Shoulder Surgery Questions

[SIGFan43]

I am a 73-year old man. I visited my primary care physician yesterday for shoulder problem in my dominant right arm. He diagnosed it as rotator cuff arthropathy, and I have an appointment in two weeks to see an orthopedic surgeon who specializes in shoulders. I have limited range of motion, such as arm straight out lifting things such as putting dishes up in a cabinet shelf above my head. For over a year, I am uncomfortable going to sleep on my right side, but often find myself sleeping like that when I wake up. I have another medical condition diagnosed recently called lupus anticoagulant disorder, which means I probably have a tendency to form clots, especially during surgery, but a hematologist told me I may also have a tendency to bleed at times. She told me I don't need blood thinners because it could cause issues with my brain, because I had emergency subdural hematoma surgery in 2014 due to a brain bleed, cause being unknown. My brain had been bleeding for a while, because the neurosurgeon told me that I had some thickening of the blood pool when he opened my skull.

I'm hoping that the orthopedic surgeon will try more simple solutions first, such as steroid injections, which I had several years ago for a medial miniscus tear in my right knee. I never had surgery for that, and the only thing I have to be careful with is kneeling on the floor, which hurts if I'm not slow and careful.

My other concern involves the fact that I shoot my 9mm pistols about twice a month at the range, usually 100 rounds or less each range session, and I carry my pistol on my right hip all the time. Back in 1970-1980, I was into combat pistol shooting, but was never much good in left hand shooting drills.

If you have ever suffered this type of medical problem, are you still able to shoot pistols after months of rehab and therapy, or did you have to quit shooting altogether?

[tk1700]

I sympathize with you on the shoulder pain. I had the same symptoms as you several years ago, in my early 50's. My ortho gave me a steroid injection and it actually made it worse. My final tipping point to have surgery was when I went to fire a 50 round qualification with a .40 and felt like my arm was going fall off when I was finished.

During surgery I had 3 anchors put in to repair the rotator cuff, the bursa was cleaned up and bone spurs removed. I was very conservative during recovery. It was 6 months before I shot a pistol again and about a year until I shot a long gun. I have pretty much the same range of motion as before it started giving me trouble and haven't had any issues. Before surgery I couldn't put my elbow above my shoulder without significant pain.

Everyone is different and reacts differently to treatments. I know several people that have had great luck with steroid injections, just didn't work for me. Good luck and I hope you are able to find a fix that works for you!

[Steamboat]

I had complete left shoulder reconstruction 10 years ago due to an accident. I credit the physical therapy afterward for the range of motion that I now have. Some of the best therapy i had was in the swimming pool and at a nearby lake. Being in the water made the stretching exercises a lot easier and less stressful. I still have great range of motion and have no problems at the range handling firearms. I wish you good luck in whatever course of action you take.

[RPBrown]

I had rotator cuff surgery about 15 years ago in my non-dominant left shoulder. Back then, things were not as advanced as they are now and I got back about 70% range of motion. I was very diligent in my PT but was still somewhat disappointed. Fast forward about 6 years and I started having the same issues in my right shoulder. Went to visit the surgeon and of course, after all of the scans came back, he said surgery.
After much conversation (nagging, lol ) my wife convinced me to try acupuncture. I, of course, always considered acupuncture to be voo doo hoo doo and was very reluctant to try it but she was very insistent if you know what I mean so I made an appointment with a lady that was recommended by a friend of, who else, my wife.
I went in, filled out all of the paperwork, and she took me back to a very comfortable chair. We talked about the pain and diagnosis for a few minutes and I told her about the limited range in my left shoulder as well. She had me take my shirt off and I think before I could even get set down good she had several needles in both shoulders. over all, she put in about 25 in my right and maybe 10-15 in my left. I stayed like that for about 30 minutes, almost falling asleep. When she came back in, she took out all of the needles and asked me to go through several range of motion exercises. Imagine my surprise when I could move my right arm at least 50% more without pain than when I went in and my left arm had almost 100% range of motion pain free.I went back to her for 3 additional treatments and have 100% motion in both arms and no surgery.
Now, I will admit that I did try acupuncture for my knee before surgery and it did not work. But she told me up front that it may not due to the type of injury I had.
Sadly, my acupuncturist passed away last year and I am in search for a new one. However, I would strongly suggest at least trying it prior to letting them cut on you.

[oohrah]

I had rotator cuff surgery several years ago, I'm just a bit younger than you. If the tendon/s are torn/detached, you will need surgery, nothing else will fix it. Depending the severity, you could just live with, but like you, I woke up at nights with arm pain. An MRI will verify the damage.

The surgery is uncomplicated day surgery, in and out. I went to a sports medicine type. The worst part is the six weeks or so of full unmovable sling while healing, then the pain of the physical rehab. However, I now have full range of motion without pain, and I am lifting weights as part of my exercise.

I wish you well.

[Bitter Clinger]

My advice would be to get at least 2-3 opinions before proceeding. If you do proceed, it is as important to find the correct post-op therapist as it is to find the right surgeon. I had a failed rotator cuff repair for a chronic condition and at my age for a chronic tear (rather than due to an acute injury) the stats only give about a 50% chance of success. Worth it? Only you can decide.

With a chronic tear, outcome depends on the condition of the tissue, which is a function of how long the tissue has been damaged. If you have had the condition for a long time, the tissue may become fatty and somewhat akin to wet kleenex. On the other hand, if the tissue is more like shoe leather, chances are better for success. The only way to find out is to invade the shoulder via the surgery, and you should consider the pluses & minuses of an open repair vs. arthroscopic for your particular condition as well...

I might suggest that you try physical therapy first and see if that gives you enough success that you can avoid surgery - just my two cents, I am not a physician...

[flechero]

at 73 with bleeding/clotting disorder, I'd say it's a high probability that they will want to try PT for a few months to see if it improves before they will even consider a surgical option.

Injections can help, but they are best to alleviate pain long enough to make progress in PT/rehab.

I had a rotator cuff repair done about 12 yrs ago and it didn't go well. When facing a redo of the surgery, last year, my new ortho surgeon said I needed to see what PT would do before we did anything new. Shockingly, even this many years later I have made progress. Better range, and strength. Won't ever be like new, but it's getting close to "good enough" to live with. (and I'm only 46.)

Good luck to you.

[SIGFan43]

I had rotator cuff surgery about 15 years ago in my non-dominant left shoulder. Back then, things were not as advanced as they are now and I got back about 70% range of motion. I was very diligent in my PT but was still somewhat disappointed. Fast forward about 6 years and I started having the same issues in my right shoulder. Went to visit the surgeon and of course, after all of the scans came back, he said surgery.
After much conversation (nagging, lol ) my wife convinced me to try acupuncture. I, of course, always considered acupuncture to be voo doo hoo doo and was very reluctant to try it but she was very insistent if you know what I mean so I made an appointment with a lady that was recommended by a friend of, who else, my wife.
I went in, filled out all of the paperwork, and she took me back to a very comfortable chair. We talked about the pain and diagnosis for a few minutes and I told her about the limited range in my left shoulder as well. She had me take my shirt off and I think before I could even get set down good she had several needles in both shoulders. over all, she put in about 25 in my right and maybe 10-15 in my left. I stayed like that for about 30 minutes, almost falling asleep. When she came back in, she took out all of the needles and asked me to go through several range of motion exercises. Imagine my surprise when I could move my right arm at least 50% more without pain than when I went in and my left arm had almost 100% range of motion pain free.I went back to her for 3 additional treatments and have 100% motion in both arms and no surgery.
Now, I will admit that I did try acupuncture for my knee before surgery and it did not work. But she told me up front that it may not due to the type of injury I had.
Sadly, my acupuncturist passed away last year and I am in search for a new one. However, I would strongly suggest at least trying it prior to letting them cut on you.

I hadn't thought about PT or acupuncture, but my secondary insurance allows 12 acupuncture treatments per year. I have heard about a good one in Chandler. I'll probably wait until the surgeon orders the MRI. I sure like the idea of acupuncture, though.

[TexasTornado]

My dad had rotator cuff surgery done about 2 years ago now. He was a terrible patient! The night after his surgery I caught him in the kitchen digging into an ice cream container with his arm.

He pushed into doing most things way too soon, using his shoulder even when he was strictly forbidden from lifting anything heavier than a remote and he only attended 2 of his PT sessions, but mom and I stood firm against the shooting range for an entire year.

When I finally relented, I stole his Kimber 9mm away in my range bag and made him shoot the 22 for a bit first. It was another 6 months after that before he trusted trying the shotgun. No problems their either.

Even post surgery he's still a better shot than I am! Grrr!

[puma guy]

My advice would be to get at least 2-3 opinions before proceeding. If you do proceed, it is as important to find the correct post-op therapist as it is to find the right surgeon. I had a failed rotator cuff repair for a chronic condition and at my age for a chronic tear (rather than due to an acute injury) the stats only give about a 50% chance of success. Worth it? Only you can decide.

With a chronic tear, outcome depends on the condition of the tissue, which is a function of how long the tissue has been damaged. If you have had the condition for a long time, the tissue may become fatty and somewhat akin to wet kleenex. On the other hand, if the tissue is more like shoe leather, chances are better for success. The only way to find out is to invade the shoulder via the surgery, and you should consider the pluses & minuses of an open repair vs. arthroscopic for your particular condition as well...

I might suggest that you try physical therapy first and see if that gives you enough success that you can avoid surgery - just my two cents, I am not a physician...

Definitely get 2 or 3 opinions from orthopedic specialists. If you are in Houston I recommend The Fondren Orthopedic Group and Texas Orthopedic Hospital. Most of the surgeons specialize in a particular joint or area. Mine was a wrist, hand and elbow guy and was an Astros Team Doctor for many years. He operated on both of my hands, wrists and elbows. We used to joke the Fondren group had right on and left only shoulder specialist. BTW Did your GP doctor mention frozen shoulder as a possible diagnosis?

[karder]

I had rotator cuff surgery about two years ago on my dominate right shoulder. I had put off the surgery for years and the problem only got worse. It had long since gotten to the point that I was making major lifestyle adjustments to accommodate my bad shoulder. Finally I got sick of it and had the surgery. Everything went great and after 9 weeks of rehab, I was good as gold. Now I feel like a dummy for putting it off for so long.

I carry on my right side and obviously that was out of the question for a few weeks. By luck, I had a left handed holster for my HK USP .40 that I had mistakenly purchased years back and never bothered to return so I used that during my recovery.

I can understand not wanting the surgery, but if you need it, you need it. Listen to your doctor and follow ALL your rehab. It is very tempting to drop out of rehab, but listen to the professionals, and solider through it. You will be glad you did. Good luck!

[rotor]

My story is a little different. Lifted a bag of corn for my feeder and over the next few weeks had more and more pain in my right shoulder. Couldn't even sleep on that side. Saw my orthopod, had 2 or 3 steroid injections, no relief. MRI neg. Underwent several months of physical therapy without relief. Had shoulder arthroscopy and my orthopod said I had a frozen joint, by manipulation under anesthesia broke up capsular adhesions, scoped me and cleaned up joint. Then I underwent 3 months of intensive PT and that is the cure for this and DO IT. I have almost complete range of motion and the only thing I can't do is scratch my back as high on my right as on my left. The main thing, find a trusted doctor, try physical therapy first unless they say the joint needs immediate surgery, and be prepared to do PT after surgery and do the exercises at home too. I thought the exercises were Mickey Mouse but they worked. Good luck with your evaluation and treatment.

[Jusme]

My story is a little different. Lifted a bag of corn for my feeder and over the next few weeks had more and more pain in my right shoulder. Couldn't even sleep on that side. Saw my orthopod, had 2 or 3 steroid injections, no relief. MRI neg. Underwent several months of physical therapy without relief. Had shoulder arthroscopy and my orthopod said I had a frozen joint, by manipulation under anesthesia broke up capsular adhesions, scoped me and cleaned up joint. Then I underwent 3 months of intensive PT and that is the cure for this and DO IT. I have almost complete range of motion and the only thing I can't do is scratch my back as high on my right as on my left. The main thing, find a trusted doctor, try physical therapy first unless they say the joint needs immediate surgery, and be prepared to do PT after surgery and do the exercises at home too. I thought the exercises were Mickey Mouse but they worked. Good luck with your evaluation and treatment.

Same issue with my weak side left shoulder 5 years ago. Three tears, and my bicep tendon had "slipped" out of the groove, at the top of my shoulder. Surgery, and two months of PT along with "at home" exercises, got me back to 90% range of motion. Acupuncture, steroid shots, etc.. was not an option for me. I was skeptical of PT, but, I would not have recovered properly without it. JMHO

[The Annoyed Man]

My wife had rotator cuff surgery in 2013 to repair a tear and a calcified tendon. She was not able to shoot her AR before the surgery, or to aim her pistol for long at the range. After the surgery, she feels no more discomfort with her AR, and she has all the strength and full range of motion back in that arm.

[eyedoc]

I have a little first hand knowledge on shoulder surgery. I dislocated my right shoulder playing football when I was 18 and also rode bulls using my right arm. A few hundred thousand miles down the road I had my right shoulder operated on. 6 weeks after surgery, a physical therapist dislocated my shoulder and broke the anchors loose. Back for round 2. I have healed up pain free with full range of motion.

I had hurt my left shoulder in a MMA match (which I won) many moons ago. A year ago, I feel 10 feet and landed on my back. There went the left shoulder. I had surgery and was doing great until 5 weeks after surgery the husband of a paralyzed patient was lifting his wife to re-position her in the wheelchair and dropped her. Of course, I grabbed her to keep her from getting hurt. Yep, tore my shoulder loose. After the second surgery, I am doing well.

With a good surgeon and good luck, you should do fine.

I do not recommend steroid shoots. They do not fix the problem and can make things worse.

My surgeon only does elbows and shoulders. He also has done surgery on both elbows, I lived an exciting life as a youngster. He also does the shoulder surgeries on our astronauts. PM me if you want his name.