Home Forums Hunting & Shooting Hunter's Campfire Rotator cuff problem.... #2

Yeah but it's BS.

I've had 3 rotator cuff surgeries and no pain on any of them.

In fact, I suggested to my son becoming a PT after my first one. Now he is a Doctor of PT.

The only people that will be hurting will be the ones that don't do PT.

My surgery is tomorrow. I have a partial tear of my rotator cuff and damage to my biceps tendon. I will see how everything turns out as far as hunting goes. I can always go and just sit by the river all day. Sitting here waiting for some ice sleeve machine to be delivered. They say it will help with the healing process.

Went for my first PT appointment Monday and the young lady just did a bunch of measuring. Very pretty young lady and my first cousin once removed. Yeah, she owns the place.

Today was my first real PT. I was led into a big room where several people were being treated.

I asked the girl, not my cousin, "Where is the changing room"
She said, " What do you mean"?
I told her loud enough that everyone could hear, "If you want me to change into one of those little hospital gowns that dont have a back to them, I need a changing room, or I'll do it right here". I stood up and acted like I was pulling off my T shirt.
She screamed, "NO!" loud enough to wake the dead. Most of the room burst out laughing and the secretary came running back to see what happened.
Me, I just put my shirt back down and looked dumb (that's not hard to do).
She looked at me a minute, shook her head, and said, " You gonna be trouble".
And I told her, "I'll do my best".

Nothing to the therapy so far. Done a bunch of stuff with rubber bands and weights. When through, they iced my shoulder and hooked up some kind of shocky thing. Said I'd be sore tomorrow and to come back Friday.

Praise the Lord !

I had a Partially torn rotator cuff last year.
It eventually healed.
I think THIS is why.

1. Rest but keeping it mobile. That meant no lifting of heavy weight above the shoulders.

2. I ate connective tissue of cow and pig parts to give the body what it was lacking. A deficiency made the shoulder weak and prone to injury to start with. I had to reverse that.

3. Supplements that address the joints, tendons and connective tissues were taken.

4. Food and supplements that reduce inflammation were eaten.

5. Foods that cause inflammation were avoided.

6. Glutens were avoided since they prevent the absorption of nutrients.

7. I avoided chemicals/ drugs and synthetic steroids since they cause the degridation of connective tissue. Some people only need a couple of shots before they really tear their shoulders badly. Then the docs start making the BIG $ BUCKS!
It's one reason for "pain management."
I've broken lots of bones and had lots of sprains and tears. I don't have a high pain threshold. I make use of God created remedies that don't make me surgeon poor and surgeons rich.
I don't judge you or others for letting their docs inject. I just care enough to tell you the truth. Too many rheumatologists, etc KNOW this, but care more about their next vacation expenses. Watch out for doctors and nurses bearing needles.

YMMV
I hope that you find a way to heal and strengthen too my friend.

☕ 🙂 👍

One happy camper

I went to PT after falling off my truck and jamming my left rotator cuff breaking my fall a decade ago and the gay fruit loop drove me crazy with the lisp. He did show me what I needed to know and I never went back.

Get the lightest tube band from Walmart for 12 bucks and jump on YouTube and watch the internal/external rotation exercises. There are several others that are useful but I don’t know the name.

In my case, I have been injury free weight training for the last two years by warming up with those rehab exercises on upper body days, and doing them on lower body/ab days with more intensity.

I damaged my right shoulder pretty bad benching in my early 20s without warming up.

True, I am weak in the upper body and a lot of the women lift heavier than me but no injuries in two years.

Best of luck to ya and I hope it all goes well.

Keep us posted.

"Yeah but it's BS.

I've had 3 rotator cuff surgeries and no pain on any of them.


Now that's some real BS!

So this afternoon they delivered the ice sleeve machine. It does ice, heat and compressions. I wish I would have had this 6 weeks ago. I have to use it 3-5 times a day for four weeks. You should ask your doctor about renting one.

Dude, Sorry, I missed this info.

I assume it’s done - or is it tomorrow?

Either way, you won’t be able to type and flip me any shít on my threads for a while.

You just keep reading and I will be sure to try and abuse you every chance I get...Taking advantage of your situation should be expected.

Hope the surgery went well, or goes well. Here’s to a Uber fast recovery and lots of happy pills for you while you’re on the mend.

Be well !

🍐🦫

Randy, having both had it and also treating others with it....

don't play Russian Roulette with it.....get the PT.. it won't start helping instantly, but over time it will be well worth it...

I had bursitis when I was in the service.... at night when I rolled over, I shot out of bed, because it felt like someone had just stabbed me with a hot glowing knife....between bursitis cause by excessive PT, and then getting a pair of hairline fractures in my knee caps, I was messed up big time...that was basic..

then I got to AIT in San Antonio, and they gave me severe food poisoning TWICE in 8 weeks... the worse one, I lost 25 pounds in 8 hour overnight...

Thought the darn Army was just out to kill me... .thank goodness I was a 24 year old guy in good shape before I started....

I wouldn't recommend enduring any of those ills ever again....once each was TOO MUCH....

Why don't you look into percutaneous, ultra sound guided needle tenotomy with platelet rich plasma injection? It is inexpensive, almost painless, non-surgical and highly effective.


https://www.mdpi.com/2077-0383/9/7/2114/htm

From the study....

4. Discussion
Our main findings are that US-guided percutaneous tenotomy of the LHBT is a procedure with 100% technical success and technique efficacy, high degree of patient’s satisfaction and no immediate complications.
This prospective study is the first cases series in living patients. Looking at the technical side of the procedure, previous feasibility studies on cadavers tested different approaches to sever the LHBT. In the first series published by Levy et al. [33], the authors cut the intra-articular portion of the tendon with an anterolateral superior skin incision, 1 cm lateral and inferior to the coracoid, similarly to ours, but obtaining a successful tenotomy in only 25% of cases. However, the authors used an out-of-plane approach that can limit the efficacy of a procedure that needs to be very precise. Then, the procedure was done by a sonographer with unreported experience in image-guided interventional procedures. Further, the authors tried to cut the tendon intraarticularly, close to the anchor, a zone which is usually not well accessible using US. This point was also underlined in the cadaveric study by Sconfienza et al. who, indeed, preferred to perform the tenotomy in the most cranial part of the intertubercular groove with 100% success [32]. Aly et al. [30] performed the tenotomy on cadavers at the rotator interval using different arthroscopic scalpels, obtaining a complete tenotomy in 67% of cases. The last cadaveric study was published by Atlan and Werthel, who differently demonstrated the efficacy of an endoscopic backward cutter using a posterior arthroscopic portal [31]. In the only one case reported on living patient, the authors used a #10 scalpel for skin incision and an arthroscopic trigger finger release hook knife to cut the extra-articular portion of the LHBT between the distal edge of the subscapularis tendon and the proximal edge of the pectoralis major tendon [35]. Their patient experienced pain relief and was able to return to normal level of activity, with the proximal tendon stump still placed at the proximal portion of the intertubercular groove at follow-up US examination. In our study, we preferred to do an anterosuperior skin incision in order to cut the LHBT at the rotator interval as medial as possible and with an in-plane approach to continuously monitor the scalpel advancement. Our choice was dictated by several reasons. Indeed, despite the poor success rate of Levy et al., the rotator interval can be easily scanned by moving the patient arm [22,39] and the in-plane approach helped us to precisely cut the tendon reducing the risk of iatrogenic injuries. Cutting the LHBT as medial as possible allowed us to keep at minimum the length of the proximal tendon stump, which may potentially impinge inside the joint. In addition, we avoided the distal approach tested by Greditzer et al. [20] to decrease the risk of damage to the crossing fibers of the subscapularis tendon and to the recurrent branch of the circumflex artery of the humerus.

Our procedure had very high overall patient satisfaction rate, with 91% of patients being satisfied or very satisfied at follow-up examination. Only one patient was neutral and was also the only one presenting Popeye deformity, cramping once per week and very minimal pain in the biceps muscle. Furthermore, all patients experienced pain relief and would have their percutaneous tenotomy again, with neither weakness in elbow flexion nor limitation in daily activities due to the biceps. These results are in line with those reported by Meeks et al. who administered the same questionnaire to 104 patients subjected to arthroscopic biceps tenotomy [42]. Ninety-one percent of their patients were satisfied/very satisfied, 95% would have the tenotomy again, 13% had the Popeye deformity, and about 20% presented cramping once per week and very minimal pain in the biceps muscle. The low frequency of Popeye deformity could be related to our approach. Indeed, we cut the LHBT as medial as possible into the rotator interval thereby decreasing the risk of both Popeye sign and intra-articular impingement of the proximal tendon stump. On the other hand, we can postulate that a high percentage of arm fat could have left invisible the biceps deformity. However, we have not available data regarding body mass index or other measures of body fat percentage. We also found similar results in terms of pain relief to those reported in a recent study aimed to compare arthroscopic tenotomy and tenodesis [18]; indeed, the authors reported pre-tenotomy mean VAS of 7.5 (which was about 8 in our series) and post-tenotomy mean VAS of 4 (which was around 3 in our series). In this regard, it is important to highlight the main differences between arthroscopic tenotomy and our novel procedure. Arthroscopy needs to be performed in operating room with a team composed of orthopedist, nurse and anesthesiologist. It requires two skin incisions and regional anesthesia, it is a more-invasive and longer procedure. Conversely, US-guided tenotomy can be performed in dedicated interventional rooms or ultrasonography rooms and it involves a radiologist and a nurse. Further, it has shorter procedural time and requires only one mini-incision and local anesthesia.

No major complications were encountered, and the procedures were no painful with no significant bleeding. Indeed, although lidocaine is generally used for local anesthesia prior to US-guided musculoskeletal procedures [29,38], we preferred to use a solution of mepivacaine + adrenaline to reduce the risk of bleeding due to the relatively invasiveness of the procedure. Further, the percutaneous tenotomy led to a minimal skin incision and was very quick, requiring a mean time of about one minute from skin incision to scalpel retraction, in line with a previous feasibility study on cadavers where the mean elapsed time was 53 sec [32]. Notably, two minor complications were observed in our series. One patient complained of shoulder pain due to subacromial-subdeltoid bursitis, which was successfully treated with a single bursal injection of steroid. Moreover, we encountered a delayed wound healing in a diabetic patient, which then resolved spontaneously. It is well known that wounds can take longer to heal in patients with diabetes. Thus, we recommend reducing to a minimum skin incision paying particular attention to skin disinfection in case of uncontrolled diabetes in order to decrease the risk of delayed wound healing and infections.
Some limitations should be taken into account. First, our sample size was relatively small, although it was enough according to sample size calculation and it was sufficient to reach statistically significant results. Nevertheless, larger studies will enable to better understand the real frequency of complications related to this procedure. Then, this is a prospective non-controlled study, thus we did not compare the results of our procedure with those of arthroscopic surgery that is considered the standard of care. However, US-guided LHBT tenotomy was never tested before on living patients, thus a feasibility study was needed. We acknowledge that the shorter procedural time and higher cost-effectiveness of US-guided tenotomy do not require any comparison with arthroscopy. Nevertheless, future prospective randomized trial should be aimed at comparing our novel procedure to standard arthroscopy to understand the relevance of possible iatrogenic injuries to joint cartilage and RC tendons, as well as to assess the risk of intra-articular impingement related to the proximal LHBT stump and the clinical impact of possible missed diagnosis normally reached during arthroscopy. Last, we used a not validated questionnaire for follow-up clinical evaluation based on what previously published [42]. However, similarly to Meeks et al. we aimed at providing a biceps-specific questionnaire to assess clinical outcomes after tenotomy.

In conclusion, US-guided percutaneous tenotomy of the LHBT has 100% technical success and technique efficacy, high degree of patient’s satisfaction and no immediate complications. Future prospective randomized studies comparing the outcome of this procedure with the standard of care are warranted.

Tarquin, thanks for info. I'm giving PT a try and if that dont work, I'll have to do something. Thanks again!

Well I had my surgery yesterday and I’m in a giant sling. Torn rotator cuff and torn bicep tendon. They also gave me a nerve block. 6 weeks in a sling and passive PT. Then I start real PT in week 7. Still having delusions grandeur about going on my hunt…

Oldman definitely keep up with the physical therapy. It will help. Stretching any strengthening will go along way.

Glad to hear you made it through surgery and hope they got ya fixed up. Dont remember you saying when your hunt was, but hope you can make it. Dont care what is going on, getting to go hunting always makes it better.

I'm headed for my second PT appt in a little while.

Randy, a few months down the road, you'll REALLY appreciate the PT.
Stick with the therapist, as the stretches and strength exercises are often progressive.
After having both biceps re-attached, I can honestly offer an "expert" opinion!

PT is awesome if you're sedentary and don't know basic exercises 🙄

My trip is planned for the last week of October. I agree. No matter how crappy things are just being in deer camp makes things better. I will see how I feel in 7 weeks. Probably take the trailer and let my hunting buddies have more room in the outfitter tent.

Good luck with your PT

Be sure and do all the PT they tell you you need. PT is as important as the surgery.

Also agree and do only what you are told to do. I know 2 guys that pushed it outside of what the PT had planned and set themselves back.

Rotator cuff surgery was a 6-9 month recovery before being released to full duty. This is in relatively young and healthy firemen.