charliefedererer

    charliefedererer Legend

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    Best wishes for a speedy recovery.

    "May the Irish hills caress you.
    May her lakes and rivers bless you.
    May the luck of the Irish enfold you.
    May the blessings of Saint Patrick behold you."
     
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  7. r2473

    r2473 Legend

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    ....(and just be happy you aren't Scottish):

    http://www.youtube.com/watch?v=G1tJJO_pVvQ
     
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  8. Pacific lefty

    Pacific lefty Rookie

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    LuckyR, well, external rotation causes pain, lifting arm above shoulder level same, and reaching across my body (like to do the popular stretch does too)...

    Thanks charlief, I hope you'll be around on the forum during rehab...

    R2473 - I love it! Trust me, its not easy being a Californian in Ireland!
     
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  9. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Good luck!

    If there's one thing you can walk away from the surgery and the rehab, it's the importance of joint balance, flexibility, and rest.
     
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  10. Pacific lefty

    Pacific lefty Rookie

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    Surgery finished!

    I had my surgery today and its finished. Delighted to say- no tears! My surgeon did rc and ac joint debridement and the acromioplasty and expects full recovery after doing PT of course. No pain in hospital but feeling it now for sure ( typing righty now). So glad to have it over with and looking forward to rehab. Sling not too bad, I am allowed to use it as much or as little as I need.

    Must take back my criticisms of Irish healthcare as I had this done in a private Catholic hospital and the quality of care was excellent.
     
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  11. mikeler

    mikeler G.O.A.T.

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    Glad to hear everything went well.
     
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  12. charliefedererer

    charliefedererer Legend

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    Happy to hear there were no "surprises".

    Also glad to here the care was so good.
     
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  13. Pacific lefty

    Pacific lefty Rookie

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    Day 3 Observations Post Surgery

    1st Observation: At the hospital the physio, surgeon, and nurse pointed out that the sling was only for comfort and to be on and off, mostly off, for 2 weeks. I am finding it hard to keep off, as there is still a good bit of pain in moving the arm especially after bathing or getting dressed.

    2nd Observation: If you're a girl its great to steal your husband's loose clothes as the majority of my tops will definitely not go on at the moment... Not even doing it the way they show you, you need loose ones.

    3rd Observation: You must do the exercises religiously, especially the pendulum, even though the size of my circles are tiny at the moment.
     
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  14. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    1st Observation: The sling is really up to your discretion. In both of my surgeries, the sling was only there depending on how much discomfort I was willing to put up. Both times, I had it on for less than 5 days. I just kept telling myself, the earlier I can move the shoulder without damaging the repairs, the better it'll be in the long run. I definitely had the sling off by the second week.

    2nd Observation: Can't really comment there, but I can see why you'll have problems there. I remember I was being excessively careful when the bandages were still on. I'm talking about Janga careful. 1) I didn't know what was underneath the bandages. I'm not going to be stupid and move it out of alignment. 2) It's REALLY hard to dress when you have one dead arm.

    3rd Observation: I was very religious with the pendulum too! Absolute crucial in my opinion during the early stages of post-op. 1-2 weeks, I was just making small circles with my arm dangling to the side of my hips. They weren't big circles, maybe like an inch or two in radius. By the 3rd week, I was able to bend over, let my arm dangle down and made bigger circles.

    Did your surgeon give you electrodes and hooked it up to your shoulder? I had it for my 2nd surgery (it was a bit more intensive repair, partially torn supraspinatus and partially torn posterior labrum). The electrodes stimulated localized twitching of the muscles and helped with pain management too.
     
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  15. Pacific lefty

    Pacific lefty Rookie

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    Day4

    Well, I am not having any luck getting out of the sling yet. My arm feels so weird when its down. Really weird. It's okay if I am sitting down doing nothing but when I am up and busy, I need it.

    I didn't have any of the electrodes hooked up, and really at the moment I do not need a lot of pain medication by day. I am waking up every night around 3 or 4 a.m. with it really painful, but I guess that's just what happens when trying to sleep. I so cannot sleep in a chair!

    It is getting a bit stronger though as I was able to use my hand more to help a little when getting dressed, so that's good. I am sure it will improve a good bit by the end of the week.

    Thanks Say Chi, your observations are really good, so I can compare how its going to someone who has had shoulder surgery already...
     
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  16. Robbnc

    Robbnc Rookie

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    When I had it done about 7 years ago I bought one of those ice-therapy machines off e-bay used for about $50 . That was the single best investment I ever made.
     
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  17. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    If you can't get out of the sling yet, then don't rush it. It won't help you in the long run if you are damaging the repairs already. I'm simply saying, they earlier you can move the arm, the better it'll be in the long run. But there's no set deadline and it'll be different among individuals.

    I think sleeping on the chair is a myth. Like you, I can't sleep on a chair.

    The most annoying thing for me a few weeks after surgery was: 1) Shoulder stiffens up first thing in the morning and it hurts. 2) Forgot I had a dead arm and I try to move it, haha yeah that hurts a lot too a few weeks post-op.
     
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  18. jmjmkim

    jmjmkim Semi-Pro

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    Best wishes to you. I had spinal surgery 3 yrs ago . .. It'll take a little time to come back to tennis, but it will be for the best in the long run.
     
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  19. adventure

    adventure Banned

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    These are inspiring stories to be sure!

    Good luck to all of you!
     
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  20. Pacific lefty

    Pacific lefty Rookie

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    Mornings are definitely the worst!!! I did get a talking to from my PT yesterday who said definitely to leave the sling off more and more during the day, so I tried that yesterday afternoon and it seemed ok. She also gave me the pulley exercise to do to raise that arm as my surgeon had told me that he wanted me to try and achieve that for my check up a week from friday (talk about a tricky challenge!!!)...

    As jmjm said, I agree it is better in the long run. The only drawback is that my fantastic coach who taught me right handed tennis is going back home to Asia, so I'm definitely going to miss him. He was top-class!!!
     
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  21. adventure

    adventure Banned

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    Lefty, did you get a cortisone injection? If so, did it help (either temporarily or long term)? Best of luck in your recovery.
     
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  22. Pacific lefty

    Pacific lefty Rookie

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    Which is worse? day 6

    I am not sure which is worse, using the sling and therefore not being able to overuse my bad shoulder's hand, or leaving the sling off and trying to use the hand, only to discover how little I can use my arm which is super weak.
     
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  23. Pacific lefty

    Pacific lefty Rookie

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    4 cortisone injections

    Hey adventure, I had 4!
    First one in Jan 2011, it helped for about 4 weeks,I had pt as well and he did a lot of soft tissue work combined with theraband exercises.
    Second April 2011, I got about 6 weeks relief, and did a month of pt.
    Third, after a full summer of tournaments in August, told to wait 6 weeks before I played, and after playing for only three weeks the pain was back and got very bad by November.
    Fourth December 2011, got advice from my pt and did lots of strengthening but the week I went back, and went back to gym, the worst pain returned, so I felt I had no option but to have the surgery.
     
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  24. LeeD

    LeeD Bionic Poster

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    Hey, PacLefty...
    How come you never comment on Misc section...Bear vs Gorilla?
     
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  25. kobun

    kobun New User

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    Very interested to see how your healing unfolds. I have impingement and shoulder instability for last 3 months or so, and am thinking to get an MRI for further eval.

    Keep to it!
     
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  26. LeeD

    LeeD Bionic Poster

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    I suspect PacLefty needs more humor in her life right about now.
    PL, please go to "bears vs gorilla", and get some laughs....
    Humor is the best medicine.
     
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  27. Pacific lefty

    Pacific lefty Rookie

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    The Bear

    So LeeD, you are right, I did need a laugh! I do comment on odds and ends sometimes! Good fun focusing on other things than the shoulder!

    Kobun- definitely have an mri, If I hadn't nagged and nagged my doctor, he would have been quite happy to keep giving me cortisone shots, etc...
     
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  28. LeeD

    LeeD Bionic Poster

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    Goes without saying..... take your time, and get well....
     
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  29. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Actually, I would advise against the cortisone shots. The little short term relief they provide is not worth the long term damage they do to soft tissue.
     
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  30. Pacific lefty

    Pacific lefty Rookie

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    Trust me, I will never again go for the cortisone shots! So its a full week since the surgery and I actually slept pretty well on my high stack of pillows last night. As well my pendulum circles have doubles in size without being sore. I am still trying to figure out how my elbow is going to move out and up but I guess I am not supposed to try that yet. Something tells me that the post 2 week physio is not going to be pleasant...
     
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  31. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    You're right, up until you have regained your full ROM, rehab isn't pretty. If you have a good PT, s/he will stretch you a little more than the day before. Then you'll walk out of the door deflated because you're going home with a dead arm.
     
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  32. Pacific lefty

    Pacific lefty Rookie

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    :cry:Yikes, I thought that was the case. In my mind two weeks was the magic number whereby I would suddenly be able to lift my arm ok.

    And what about driving? My surgeon said that people go back to doing different things when they feel "comfortable" to do them and he didn't specifically say no driving for a certain period. I guess that means I can drive when I am happy enough to, or when my arm feels just a little less dead? I drive a right hand drive automatic...

    So I just finished a dinner party, serving Spanish paella up to about 20 people (cooking one armed but with the chopping done by others), had to keep my arm in the sling all night because I was covered miles back and forth in the kitchen...
     
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  33. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Driving will be up to you. It didnt affect me at all because I predominantly steer with my left (non-playing) arm anyway. I definitely did NOT use the surgically repaired arm for steering until I had some strength back.
     
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  34. Pacific lefty

    Pacific lefty Rookie

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    Day 10 Big Improvement

    So, strangely enough, today is 10 days (well really 11.5) after the op and I have noticed a big improvement. I noticed I could easily put both hands out in front under the sink to wash them. Movement at waist level is really comfortable and I can help do things easily with my left hand which is great. I will attempt driving tomorrow I think just to see how it goes. My physio was right about trying the pulley exercises because that is helping loosen up my arm and shoulder. I can feel the muscles in my forearm are a bit weak so I am trying to squeeze a tennis ball to strengthen, and wondering if there is any point in using a light weight with arm supported to strengthen them (like the last part of the thrower's ten),,,or would that be too hasty???
     
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  35. LeeD

    LeeD Bionic Poster

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    Driving... shifting is no problem.
    The problem is if your arm jolts from pain while you're STEERING, you will drop the wheel in order to wince from pain. So, keep injured arm low to steer, bottom of the steering wheel.
     
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  36. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Hasty indeed! The strength will come in time, and there's really no point to rush and add weights to ANYTHING until you have your ROM back. You may be underestimating how often you use your hands, so once you get your ROM back and have full use of your arm/hand, the forearm strength will come back in no time.

    Also, not to burst your bubble or anything, but these "big improvement" days will come and go. It's fool's gold to rush ahead because of these random "big improvement" days.

    Individuals will have different healing capability (I was a fast healer), but there's still a predictable range among individuals. I believe physical therapists and surgeons have seen them all. Of course, it's your body and you know it the best. But I can assure you, these physical therapists and surgeons have far more experience than you and myself.
     
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  37. monticore

    monticore Rookie

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    i am in a similar spot, shoulder impingement with subscapalaris tendonitis, with some limited ROM, mri/u/s negative for tears , i am leaning towards trying cortisone, physio / etc.. hasn't seem to have helped much.
    i understand some of the side effects of cortisone , is there something i am missing?

    cory
     
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  38. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Also, about these random "big improvement" days, I think there are several contributing factors leading them to be fools' gold.

    1) By chance, you had the PERFECT ratio of stretching, anti-inflammatory treatment, and rest. Thus, the joint feels great the next day. Not saying it doesn't happen, but rare.

    2) You always sleep on it weird, so you never feel as good as you can possibly feel the next day. Then on several occasions, you don't sleep on it as often, so therefore the next day it feels great.

    If you have been any kind of training, you know nothing happens overnight. Even when you have overworked yourself, the soreness and fatigue generally don't set in until two days after. Then it feels like you've hit the wall.

    All I'm saying is, don't think too much into these magical days, because they're fools' gold tricking you into doing things beyond the capability of the surgically repaired joint.

    Remember, the surgery itself is a significant injury to the joint. All the surgery did was to put the joint in the best possible environment to let the body heal itself.

    Individuals are different and heal differently, but stay steady. If you're on path to get better by 1% each day, then keep it. If you're on path to improve by 2% each then, keep at it.

    Don't go 5% on your 1% path. ~ 1 to 3 months is nothing in the grand scheme of things.
     
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  39. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Of course, you should consult your shoulder specialist on further treatment. I will say a couple things.

    1) Did they use a contrast/dye on your MRI? The contrast/dye will show tears/defects better than a regular MRI. However, it's entirely possible MRI and other imaging technique will give you false positives/negatives.

    2) An arthoscopic surgery will provide a direct view of the joint. Any defect or the lack of it will be 100% confirmed. But, it's still a surgery. And like I keep saying, that is in itself an injury.

    3) The shoulder impingement can be helped by a subacromial decompression. I would go with the surgery if they can confirm bone spurs, thus irritating the joint. Otherwise, strengthening can greatly help shoulder impingement issues.

    4) You say it's tendinitis, to my knowledge, I can't see how surgeries will help? Also, your lack of ROM can be a result of the tendinitis. I mean if it's irritated and inflamed, tendons won't want to move/stretch. Rest and anti-inflammatory treatments are the best for tendinitis.
     
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  40. Pacific lefty

    Pacific lefty Rookie

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    Firstly, its great to have the advice of someone who has been there (twice I guess?) as I had mentioned before, where I live there are very few people who play lots of tennis, and have had tennis related injuries. I will stay away from the weights for sure. I certainly get what you say about sleeping because it is hard to sleep "right" sometimes on the arm. I suppose the best thing is a day to day approach and not to rush...

    monticore- I felt as though the cortisone helped in the very short term, however it masked the symptoms I had, therefore allowing me to serve and play long matches, just damaging the shoulder even more, because when it wore off, I was in a lot of pain. Having had the surgery, and knowing now what is involved, I still think I was right (my surgeon was right) in not rushing into it until all options had been explored because it is quite sore and a long commitment in terms of PT and getting the shoulder back to the original way it was (hopefully that will happen)...

    Thanks for the driving tips LeeD. I think I can just about manage to drive with my right hand and left down low, but maybe not today!!!
     
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  41. monticore

    monticore Rookie

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    thanks for the info i'll keep working with physio/massage therapy but might look for ones who specialize in rotator cuff.


    and gl with the rehab to the OP

    cory
     
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  42. jonahnaturals

    jonahnaturals Rookie

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    Guys, many cases of shoulder impingement are actually caused by a tight posterior capsule. This is more common than one would think in tennis players.

    If you haven't tried stretching your posterior capsule on a nightly basis for a few months, give it a go. You can learn more about this here:

    http://drbenkim.com/posterior-capsule-stretch-shoulder.htm

    This stretch has allowed me to serve normally again after six years of suffering with explosive shoulder pain when serving.
     
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  43. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    I was under the impression that you had consulted with a specialist already. That is crucial!

    You should come here for experience on recovery and etc. But your problems are different beasts in themselves, then I'm just speaking jibberish.
     
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  44. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Twice indeed!
     
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  45. Pacific lefty

    Pacific lefty Rookie

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    Origin of injury???

    So, I am just curious, forgive me if it sounds nosy, but how did you injure your shoulder twice? I got the impression that you are younger than me (moi- 44). I know the terrible mechanics of my serve probably got me into this and developing a real big loop on forehand for topspin only exacerbated it. And then what finished me off was continuing to play with the injury and not resting. Just wondering how it happened, you're fully recovered now I take it?
     
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  46. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    I was 16 when I first injured my shoulder. While the MRI showed a partially torn supraspinatus. My surgeon was not convinced of the findings and even if there was indeed a tear, it was extremely small. He was optimistic that my athletic build and young age, coupled with physical therapy and rest would heal the shoulder. After 6 months of physical therapy, I demonstrated an increase in strength and etc., but I still could not serve due to aches and pains. I then pushed the conservative surgeon into arthoscopic surgery so we can see the shoulder directly, and fix it. My supraspinatus was indeed healthy and not torn, but I had an inflamed bursa, bone spurs, and he proceeded with the subacrominal decompression. Rehab, rest, and back to tennis.

    Then at 22, I injured my shoulder for the 2nd time. I was playing basketball and my arm was caught by two defender attempting to block my lay-up. Nothing dirty, just an accident and I was at the wrong place at the wrong time. I suffered a partially torn supraspinatus (for real this time), and a partially torn posterior labrum. Rehab, rest, and back to tennis.

    I just turned 27 and I don't seem to be suffering from any significant ill-effect of those surgeries. ROM is full except for interior rotation, I have ~90-95% of interior rotation? You can easily check it by attempting to run your hand up your spine.

    Strength wise, both arms are equal and I'm benching 200lbs x 10reps. If I'm using dumbells, 80lbs x 10reps on each arm. I'm about 5'8, 140lbs. That should give you an idea of my strength.

    I'm going to say something about working out. I try my best to make sure my joints' stabilizers are not overwhelmed by the larger muscle groups pulling on the joint itself. I do stay away from MANY shoulder-hazardous exercises at the gym. For example, I don't do "dips". It's one of the stupidest, showboat-est exercises out there. It works out the triceps but at the same time, it puts the shoulders at an awkward position. There are better and safer exercises for triceps. I also don't do inclined benching, it exposes and makes the bicep tendon vulnerable. Basically, I stay away anything that puts the shoulder in awkward positions and unnecessary loads. Also, for the external/internal rotation exercises which you'll be doing in about a month or two, I do not exceed 10lbs and I always go for high reps, up to 20 reps/set. You need to understand the rotator cuff is made up of muscles designed to stabilize the joint when the larger muscles groups are utilized. As a stabilizer, the rotator cuff was never evolved to bear short, instantaneous blunt forces. So there's no need to do your external/internal rotation exercises on 50lbs. I'll pick a harmonious joint over an unbalanced joint any day. I am still doing the rehab exercises as a maintenance routine. I recommend you to do the same too, and keep the weight low and high repetition.

    Tennis wise, there's no restriction. I almost always play singles. Average playing time is about 3 hours, with the occasional 5 hours sessions. Now I have more free time than ever, I work on my serves during the day, and play at night.

    Serves about 150-200 balls, come home, ice it once, then go out at night and play for several hours, come home and ice it again. I play about 5 or 6 days a week.

    You can see my racquet and modifications in the signature. I do play with natural gut and I am in the process of experimenting with several polys in the crosses.
     
    Last edited: May 9, 2012
    #46
  47. Pacific lefty

    Pacific lefty Rookie

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    Thanks for the background. Your first surgery and results look the same as what I had. Its awesome that you are playing singles and serving plenty without any problems now. For me, that is something to look forward to. I do realise I will have to ice it and continue maintenance exercises indefinitely, which I don't mind once I am up and playing.

    The gym was defininitely what caused the worst problems just after the last cortisone shot. I am 5'4" and 110 pounds, so I was told I should "bulk up" a bit in the arms and shoulders. I started using the lat pulldown and seated press, light weight, but it was not suitable. Before that I was doing fine just with tennis and 5k runs a couple times a week.

    As for racquets, its Pacific finesse (I know, all my male friends say its a girls racquet), multifilament (can't use natural gut as it is too wet in Ireland), 9.0 ounces. I know what they say about head heavy,light racquets, but because of my small size, I find swinging a heavy racquet difficult...
     
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  48. scotus

    scotus Legend

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    Hey Ben,

    Thanks for the instruction. You have a very nice voice.

    Are you an orthopod, chiropractor, or what?
     
    #48
  49. Say Chi Sin Lo

    Say Chi Sin Lo Legend

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    Nevermind the equipment, I am a firm believer that if you have proper technique and fitness, you can play with a bat and your arm will be just fine.

    Just balance out your workout so that the joints aren't overwhelmed by the larger muscle groups. I think that was the most important lesson I learned from these surgeries. Because until you injure them, no one ever think about the stabilizers.
     
    #49
  50. Pacific lefty

    Pacific lefty Rookie

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    Europe
    I will follow that advice.

    Driving 12 days post op. Not so easy. Wheel on right side and driving on left hand side of road. So I moved steering wheel closer and lower because I can not lift arm to move turn signals. This worked just about. Its really difficult to use left hand on wheel. I am so glad my car is automatic which is not the norm here...So I made it to the soccer pitch and back home. Just getting out of my car, because the steering wheel is so close, I whacked my arm on it and that was so painful!!! Brought tears to my eyes! I am not kidding, if I had had a baseball bat, then and there, I would have finished off my car!
     
    #50

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