Torn rotator cuff or shoulder injury

Jeremy Riesberg wrote:The first time I dislocated my shoulder was snowboarding at age 26. After that, it popped out maybe 20 times before surgery. I had surgey the next year after a MRI showed how bad it had gotten. It took me 3 months before I was able to tie back in. I'm very happy I went through with having it repaired. The younger you are when you have the surgery done, the faster and better the process will be.

Hey Jeremy, did you tear your labrum or your rotator cuff? I've dislocated my shoulder about 6 times in last 7 months. It goes back in pretty easily now, but the first 4 times my shoulder remained out for over an hour. I was wondering if your separations were similar?

Finally got MRI and the results.

Nonretracted full thickness and partial thickness tears of the supraspinatus tendon. Subdeltoid bursitis with some intraluminal debris, & Mild acromioclavicular osteoarthropathy.

Looks like my Ice climbing year is done as well as canyoneering, rock climbing for the next 9 months. Really sucks to.

Surgion says best to get it done right away or It will be harder to fix. 6 to 9 month recovery and PT. This really sucks cause I had a new pair of Ice climbing boots ordered for the ice climbing season. If anybody cares, ill be in the corner crying myself to sleep. I don't even have a good story to tell how I hurt myself. Probably lifting my pack with three ropes, a full rack of cams and stoppers.

Sorry to hear but yes get it done now…… before you know it you will be back cranking.

DennyW wrote: I don't even have a good story to tell how I hurt myself. Probably lifting my pack with three ropes, a full rack of cams and stoppers.

You might have had those injuries at the same or lessened severity for years now. Something like 10% of MLB pitchers are thought to have full thickness cuff tears and don't even know it.

Hey Denny, sorry to hear you didn't get better news. Good luck with recovery. You'll be back before you know it!

I have an injured left shoulder from a few years ago and now that I've started climbing it's become a bit of a problem. Doctor diagnosed it as an adhesion, basically a wad of scar tissue. He's told me to smash and rub a hard rubber lacrosse ball into it, to essentially tenderize it. It hurts like crazy but has been working to increase range and lower pain without resorting to a surgical fix.

Thank you for your well wishes and support. I wish tendons could heal themselves.

Definitely et it done ASAP before any retraction or atrophy start. You will miss this ice climbing season but I think the standard 9-12 months recovery project that is the party line is usually pessimistic. I don't know how old you are but I am 60+ and have had both rotator cuffs repaired in the past 3 years and in my case the damage was more extensive then yours. In both cases I was climbing easy stuff in 4 months and interesting stuff in 6 months and almost 100% in 8 months.

Denny- Shoulder injuries are very complex as mentioned by previous posters. It also appears that they do not heal by simply stopping or limiting the range of motion… you must be proactive in seeking answers and treatment….don't wait! A simple but very painful impingement lasted me for years..I stopped climbing and lifting weights for a long time hoping it would go away and it never did…a simple problem with some shoulders in some cases is a muscle imbalance due to the pectoral muscles, intercostal muscles and costal cartilage (rib cage area) being too tight and essentially pulling the shoulders forward and down…this creates a slightly hunched over appearance in climbers…I went to a medical massage therapist and told him about my shoulder injury and he kept shaking his head "no" as I tried to tell him that the problem was in my shoulder…he worked on my pectorals and my rib cage in the arm pit area and it brought tears to my eyes due to the pain…he suggested rolling those areas daily with a foam roller and I did…it brings tears as well but after 1 week my full range of motion was back and I am climbing again…I keep rolling it out to make sure it stays limber and it has been good so far…as a previous poster mentioned it may be scar tissue build up ….I had problems with an impingement in the past and went to the traditional therapy route but it always came back…the medical massage therapist I went to is in Santaquin Utah and he charges $25 a session…he is about 5 minutes away from Santaquin Canyon…PM me if you want his contact info…if you don't have a tear then this may help…hard to know unless you have an MRI but $800 to $1000 later the MRI will tell you for sure what you are dealing with…maybe try a session with this therapist first and if no improvement then go family doctor/MRI/shoulder specialist/physical therapy route

I strongly agree with Frank F & others who recommend proper diagnosis ASAP if you think you tore it episodically or it's a long-term nagging injury. In my book, "proper" is heading to a SPORTS doc & the nearest MRI; don't screw around with crystals & incense. MRIs are not as expensive as they used to be....a good doc's staff will literally shop around for you (or you do it). Have had both shoulders done in the last 5 yrs but did what Frank suggests: see a sports doc.....they have a different take on it all (in my experience). I lucked out cuz I know a sports doc who is also an ice climber. Two years ago I had a partial tear....kinda the worst of decisions cuz if you don't have it surgically repaired & decide to risk it for X years, it won't take much of a jolt to completely tear it.

Ice climbers' shoulders do a lot of things besides the obvious: swinging & pulling up (with arm & shoulder high....kinda the worst position for a shoulder already injured). We've all placed tools by simply hooking, etc. but when a tool suddenly pops or 'jolts', say 8", cuz it ripped thru the ice (as in chandeliers), your arm is obviously going to just as suddenly react and that's more stress on a complex anatomical area. Add all of that with rope handling, belaying, rappelling, possibly needing to help a partner down (lower or a rescue) and it's a recipe for bad juju. It's common knowledge that if one body part is injured, the natural thing to do is favor the other.....and you might end up with a bent frame if you depend on the other appendage too much (whatever you're doing).

During your year off, you don't need to stand by the fridge & watch the ice cubes form and be bummed out. Hang around ice climbing areas, talk to people, watch their technique, stay part of the scene (all the while avoiding the "I wish I could....."), hell, put your harness on, walk around and don't feel stupid about it...."feel" it all, STAY IN THE GAME (even if you have to be an umpire for an inning). You will likely meet people with similar stories.....see how they are faring with it all. It will definitely psych you even more for the next season. With your sports doc's OK & some healing time, put your crampons on & traverse WI.01 & use your other hand -- not a tool (but don't push it nor get hit from above). I'm a big ASAP MRI fan, so much so that I keep one clipped to my harness just in case. I'll lend it to anyone, whether they need it or not.

Denny,

Your diagnosis would be a novel name for an FA somewhere, regardless of grade. "Nonretracted full thickness and partial thickness tears of the supraspinatus tendon. Sub deltoid bursitis with some intraluminal debris, & Mild acromioclavicular osteoarthropathy".

Let us know where & when you did it and we'll all go do it in your honor, wishing you the best in the meantime. Well known Turkish saying: "May it pass quickly".

Here is my diagnosis from an ink inject MRI:

1. Sizable full-thickness partial width tear the anterior distal
supraspinatus tendon at the level of the footprint. There is
approximately 2 cm of AP gap. Associated partial-thickness
infraspinatus tearing noted as well.

2. Degeneration the superior labrum noted. Associated tendinosis
of the intra-articular biceps tendon

Sounds almost identical. My doc told me surgery now, as the injury is over 2 years old. But here's the kicker with me: I have almost no pain, and full range of motion. I went to a seminar from Regenexx hoping for an easy way out, the dr. there said with my tear I should be structurally unsound and have range of motion issues. He could not believe what I was able to do in front of him. Then lately I have been remodeling a high school, and the guy who teaches physiology and I have become friends. He strongly urged me not to get surgery and instead build the surrounding muscles up. Tomorrow he will show me some specific exercises, I also have a pT appointment for the same thing coming up.
I have a bad tear, but by being pretty well built around my shoulders seems to have spared me from a lot of trauma.
So, the reason I am posting this is twofold: one to the OP that there MAY be an alternative to getting stitched up, but then also to see what other folks opinion is on the building up surrounding structures are for long-term success.

I vote with your doc. Several of your diagnostics are likely to worsen over time (yrs), regardless of how beefy you keep your shoulders, etc. You might even develop a false sense of security (I know that drill). Get thee to the OR.....

There is plenty of evidence showing people with very similar injuries competing at a very high level without surgery. I'm actually surprised your surgeon (OldandBusted's surgeon) would even consider surgery if you're pain free with as good motion as you claim.

http://www.ncbi.nlm.nih.gov/m/pubmed/23775245/

Note: the key word in the linked study is asymptomatic...as in they have no idea they have any shoulder pathology.

I tore my Rotator cuff, labrum and bicep playing baseball in high school the summer prior to starting college football (at a D1 university in the south-east); the thing never healed. In all actuality, I only started climbing seriously after the injury, albeit with months of surgery and physical therapy... not to rain on your parade. Now, 6 years later, i have limited range of motion, but climb (most of the time) without pain. you get use to shifting your hips to compensate for lack of motion in your shoulders. Best of luck, my man. I hope this is not a life-changing injury... I went from a complete jock, to a climbing bum within months... ohh, how life throws curve balls.

DennyW wrote:Finally got MRI and the results. Nonretracted full thickness and partial thickness tears of the supraspinatus tendon. Subdeltoid bursitis with some intraluminal debris, & Mild acromioclavicular osteoarthropathy. Looks like my Ice climbing year is done as well as canyoneering, rock climbing for the next 9 months. Really sucks to. Surgion says best to get it done right away or It will be harder to fix. 6 to 9 month recovery and PT. This really sucks cause I had a new pair of Ice climbing boots ordered for the ice climbing season. If anybody cares, ill be in the corner crying myself to sleep. I don't even have a good story to tell how I hurt myself. Probably lifting my pack with three ropes, a full rack of cams and stoppers.

I too had a moderately serious shoulder injury (complete Supra, partial of two others, dislocation of a biceps tendon, and labrum tear). The regional surgeon requires 9 mos. to 1 yr. recup; I researched other options and found an accelerated PT program that, if successful, requires only 3 mos. rehab. Since I'm a professional guide, I opted for this program, despite higher risk of re-injury and having to travel outside my area to find a surgeon willing to utilize the program. Happy to say it was fully successful - tho the rehab was Hell. I returned to full time guiding 3 mos. after the surgery, and within 5 mos. was climbing as well - or better - than ever before.
I don't have quite the mobility in that arm I once had, but loads more than I had while dealing with the injury. I would guess less than 5% loss of angle of usage, and perhaps 3/4" loss of reach (the surgeon had to pull quite a lot of tissue to sew it back together). I must sometimes swing my arm a time or two to get a bit more reach or get that awkward "behind me" reach. To date only one route -Junior at the Gunks - has thwarted my efforts to "resend" since the surgery.
It was definitely worth the 3 mos. layoff. The biceps tendon injury did not stop me from climbing, but caused intense pain immediately after releasing any pressure on it. The weakness caused by the rotator cuff tendons was definitely limiting my ability more than any loss accrued due to surgery.

I'm sure those posting that they had a "biceps tear - full or partial" knew or was told by their doc that a "biceps tear" is a general term (& the patients know by now which type they had/have). There are basically two kinds: a 'distal' tear, one which occurs near the elbow where the biceps tendon attaches. The second kind is a tear (called a "proximal tear") of one or both of the biceps tendons that attaches in the shoulder area. Less than 5% of biceps tears are distal. (For orientation, think "distance" [away from the body] when referring to 'distal'. "Proximal" orientation can be remembered by "approximate" or "near by", meaning towards or closer to the body.

This isn't an anatomy lesson, rather a note to those considering surgery or not, long-term re-hab v. hopeful short term and then the kind that come to us all at some point.....when you get older....and THAT is when the decision you made 30 yrs ago may knock on your door. As I've said earlier, I'm a huge fan of MRIs because they will reveal (almost) exactly what the pathology is (or is not). The very best PTs can't look into your shoulder (but come pretty damn close to know what's going on).

The posts describing their pathology to a "T" are MRI members; their descriptions are what the surgeons are looking for. (These days, you can get a knee MRI-ed for $400 if you shop around. Yeah, shop around....call a clinic that offers MRIs. I know because I've done it (at my surgeon's suggestion). "Bids" ranged from $400 to $1,100 for the exact same thing, including the radiology reading. It's a very competitive biz and an MRI is an MRI....nothing special (except the radiologist who reads it).

Why should you care about the two kinds of tears (distal v. proximal) and the choices you make? Because the pathology & subsequent repair (tendon sewn v. "stapled" - a generic term -or other methods such as grafting but let's not go there now; that's a bit rad and unusual) & recovery will often hinge on what you do athletically. Plenty of fantastic surgeons out there who will do a great job fixing your shoulder but if you & she/he haven't discussed your (presumably) continuing interest in climbing, a general or even an orthopedic surgeon may recommend other repair methods (such as hammering in a 2" Bugaboo into your shoulder & calling it good. And bill you).

A biceps tear (distal or proximal) can affect your body's performance over the very long run (years); if it didn't have the best repair in the beginning, it will, count on it, re-visit - it probably will anyway. The biceps doesn't do just one main motion; it's a multi-tasker, depending on which part, which bones it is attached to and other variables. Couple that with the other complicated rotators (arguably the most complex of the musculoskeletal regions) and that warrants avoiding the hocus pocus; know exactly what your pathology is before you see my incense burning massage therapist down the street for a first opinion.

As Frank F and others emphasize, see a SPORTS MEDICINE M.D. at least for a consultation BEFORE you choose which course you think is best for you. What really might be that nagging, lifetime problem.....might have already begun, regardless of your decision. Maximize the repair course now so as to minimize potential future limitations and Fred Beckey might....might let you belay him.

Here's a fun fact.
I don't know anyone over 50 who does not have some sort of tearing going on in their biceps or shoulders. None.
I had a Dr. tell me once we are only supposed to live to 45 from a evolution perspective.

Hey Denny, just noticed your tear is non-retracted. You might give Regenexx a call. They couldn't help me b/c of the 2cm gap, but they were a couple months ago looking for rotator cuff tears for a study (free treatment).

So I see that Regenexx lost the FDA v. Regenexx lawsuit earlier this year, but the judge's argument was that the stem cell therapy should be regulated as a drug. Is that the gist of it? Is Regenexx appealing....you seem to be familiar with the company. Do you have friends who have had successful cartilaginous repair via their stem cell work? Interesting stuff.