Shoulder Issues -- Therapies, Surgeries, Etc.

[ab70]

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.

[FastFreddy]

Originally Posted by ab70

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.

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?

[ab70]

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!

[GZim]

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.

[FastFreddy]

Originally Posted by GZim

Sorry to hear that Freddy, and thank you for the kind wishes.

I hope if anyone else is going thru it, they will contribute to this thread, as for me it was great to follow their progress in rehab.

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?

[GZim]

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

[kaiserkai]

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

[FastFreddy]

Originally Posted by ab70

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!

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

[GZim]

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.

[FastFreddy]

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.

[GZim]

Freddy,

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

[FastFreddy]

Originally Posted by GZim

Freddy,

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

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.

[GZim]

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

[STP]

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.

[FastFreddy]

Originally Posted by GZim

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

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.

[GZim]

Originally Posted by FastFreddy

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.

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

[larry10s]

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

[FastFreddy]

Originally Posted by GZim

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

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.

[GZim]

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

[GZim]

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