Shoulder Recovery

I recently had surgery on my shoulder (torn labrum and rotator cuff/ chipped humeral head) and am in the process of rehab-ing it and starting to climb again. I am told there is a lot of "impingement" going on and I also feel like I am developing a bit of bursitis to go along with it. Could someone please tell me what "impingement" is and let me know how to get rid of it, and the bursitis?

From what I have read it seems like "impingement" is a separate issue that also may need surgery, did I just get cut open only to develop something new? That better not be the case, or someone is getting a flaming bag of dog shit on their porch...

Thanks for the input!

Impingement is where the arm bone makes contact with the bone surrounding the socket stopping your shoulder from moving any further, bone meets bone. The head of your arm bone is actually supposed to "float" inside the socket to create room for the head of your bone to move out of the socket a little. During these surgeries the "over tighten" the arm in the socket and you must then loosen back to where it should be by stretching.

It took me about 3 month of stretching before I could hold my arm above my head without my arm bone making contact with the bone on the edge of the socket. It was a full year before I could do a dead hang from a bar.

If you have any questions, feel free to PM me. Hang in there! ( no pun intended )

One more thing.... your doctor didn't tell you all this??????

Will, I just googled it. I had a bone impingement caused by my surgery. I saw on line there is a "shoulder" impingement which is where the rotator cuff gets wedged between the bones. This is due to swelling. It appears your condition is probably different than was mine.

I had a bilateral dislocation. My arm used to come out of its socket where my fingers would actually be hanging below my knees. Damn that used to hurt.

Anyway, all the best and I hope you are getting good guidance from your doc.

I am 8 weeks out from shoulder surgery. I am working with a physical therapist who is helping me rehab. My rehab is specific to the type of surgery I had. I am just beginning stretching. The first 7 weeks consisted of minimal activity to allow healing. I have been warned that trying to advance too fast will cause more damage (swelling, frozen shoulder etc.). As impatient as I am I don't want to do this again so I guess it's going to take some time. I have been told that I will be at 2/3 strength in 5-6 months and that it will take a full year to be at full strength IF I do what I am told.
Find someone who knows how to rehab from YOUR surgery and do what you are told or you may be seeing a surgeon again. Good luck, I know how frustrating it is.

Will,

+1 what minielle is saying. And don't over do it. Take it easy. And yes, when you are ready, you will be climbing 5.easy for quite a while.

If money is an issue, go to the PT once a month. You should be able to do their exercises on your own.

I had rotator cuff/SLAP tear repair ten months ago. I did my first climb (if 5.7 counts) eight months after the surgery. I would suggest waiting at least nine months to get on anything close to vertical.

The best advice I can give is to do all the PT you can without overdoing it, you have to figure out your limits, which is the hardest part. When in doubt take it easy. Currently, I'm pretty frustrated with the pace of my return to climbing, but trying to be patient.

The best cure besides sticking to the PT, stretching and ice is time. I had to find other vices like running in order to keep myself from overdoing it and going back to climbing, throwing etc too early.

I hope this helps, I know it is a long, doubtful process. When they first told me 9-12 months to recovery, I thought it was bull shit and my athleticism and dedication would cut months off of it. It turns out the doctors knew what they were talking about.

PS, I'm dealing with some impingement too, you can beat that without surgery, stretching and PT can get you through that.

Hope everyone has a speedy recovery. I had surgury 9/2 on a torn Labrum and to remove a cyst that had formed due to shoulder fluid leaking out the tear. I didn't realize how much muscle I had lost due to the pressing on nerves and the blood supply until I started PT. Heal well everyone.

You did not say how long it has been since your surgery, but it sounds like you had a pretty major repair done (between the labral tear, cuff tendon and chipped humeral head). Even a 'simple' rotator cuff repair takes a long time (10-12 months is not unusual) to get back to strenuous overhead activities (like climbing) as others on the thread have mentioned.

If you are developing impingement it is likely due to poor scapular stabilization with overhead movement. If the scapular stabilizers and rotator cuff muscles are not kicking in appropriately to control the joint mechanics, the head of the humerus ends up riding upwards in the socket and impinges the rotator cuff tendons and subacromial bursa against the roof of the joint. Bursitis can be the result as you have described. Bursitis is an inflammatory process, so ice after activity may help the symptoms somewhat (but not the cause!)

PT should be able to help you with this, but if you do not feel it is being addressed adequately by your PT, I would recommend trying someone else. Feel free to PM me if you need help finding someone in your area who specializes in sports/ortho physical therapy. Other than that, be diligent about your exercises, work on scapular strengthening/control, be patient, and perhaps try a more gradual return to activity...

Good luck!

For those of you who are or who have successfully recovered from you shoulder surgery and have started climbing again-- did you work your good arm while you were letting the other one recover? I mean, is it ok to keep doing curls and such with my good arm while I'm recovering or should I just forget upper body stuff until I can do things equally with both arms?
Also, what other work-outs and such did you do to keep in shape while you were recovering and doing pt?

My rotator cuff repair and "bone shaving" is October the 15th. I have a LOOONG winter ahead of me and find it hard to let myself keep still and go soft altogether.

Also, happy healing to the OP! Keep us/me posted as I have the same impingement issues in both shoulders.

lisa

Lisa, I had a good recovery from surgery for labrum tear, rotator cuff, biceps tendon reconnection, and bone shaving. Personally, I just did the stretchs and strengthening exercises with both arms as prescribed by PT and no additional upper body workouts. I was religious about following PT instructions. In the end (6 months) both arms were equally strong and I was climbing harder than ever. I was only allowed to walk for additional exercise the first 2.5 months. Then stationary bike/spin classes for 1 month, then outside road riding. Started mtn biking at 5 months. The cycling got me back on track from getting too soft after those first couple of months which involved nothing but simple stretchs for me.

I agree with above posters about a good doc and PT for your injury. I switched two weeks before surgery for that very reason and was so glad I did. I had my surgery with Noonan at Steadman's Clinic in SE Denver, my PT with Boulder Center for Sports Medicine, both were excellent.

All the best with the surgery!

Re: original post

Depending on how "recent" your surgery was, your impingement is likely due to a combination of swelling and/or tightness in the repaired tissue. Be religious about your stretching, and make sure your stretches are based on the surgery you had (i.e., get advice from your surgeon or a good physical therapist).

Background: biceps tendonesis on 02/23/10 to fix shredded labrum

After almost a year of seemingly weakening shoulders accompanied by general pain and soreness, I found out that I had major labrum tears on both sides of the long biceps tendon. The surgeon couldn't repair the labrum, so he cut the tendon short and re-attached it to the ball of the humerus. He also cleaned the damage labral tears, fixed one other minor tear, and attended to some bursitis.

Six weeks in a sling have been followed by months of stretching for range of motion. I began strength exercises at about 3 months, and I'm still doing most of this regimen, as full range of motion is just out of reach and strength is far from normal.

Just over 7 months out from surgery and I'm still feeling impingement, but only for the maximum range of motion. The main issues at this point, are some remaining pain (mostly milder discomfort, but severe on occasion when climbing) and a major lack of strength and endurance (your fingers and forearms will go to shit while you are recovering).

Relative to most other stories, I was able to climb sooner (after about 4 months), but I've had to be careful. My goal was to put in lots of mileage on easier routes, but my usual partners typically are more interested in projecting .11s and .12s. I tried to hang with them for a few weeks, but found that level of climbing (even .9s and .10s at that point) was potentially re-damaging. So I've spent lots of time in the gym (both with weights and, to a lesser extent, on a climbing wall).

One thing I am noticing at this point, is that now I feel o.k. on 5.9 and 5.10ish climbs for a few routes, but get very tired after just 4 or 5 routes, when my shoulder starts to hurt. The following days, my shoulder is extremely sore and tight.

So, without regular partners to climb easier stuff, I have written off this year, plan to spend the winter in the gym hoping to get back in shape, and will assume that if I stay with it, that by spring, I'll be back to "normal".

I think it would be reasonable for most climbers to get back at it more quickly, but you will need to be intelligently aggressive with your rehab and devote significant time (like hours per day) to the exercises. Rounding up some friends who are willing to climb at an easier level for a while won't hurt either.

Good luck to anyone patiently suffering through shoulder surgery recovery.

(my details are above)

I like the "intellegently aggressive" approach you menetioned. You'll never get back to a high level of performance without pushing it, but pushing it too far will put you back in the OR. There were plenty of times when I was scared that I re-injured myself. When this happened, I would back off for a few days and come back even stronger.

I have had to spend a lot of time in the gym, lifting weights (light weight 20-30 reps). When I reached a pretty good level of recovery, I had no anterior deltoid muscle (they had to partially detach it during surgery so its taking forever to get back to normal). Its coming back quickly now and I have started doing as many laps as I can in the climbing gym (ARCing), which has increased my endurance as well. My shoulder gets tired more quickly too, but I've seen good progress since starting the ARC training.

I think the best advice I can give anyone who is transitioning from recovery to regaining their ability to crank is ICE, ICE BABY. I ice mine for at least 20 minutes a day, even if I don't do any climbing or working out. Power yoga has been great too. I had to take years off from climbing, so finishing out my recovery is like a 20 hour a week job, but it definitely beats the months I had to sit around watching the atrophy set in.

I had a Bristo reconstruction 24 years ago at the tender age of 19. This past summer I landed on my good shoulder in a mtb accident. Luckily I just have micro tears in the labrum and a case of bursitis, this go around. The main thing my experience has taught me is the rehab is FOREVER. Make those rotator cuff exercises a part of your life.