Shoulder Issues -- Therapies, Surgeries, Etc.

[Pacific lefty]

Hey pdx tennis, I just had the decompression surgery, bursectomy, a/c clean out so I am now 6 weeks post op.

I was in with my PT today and a bit disappointed but she didn't give me any green light whatsoever so start hitting. She did a bit of dry needling as apparently I have some really sore trigger points in the back of my shoulder. That was the second time she did that and every time it made the muscle twitch I shouted! Couldn't help it!

Patience is hard! Especially watching the French open every day and not playing, but Say Chi you are right that I would rather wait and be able to play longer and with no pain recurring. I do feel like the movement is getting much better, I can really lift my arm well now.

I am doing PT routine twice a day and need to work up to doing everything with the small weights before I can hit. That is what she said and I am to work on that for the next 2 weeks.

[FastFreddy]

Originally Posted by Pacific lefty

Hey pdx tennis, I just had the decompression surgery, bursectomy, a/c clean out so I am now 6 weeks post op.

I was in with my PT today and a bit disappointed but she didn't give me any green light whatsoever so start hitting. She did a bit of dry needling as apparently I have some really sore trigger points in the back of my shoulder. That was the second time she did that and every time it made the muscle twitch I shouted! Couldn't help it!

Patience is hard! Especially watching the French open every day and not playing, but Say Chi you are right that I would rather wait and be able to play longer and with no pain recurring. I do feel like the movement is getting much better, I can really lift my arm well now.

I am doing PT routine twice a day and need to work up to doing everything with the small weights before I can hit. That is what she said and I am to work on that for the next 2 weeks.

I was reading up on your surgery from your thread. our surgery was cake a scope job just to clean up and give more room to your tendon. Lucky u caught it early and had no tears like me. When did they say u can hit and be fully healed? Sounds like u will be healed right away. Did u have any bone supurs removed if so how many?

[Say Chi Sin Lo]

Originally Posted by Pacific lefty

I am doing PT routine twice a day and need to work up to doing everything with the small weights before I can hit. That is what she said and I am to work on that for the next 2 weeks.

My advise is: if you can't breeze through at least 1 set of 20reps external rotation with the highest resistant band, then the rotator cuff is not strong enough to withstand tennis.

It's fine if you're in agony by the 3rd set of your external rotation exercises. But if you're agonizing through the 1st set, you're not ready.

[Pacific lefty]

Fastfreddy, I had the acromioplasty with the surgery which I guess is just the shaving away of some bone to make room for the tendon. Really glad I did it now and not later because I am certain the tendon would have sustained more damage.


Say Chi, external rotation is pretty good and my goal for the next two weeks is to move up to the highest band in all exercises, then I think she will have me do light weights and I will be able to hit then.

[Hal]

Hey Folks, I just had surgery in my right shoulder last Tuesday (Aug 14). They did SAD, and removed a couple bone spurs. While they were in there they found a small tear in the rotator that wasn't on the MRI, and I think they fixed that, too. I don't see the doctor until next Monday but I'd like to see if you guys think I'm on track?

I wasn't in much pain when the block wore off, so other then at night, I didn't use any of the pain medication (just taking Tylenol and Celebrex). They also told me to do passive pendulum exercises twice a day. I've been icing it, using a "Game Ready" device, as well.

At one week (Aug 21), they said I could take the sling off, so I did. They also gave me another packet of exercises to start doing (they haven't assigned a PT person to me yet). These exercises included trying to lift the arm in front, side, and back (at the elbow). Each of these exercises is extremely painful. It's been a couple days and I'm able to lift in the front to about 50-60 degrees, the side, about 30 degrees, and the back barely at all (I don't think I could put something in my back pocket, for example). When I'm not doing the exercises, my arm feels pretty good (sometimes just a dull sensation).

As I said, I don't see my doctor until next Monday, so I was hoping to get some feedback to see if the pain that I'm experiencing when doing my exercises is normal?

Thanks!

[Posture Guy]

Hal......you should not, in my opinion, be doing ANY exercises on your own without first having done them under the supervision of a licensed physical therapist. I would request/demand a PT appointment immediately.

Are you in the US or elsewhere?

[Hal]

Thanks for the advice. I'm in Minnesota. Most of the exercises I'm familiar with, since I did the PT routine before surgery. However, it's not clear to me what level of pain I should be experiencing right now while I'm doing them.

[Posture Guy]

It's not a question of whether or not you know how to do them. A quality PT should be assessing the intrinsic mobility of the joint, the position of the joint, and taking the joint through passive ROM under their manipulation to gauge restriction and movement capacity, then watching you do prescribed exercises to ensure not just that you're doing them correctly but that your shoulder is exhibiting a fundamentally sound movement pattern that is constructive and not destructive.

Honestly, after a shoulder surgery, I think it's extremely irresponsible for a physician to have a patient begin rehab exercises without first having them evaluated by a physical therapist, and then having them do the exercises initially under direct supervision and evaluation.

the answer to your question is impossible for any of us to answer because we don't know WHY you are having the pain you are having. Is it because you are experiencing normal post operative pain? Perhaps. Is it because the shoulder is not moving functionally and you are overstressing the repaired areas? Perhaps. Is it because you are doing an exercise your shoulder is not genuinely prepared to do at this time? Perhaps.

Only one way to make that determination, and that's to utilize a physical therapist to evaluate and advise you.

[Hal]

Ok, Posture Guy, if you look through this thread you'll find plenty of knowledge being shared. I gave my type of surgery so I don't think it is too out of line for someone else that underwent a similar surgery to answer my query based on their experience.

That said, to satisfy you, I'll change my question to: For those that had similar surgery to what I described, I would greatly appreciate it if you would share the level of pain that you experienced when you first started doing active ROM exercises?

Thanks!

[Posture Guy]

Hal.....i understand what you're after. I just hope you understand that ANY answer you get here is going to be completely speculative and absolutely not grounded in what is happening with YOUR shoulder right now. I would just hate to see you doing something on your own that is going to either delay your recovery or damage the shoulder in some fashion.

I wish you well and hope your recovery is fast and complete and you're back on the court soon.

[Hal]

If that is the case then we may as well delete this thread now. However, I think there is knowledge to be gained by sharing our experiences on this board. Some experiences may be relavent, some may not. It is up to the reader to determine what, if any, action should be done with that information. For example, your advice confirms my thoughts that I should request a PT when I see my surgeon next week.

[Pacific lefty]

Hi Hal,
I had SAD and bursectomy at the end of last April. (Just played friendly doubles last night- only 2 sets, and delighted to say my arm feels great!).

I live in Ireland where tennis is a minority sport so I was very concerned that I would have to pick a good PT. My surgeon, who was excellent, was not at all in touch with what the "real" recovery time and return to tennis time would be.

I kept a diary of my progress which my PT suggested and here are some of the tips:

Firstly, I was only to do very gentle pendulum exercises and arm, neck movements for two weeks after the surgery. She would not increase the exercises till the third week. Even though there are some more "rapid recovery" programmes, she stressed the importance of tissue healing time. Even when I did receive the first two sets of more advanced stretching and strengthening I was only to do them once a day.

Secondly, when doing the exercises given, most important thing, was to do them pain-free. You should feel some discomfort but not pain and especially not pain the day after. I was told not to move on to the next series of exercises until the first ones were achieved pain-free.

The stiffness, which you obviously have to eliminate through stretching,sometimes takes time. And that is the third thing! TIME! I was so impatient, especially to achieve forward movement in my arm and movement behind my back. But I did notice, day by day, that it magically seemed to get better. This was another reason why my PT said to keep a diary, so that I could track progress and would realise that time is needed to recover. This is the last thing I am working on. I have all ROM and I can get my hand up behind my back although still about 2 inches lower than pre-surgery. So I am still working on it.

All in all, really happy with progress. This forum has been very helpful to me as I don't know anybody near me who has had SAD.

I wish you the best of luck! Give things time to heal and you will be back soon!

[Hal]

Pacific lefty,
I was hoping you'd reply as I noticed that you had a similar procedure to mine. I forgot to mention that my surgeon also cleaned out the bursa as well.

Since you kept a diary, I was wondering if you could tell me what your Range of Motion (ROM) was like when you first started your PT? Also, when you said you did your exercises pain-free, does that mean that you did not experience pain or that you backed off when started to notice pain. For example, when you're working on your ROM, did you lift your arm until you experienced pain and then stopped or???

Thanks again!

[Pacific lefty]

Hi Hal,
The first week post-surgery, when I did the pendulum exercises, the circles were only between 3 and 5 inches in diameter! As the first and second week progressed they got bigger and bigger. Post surgery ROM was not great! I really could not get my elbow out from my side, but for those 2 weeks was told to just work on pendulum and elbow and hand ROM. There was no question of trying to forcibly lift my arm out to the side or front.

Advancing to 4 weeks post-surgery (1 week after meeting PT) I was able to get arm up in front to 90 degrees. I achieved this by slowly working on the stretching and strengthening exercises. Yes, once or twice I felt a little pain later in the day, and felt afraid that I had gone too far. The next day, I would ease off if it was still sore, or advance a little if it had settled and was not sore. Usually my PT would give me a set of exercises and on Monday they would be really hard to do and a little sore. I would keep going very carefully and by Friday they would be easy and I would be ready for the next set.

By 5 weeks, external rotation ROM was nearly 100%. At 8 weeks, I was using stronger resistance bands, but had not yet achieved more than 90 degrees up.

The hardest thing to get back was internal rotation, but as people on this forum, and my pt convinced me, this would come later with more stretching and work. I would say that now at approx 17 weeks it is at 95%.

[charliefedererer]

Originally Posted by Pacific lefty

I would say that now at approx 17 weeks it is at 95%.

That is great! Glad to hear you are doing well.

[Pacific lefty]

Thanks CharlieF. I am delighted with my progress, and its going steadily really well. I will say for sure that TIME is so important and patience is needed for these procedures. Also, the quality and time spent on rehab. is a good investment. Finally, I learned most importantly what you were saying all along "Listen to your body" and "Don't play through the pain". I'm really glad I had the SAD done and I think am enjoying coming back slowly all the more...

[Hal]

Pacific lefty, thanks for your insight. I'm pretty sure I was pushing too much. I had no idea what to expect so I was trying to push past the pain (and it was pretty painful). I just hope I didn't reinjure anything. I can't wait to see the surgeon on Monday.

[Pacific lefty]

Best of luck Hal, hope it all goes well!

[Hal]

Thanks Pacific lefty! I saw the surgeon today and he said I was progressing normally. He told me to continue to do the ROM exercises for another week and then start with a PT next week. He showed me how to do one of the more painful exercises so that I don't experience any pain. He thought that I'm experiencing the pain because of the large bone spur that was removed. He thought I should be able to hit ground strokes in about a month. Serves would be a little while longer.

[FastFreddy]

I took some serves yesterday for the first time in 10 months since my 4th shoulder surgery. Got my lefty and righty serves working well and no pain or soreness during or the day after. I had a full rom plus when I decelerate I still had no pain and my arm took a natural path. So my service motion was not changed aleast from my point of view. I will have my gf shoot some video and compared it to presurgery to see if their is any difference?
PS: got my free weight bench to 245 for 15 reps. First time benching with freeweights since before my first shoulder surgery back in 1996.