Shoulder Problems - Need Surgery? Your Thoughts!

joshmat · #1 04-14-2011, 05:56 PM

OK Guys and Gals,

For those of you that have been under the knife for a shoulder issue, please lend a brother some advice as I'm concerned and quite honestly, SCARED OF HAVING MY SHOULDER OPERATED ON!

Back in October 2010, I injured myself at the office. I'm an "IT dude" and bonked my shoulder up moving a gang of equipment around after a catastrophic office flooding due to a water main failure... In a nutshell, moved much stuff, shoulder payed the price...

So... I've been through crackpot doctors that wanted to do no more than prescribe me narcotics, and fought enough to get a trusted orthopedic surgeon involved in my case. After six months of "pushing" for an MRI (if you've had any experience with workers comp, you'll understand), I got and MRI approved. Subsequently, I've been diagnosed with a labrum tear and in short, I need a surgery for the repair. I've already been through PT and none of that was really effective.

Essentially, after months of shoulder pain, I now have to decide whether or not to have a surgery to repair it or if I should try to tough out the pain indefinitely. I'm aware that it will most likely continue to ail me if I don't have it repaired, but I want to know if any other TB'ers out there have been through a labrum correction and how that worked out. I currently play in a pretty busy jam band with gigs nearly every weekend (weekend warriors!). My doc told me I wouldn't be able to strap a bass on for at least 3 MONTHS post op!!!! Need I say, ACK!!!???

My bandmates won't desert me, so that's not really a concern.

So I'm asking TB this ... Should I deal with the current pain, look for alternatives as far as shoulder strengthening/rehab goes, or dive in with the repair?

* *For background: I'm in my early 30's so I'm still somewhat in a position to bounce back from a surgery, albeit inevitable as this won't heal itself over time (at least I don't think so). Adding to the issue is that it's my dominant hand/arm.**

So if any of you out there that have been through something like this and want to help me feel better about it or have some genuine concerns that I need to address/be aware of, please let me know!

Jeff K · #2 04-14-2011, 10:37 PM

I guess it's not the same thing, but I've had surgery on both shoulders for torn rotator cuffs. I think I was in my late 40s when I had the first one. That one was particularly bad. The tear was quite bad - barely hanging together. The surgeon had to drill holes in the shoulder bone and the top of the upper arm bone and tie it all back together with some kind of laces. It took me nearly a year to fully recover.

The other shoulder wasn't nearly that bad. But physical therapy was required for both. As to whether or not you should have the surgery, I think you've answered your own question. You've been miserable for a long time. You finally got your MRI and talked to an orthopedic surgeon. If the surgeon says you need the surgery, then you probably need the surgery.

"Toughing it out" and trying to live with it might sound like a manly thing to do. But at some point you will quite probably injure it further, which will make the surgery more difficult. Get a second opinion if you want; but I'd recommend you get it fixed...

EricssonB · #3 04-14-2011, 10:40 PM

Not much to say beyond that. Sucks that you had to wait so long to get all of that done, but hey, tough it out. It should be worth it, unless the anesthesiologist messes something up. =X

tercesyrev · #4 04-14-2011, 10:49 PM

Sorry to hear about your situation. Time to start looking for a light weight bass . . . You don't want something heavy aggrevating a repaired shoulder.

R Baer · #5 04-14-2011, 10:51 PM

I'm dealing with a ripped extensor tendon in my right elbow. Doc said 90% of these cases don't need surgery, so I guess I'm one of the lucky ones. I tried everything on my own to get it to heal, but with no luck, so after dealing with the pain for 9 months, I'm finally going under the knife tomorrow to get this fixed. Am I worried about being able to play again? Not really, surgery and PT should heal this up just fine in a couple months. Heck, I can't play now because of the pain, so it can only get better, right?

So, I guess my advice would be that if the non surgical methods didn't work, then look for a good orthopedic surgeon and get it over with. Always get a second opinion. Orthopedic docs that specialize in sports injuries are usually good with this type of injury. Just don't let them shoot cortisone into you every few months. It's only a temporary fix and breaks down cartilage and tissue in the long term.

dystopiate · #6 04-14-2011, 10:53 PM

If our positions were reverse I would:

Get more opinions on whether or not to get surgery. You should at minimum ask:
1) what kinds of improvements in pain, and joint stability to expect from surgery.
2) anticipated arthritic changes from surgery vs no-surgery.
3) that they will be doing to the labrum (i.e., sew it up, cut it off).
4) what are you at increased risk of without surgery.

A labrum is just cartilage, so it's a passive restraint. The active restraints will always need to work properly to avoid shoulder pain, regardless of whether or not you get surgery. Most surgeons won't take this into account and most physical therapists are just terrible at their jobs. So, even after a successful surgery, "rehab" often goes so poorly that you're just a ticking timebomb that will never feel better, and may feel worse. Be sure to get a good PT. It will probably be hard, but it's your shoulder.

When checking out physical therapists for a labral tear I would want to at least know what they think about:
1) my scapulohumeral rhythm
2) the position of my scapula
3) choosing traction vs. approximation exercises for the glenohumeral joint
4) the length/tension of my pec minor
5) my thoracic spine
6) performing manual therapies to fix length/tension imbalances

If any of those are not immediate concerns for them, you're probably better off going elsewhere.

joshmat · #7 04-15-2011, 06:13 AM

Quote:

Originally Posted by Jeff K

The surgeon had to drill holes in the shoulder bone and the top of the upper arm bone and tie it all back together with some kind of laces. It took me nearly a year to fully recover.

I think it will be more like your first surgery. They will anchor sutures in my shoulder to reattach the labrum where it's torn.

joshmat · #8 04-15-2011, 06:14 AM

Quote:

Originally Posted by tercesyrev

Sorry to hear about your situation. Time to start looking for a light weight bass . . . You don't want something heavy aggrevating a repaired shoulder.

This is why I can't currently play a jazz bass!

joshmat · #9 04-15-2011, 06:17 AM

Quote:

Originally Posted by R Baer

I'm dealing with a ripped extensor tendon in my right elbow. Doc said 90% of these cases don't need surgery, so I guess I'm one of the lucky ones. I tried everything on my own to get it to heal, but with no luck, so after dealing with the pain for 9 months, I'm finally going under the knife tomorrow to get this fixed. Am I worried about being able to play again? Not really, surgery and PT should heal this up just fine in a couple months. Heck, I can't play now because of the pain, so it can only get better, right?

So, I guess my advice would be that if the non surgical methods didn't work, then look for a good orthopedic surgeon and get it over with. Always get a second opinion. Orthopedic docs that specialize in sports injuries are usually good with this type of injury. Just don't let them shoot cortisone into you every few months. It's only a temporary fix and breaks down cartilage and tissue in the long term.

Good luck today and in the recovery, man! I do have a sports med doc, he mentioned this happens to pitchers frequently.

baileyboy · #10 04-15-2011, 06:20 AM

Buy The Trigger Point Therapy Workbook, 2nd Edition by Claire Davies (soft cover, about $20) and a theracane ($25). For under $50 I have gotten rid of my own shoulder impingement, tennis elbow, and a multitude of myofascial pain. My girlfriend had a nagging back pain since the 80s...once she found the "trigger point" she got rid of it in a day's time. Hey, man, I've done my research and for the price of a good set of bass strings, you'd be nuts not to give it a try.

lomo · #11 04-15-2011, 06:20 AM

Without seeing your MR (I am a radiologist) I can't comment for certain. However I can tell you that if you truly have a labral tear, it will not heal properly without surgery. In the end, there are risks inherent to both surgery and leaving it alone. I'd have it fixed if it were me.

joshmat · #12 04-15-2011, 06:37 AM

Quote:

Originally Posted by dystopiate

If our positions were reverse I would:

Get more opinions on whether or not to get surgery. You should at minimum ask:
1) what kinds of improvements in pain, and joint stability to expect from surgery.
2) anticipated arthritic changes from surgery vs no-surgery.
3) that they will be doing to the labrum (i.e., sew it up, cut it off).
4) what are you at increased risk of without surgery.

A labrum is just cartilage, so it's a passive restraint. The active restraints will always need to work properly to avoid shoulder pain, regardless of whether or not you get surgery. Most surgeons won't take this into account and most physical therapists are just terrible at their jobs. So, even after a successful surgery, "rehab" often goes so poorly that you're just a ticking timebomb that will never feel better, and may feel worse. Be sure to get a good PT. It will probably be hard, but it's your shoulder.

When checking out physical therapists for a labral tear I would want to at least know what they think about:
1) my scapulohumeral rhythm
2) the position of my scapula
3) choosing traction vs. approximation exercises for the glenohumeral joint
4) the length/tension of my pec minor
5) my thoracic spine
6) performing manual therapies to fix length/tension imbalances

If any of those are not immediate concerns for them, you're probably better off going elsewhere.

I really dig your experience here! Thanks for the insight!

I think that I'll have improvement post-op, but a surgery won't guarantee anything. I have good range of motion and reasonable strength, so the connecting bits are "good" for the most part. I'm sure the shoulder isn't as strong as it was before the injury and anytime I push it, well it pushes back with pain.

I couldn't agree more that knowing a before/after prognosis with and without surgery is the best way to assess. I think some of the answers are subjective coming from doctors and partly why I posted for real world experience. Sports med doctors deal with athletes who have physical regimens and activities that put them above the average Joe, so I don't always trust the "typical" recovery type of language as they're often dealing with performers rather than normers.

They will indeed be cutting the frayed part of the labrum off and re-attaching to the bone with sutures.

The questions you posed are genuinely insightful, thought provoking and helpful! Thanks for for taking the time to do that!

wiseguy1040 · #13 04-15-2011, 08:49 PM

I just had shoulder surgery Feb 28th I had a torn rotator cuff and I can tell you the first day thru a week after surgery you will be in alot of pain and if they ask you if you want the nerve block you answer YES I strapped on my bass the first time tonight. I dont have full range of motion and it hurt a little putting on my bass but I'm so glad I had it done. No I did not like the pain and discomfort but I love being off work and knowing I'm getting better not worse. I had both carpal tunnel surgeries on each wrist and I can tell you the minute you come out of surgery, the very second you will feel no pain or numbness in your hand. The best results I can think of. I can play and play and not have numbness or tingling at all.

I say go for it!

audiophile21 · #14 04-15-2011, 08:56 PM

I've never had shoulder surgery, but this summer I had the most brutal of all surgerys; spinal fusion surgery i had a 92 degree curve in my back and the only option to correct it is spinal fusion surgery, so what they did is they cut my back open from the end of my neck to the top of my ass crack and put two titanium rods and screws in every single one of my thoracic vertebra. Then they put bone grafts around each screw to help fuse my spine together... don't get me wrong your surgery will be rough, but mine was very rough but hey i got through it in no time and you will too i'm 17 and have been gigging every weekend for the past couple months, I had the surgery in July and eight months later i'm opening for Ligea