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Partial tear in rotator cuff
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I've been dealing with a partially torn rotator cuff for about a year now. Started last April, rehabbed it last summer and by fall I had no pain. I started climbing hard again and I think I overdid it, causing an intense shoulder pain that started in December 2023. I finally got an MRI in January 2024 and found out about the tear. The doctor recommended I try physical therapy before surgery since I'm young and fit. I've been in physical therapy since January and also rehabbing it myself. I took a few weeks off climbing but then I was told to try and start easing back into climbing slowly (which I'm pretty bad about taking it easy). It was going well at first, but about two weeks ago just doing a move that normally didn't irritate my shoulder caused my shoulder pain to come right back. I guess my question is, has someone else dealt with this issue before? How did your recovery go and how long did it take? At what point should I consider looking into surgery? I'm feeling pretty down about how long this injury is taking to heal so I would love to hear other people's stories! |
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Welcome to the club brother. I have rehabbed my shoulder a number of times and it is a process including the amount and type of climbing you do, after rehab. Your Dr. is right to suggest rehab before surgery. The damage can be limited and yet the healing can be protracted. But not as protracted as if you have surgery, which will ensure you will be sidelined for 6 months or more, and it can take up to 9 before it feels normal. Even if you are a great healer, you will not be doing hard climbing for quite a while. I would stick with the rehab and slowly build your volume of climbing and the intensity. It is likly the shortest path to getting back to where you want to be. I wish you luck and most importantly I wish you patience. You have to play long ball here. |
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I've had a partial thickness tear in right shoulder rotator cuff (sub scapulerus tendon?) for about 8 years. No surgery just tons of PT and it barely slows me down. Climbing as hard as I ever did, but definitely can't do certain low compression moves as well as I should be able to. My left shoulder has had a similar injury (undiagnosed) since 2022 and it's kinda the and boat. Flares up every now and then, but you learn to avoid what aggravates it. |
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Thanks for the advice! Did either of you stop climbing to let your shoulder heal? And did you climb in pain? Or did you stop if you felt any pain? The Dr kinda freaked me out because he said there's always a chance a dynamic move will cause a full tear so I'm super afraid to do overhangs and dynamic shoulder movements now. But yeah I figured it's just a long long recovery but it's been a challenge for sure. |
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Ooof. So I was in a car accident 1/2023 and went to PT for neck/back issues but kept having weird shoulder pain. Saw a shoulder doc, MRI said partial tear, so I worked with a phenomenal climbing PT for 2 months and pain resolved. Then over the summer got weird pain in my deltoid and golfer’s elbow. Went back to PT and then decided to go see Hackett at the Steadman Clinic in Vail. He saw my images and said full tear, said the deltoid pain + golfer’s elbow were all because of my shoulder. Tested my strength and I had noticeable weakness on that side despite so, so much PT and strength work. He told me what I’d read in the research: partial tears are going to turn into full tears, particularly given our sport (he’s a climber) and the only option to get my strength back was surgery. I really noticed the weakness on lockoffs. I got to the point where I couldn’t trust my shoulder. I had surgery 12/4 and it was a full tear. I followed Hackett’s orders 100%, worked with my climber PT, and started climbing again at the 4-month mark. I’m having to be cautious for now but I already see my shoulder getting stronger. I think surgery was worth it. |
Lauren Errichiello wrote: As a non-licensed, non-trained, non-medical professional, I'd say stop climbing completely for 2 - 3 months. Give it a full opportunity to heal. |
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Lauren, both of mine have been torn. One for 30 years. The other happened last June on a single event in an off-width. 90%+. Told by two docs including the official shoulder guy for the US ski team that I would have to have the new injury repaired asap. I was scheduled for surgery in the fall so I would not miss out on the summer alpine season and then suffered a dissected carotid artery in Oct which forced me to quit climbing or running or lift weights for a solid three months while the artery healed. Of course the shoulder surgery was postponed due to the artery being on the same side. I hit it hard again before I was even cleared yet by UNM in January. Climbed three months straight in Cochise, Jtree, Red Rock and Zion and the shoulder feels solid at the moment. As you study it, these kind of massive tears are not going to heal themselves. However, if one has great fitness and skeleton muscle developed and takes real good care of what they eat, drink, etc., I do believe I can go longer with my new shoulder tear then the docs predict. The 30yr old injury on the other side I was told I needed surgery as well and have yet to have it. But, the caveat is that I relied more on my good shoulder those 30 yrs. That was why I was willing to have the fresh one repaired. I completely rack on my right side and hang on my left and could always lead through 5.11 trad, long 20 pitch routes, no worries. Obviously, I could cheat the system by switching to my right shoulder when mandatory all those years. Bottom line is you more than likely can live and climb with it through proper management, training, lifestyle and awareness. If it is 90% tore, the docs will warn that when it does go, it could take longer to heal and possibly not heal as well. Very complex human joint including the bicep configuration. This is one of those deals one definitely wants at least three opinions if you can afford to get them. Recovery from shoulder surgery is a bitch as you no doubt have learned. ps, there is speculation that I suffered the dissected carotid artery in an off width in Indian Creek in Oct because I was favoring that same side shoulder, putting excess pressure on my core. If that is true, obviously I wished I stopped to have the surgery when the injury happened. An injury like I had to my artery had a good chance of killing me. Having a complete circle of Willis is probably what saved me in that situation. Just speculation that is what caused the dissection though. Good Luck with it Lauren. |
FrankPS wrote: Sadly, there is no healing of a torn rotator cuff. The tendons don’t heal without surgical intervention. Working with a PT who knows climbing is helpful for strengthening the surrounding muscles/tendons and climbing can actually be beneficial for strengthening the rotator cuff |
Jennifer M wrote: Aren't you concerned that climbing on it will further damage/tear your rotator cuff? Edit: You said you already "overdid" it before, your doctor said the wrong moves or type of climbing could worsen your shoulder, so is it just that you can't stop climbing? Are you a climbing addict? Is this a cry for help? :) |
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I had rotator cuff surgery on both shoulders -- one in 2012 and the other in 2014. Recovery was no fun and I no longer remember how long before I was climbing again, but I'm still climbing now. |
FrankPS wrote: Ha! The surgeon gave me the go ahead to climb at the 4 month mark. He’s a climber himself, so gets it more so than others. I’m avoiding some positions/moves for now such as pushing in dihedrals, gastons where my body moves away from the surgery side, burly lay-backs, etc. Overall being very cognizant of the position of my shoulder when I climb. But no, climbing won’t worsen it. Once I get to the 6-month mark, the doc says I can do whatever. I just have to listen to my body… my head says hop on the hard stuff but my body says to go slower. I didn’t cause any damage going a little too hard that first/second week coming back from climbing but can’t just resume climbing 3-4 days a week when my upper body hasn’t done that type of thing since Thanksgiving. I just was achy and that was the sign to ease in a little slower. |
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As Jennifer said, Hackett's the man. He did my right shoulder, it's great. Wish he could have done my left shoulder (insurance wouldn't allow), and it's still problematic. . . |
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As others have said ....recovery will probably be slow. Anatomically, the human shoulder isn't really made for "hard climbing" (unlike a monkey's shoulder), so be gentle even after "recovery". My blown shoulder took 2 1/2 yrs to heal, so long I wondered if it would ever heal well enough to climb again.. |
Ian Dibbs wrote: Thank you Ian! That's helpful to know because I feel like I'm in that same situation after 1 full year. Did you ever stop climbing at any point to let it heal? |
Lauren Errichiello wrote: I used to work as a Registered Massage Therapist, who treated rotator cuff injuries. Strangely, most rotator cuff injuries often take 2 years to heal, no matter rehab/physio that you do. I never stopped climbing (bad shoulder was only one side), sore shoulders do force you to focus on footwork. "Rotator cuff" is composed of a 4 muscles, so together they try to compensate if one specific muscle is injured. |
Jennifer M wrote: True of full thickness tears (not what the OP has) but this matters less than you might expect. Evidence that (Achilles) tendons heal with non-surgical care: https://journals.lww.com/jbjsjournal/abstract/2012/12050/surgical_versus_nonsurgical_treatment_of_acute.4.aspx 10-70% of rotator cuff surgical repairs "fail" - the tendon tear is not better - but people still function better and with less pain following surgery that has "failed": https://pubmed.ncbi.nlm.nih.gov/21350064/ Evidence that outcomes in non-surgical treatment of people with rotator cuff tears is very little different from surgical repair. https://www.sciencedirect.com/science/article/abs/pii/S1058274621004316 What does this tell us? Firstly, tendon tears are only loosely related to pain and loss of function. You can have a tear and no pain and vice versa. Secondly, the corollary of this is tendon tears do not need to be fixed for people to function well. This is counterintuitive. We tend to think of tendons as like climbing ropes with tendon tears like core shots. It is understandable we think tears are something that need to be fixed. However, the rotator cuff tendon is not like a rope, it is like a sheet. A partial tear is like a worn spot in a sheet, perhaps not ideal but the sheet can still work very well. Thirdly, very good function is often possible following good physical therapy. PT is not guaranteed to work, but I would almost always give this a proper go before trying surgery. This needs a patient patient and a good therapist. The US healthcare system is very orientated towards surgery for sporting injuries. Ask yourself why this might be. [edited to reverse points two and three, hopefully makes more sense in this order] |
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For shoulder rotator cuff tears - does anyone have any good Front Range (Boulder area) recommendations for an Orthopedic Doctor who works with climbers and can diagnose and /or order an MRI? |
Michael L wrote: Michael Repine at BMC repaired both my torn rotator cuffs, one in 2012 and the other in 2014. (He also did my hip replacement.) I got back to climbing soon after, though I no longer remember how long it took. I've been very happy with the results. |
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I have a repaired left labrum and a torn right labrum that could stand to be repaired but I have been doing rotator cuff strengthening exercises for years now and the right shoulder is doing fine. As mentioned above, I try to stay away from loading it excessively in corners (dont go do Book of Hate). Also I try not to let the labrum take the load on either shoulder, which is sort of a drag if just hanging from an arm or carrying something heavy, it helps to keep the back of your shoulder engaged. If you do get surgery track down a specialist, I was lucky enough to get the doctor who treats a lot of professional surfers shoulders in Hawaii. 6 months was my post surgery recovery time. |
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Im on the side of recommending PT as well having dealt with same injury. Also things that will reduce inflammation and heal time like Peptides. BPC157 and TB500 are a game changer when it comes to these kinds of injuries. https://bengreenfieldlife.com/article/supplements-articles/how-to-use-bpc-157/ https://bengreenfieldlife.com/article/supplements-articles/how-to-use-tb-500/ |
scott pedersen wrote: There is no clinical evidence that taking these peptides helps with soft tissue injuries. |
