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caliclimber88
Jun 20, 2005, 6:30 PM
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I injured my shoulder playing pick-up football in the middle of the summer last year (left arm forced up and behind head). For the next few months, sometimes when I climbed, it would get extremely sore. Other times it would be fine.
When I realized it wasn't going to heal on its own, I took a break from climbing and had it checked out. When I rotated my arm so that my thumb was pointing down and then tried to push against my ortho's arm, my left shoulder smarted like heck and was really weak. Based on his advice, I started physical therapy & got an arthrogram.
The arthrogram showed no rotator cuff damage and no labrum tear.
However, it's a year later, and my shoulder still snaps and pops like mad whenever I rotate it forwards, and I have this indeterminate feeling that something is "off" in there. I can constantly feel it, even though there really isn't any strong aching or pain. When I rotate my shoulder so that my arm is straight up behind my head, there's an audible "clunk," and then it slides over.
I was climbing this past weekend and pulling hard on it, when I felt something sort of "shift." It hurt to move it for about twenty seconds afterward, but now it sort of pops and catches in a different range of motion than before.
I'm only 20, and I'm debating my options. On one hand, it never hurts enough to keep me from climbing. On the other hand, there's that nagging feeling of something being "wrong" in there, and the clicking and catching.
I'm considering having it scoped, but there's a lot of factors in play:
BIG-Anti) I'm scared that if they go in there, they might mess it up worse, and I'll be left with a seriously f*ed up shoulder at 20.
Anti) If I let it ride until something goes *seriously* wrong, like a dislocation, the surgery techniques might improve between now and then.
Anti) I might seriously injure it post-surgery, putting me on the slippery slope to a f*ed-for-life shoulder.
Pro) I'm young, and might be able to recovery from surgery well.
BIG-Pro) If I wait on it, I might just grind things down and irritate them to the point where the problem can't ever be fixed.
Does anyone have any input on this? Post-surgery experiences? Experiences with dodging surgery?
I'm in Kaiser, so if you've got any advice in terms of surgeons to request, that would be appreciated too.
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mdhf
Jun 20, 2005, 6:59 PM
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I'd say get a second opinion and an MRI. I had a shoulder that was a bit worse than that surgified, and it helped enormously. No more pain, no clicking, no noise, 2 little holes. If you do it, though, http://tinyurl.com/9dmnh is a miraculous invention. It's basically a pump that keeps ice cold water circulating around your shoulder while it heals from the surgery. I rented one, and had practically no swelling, and little pain (though it could've been the vicadin).
All the best,
-Ben
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learnin2climb
Jun 20, 2005, 7:43 PM
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Surgery isn’t a guaranteed fix. I have dislocated my shoulder so many times, I’ve lost count. I had surgery on it once, but 6mo later I dislocated it again. I’ve learned to deal with it. Sure I have limitations, like I can’t hang on one arm for very long or the 3-4 days I can’t do anything after I dislocate it, but I’m not at a point in my life were I want to be bandaged up for 6-8 weeks and then go through 2-3 mo of PT before I resume my current lifestyle (I’m 25 and a student). I deal with it by keeping my shoulder strength up and being aware of the position of my arm. I figure once I get a full time job and start to settle down, I’ll get it fixed, again.
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ksolem
Jun 20, 2005, 7:48 PM
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Yes, a second opinion is in order. I would take your orthogram (MRI with contrast dye injected) to a real sports medicine orthpedist who specializes in shoulders, and have them read it. I had my shoulder "surgified" at Kerlan Jobe by Dr El'Attrache last October. 6 little scars. 6 Mo's therapy. Like new shoulder - and I'm old. Nothing against Kaiser but I don't think that's where the top athlete's go when they want to get back in the game.
(You can look up Kerlan Jobe on the net.)
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climbingbetty22
Jun 20, 2005, 8:09 PM
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Sounds like your supraspinatus muscle is on the outs. Were there any other tests your ortho performed that reproduced the pain or symptoms you've been having?
If you're worried about it, but want to try and avoid surgery, there are some non-surgical options/practioners you could try consulting first. PM if you're curious.
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campo
Jun 22, 2005, 5:52 PM
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To be totally honest, I literally just returned from the DR about this same thing. Same pain in the same arm positions, with the same sort of injury (baseball batting). He told met that I had done damage to the rotator cuff, or that some ligament or cartilage had torn or slipped (to be determined by MRI). To my dismay, he told me to cease ALL activity for 6 weeks, to give it a chance to recover (gasp). He then told me that if it was still majorly painful after 6 weeks, then reconstructive surgery would be an option, with a (double gasp) year of recovery time with physical therapy.
Id say get it checked out man, shoulder injuries can plague you the rest of your life.
No climbing for 6 weeks, what to do what to do? :x
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roboclimber
Jun 22, 2005, 7:27 PM
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Here is my two cents. I dislocated my shoulder at 24 and I was able to reduce it myself. I have subluxed my shoulder several times, and each time I do, it takes a few days to heal. I too am limited by my range of motion and I have weakness and instability in certain positions. Most sports medicine doc's will tell you that the probability that you will need surgery if you dislocate before 24 is almost 100% (and the research is there to support this); however, I always try to warm my shoulder up and I never push it because I know that this will only further damage it. From the perspective of a (prospective) medical professional, I have always tried to get by with paliative care (ice, rest, massage) until surgery is an absolute necessity. BTW, I started climbing to rehab my shoulder; thanks to climbing, my strength and range of motion have drastically improved.
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madgey28
Jun 22, 2005, 7:47 PM
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I had shoulder surgery the end of last August and I can tell you that it isn't fun. I won't hide that. I had a torn labrum and years of damage from pitching in softball (nearly 13 years as a pitcher). In addition to a labrum repair, they had to shave off parts of my collar bone due to deterioration of the bone that was literally ripping away at shoulder tissue every time I moved my arm. I was told from the multiple opinions that I got that damage won't necessarily show up on an MRI or other image due to the slight gaps in the coverage of the machine areas. With the way a shoulder is built, it is difficult to get a total picture and some damage can't be seen by those images.
With surgery you do risk complications. My complications included a blood clot (at age 24) and severe muscle spasms a week post surgery. Recovery time included 4 months of intense physical therapy (3-4 times a week). I started climbing for the first time in my life in the beginning of January as another way to strengthen my shoulder. I was told based on the damage in my shoulder that I would either have to live with the clicking, popping, and pain or have the surgery.
The major thing that I have to remember post my surgery is that there are certain moves that I just can't do (yet at least). My shoulder does not move in a few different ways anymore.
You really need to take stock in what is important to you. I realized that if I didn't do the surgery, I would not be able to do many of the functions that I wanted to be able to do (such as climb and return to play softball). Going through a few months of hell was worth it to me to be able to do the activities that I loved.
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talus_
Jun 23, 2005, 11:08 AM
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shoulders can really be a drag. there are a couple of important pieces of information needed here but i will try to be brief. did you get an arthrgram or and MR arthrogram? if not the later than you should request one. its and MRI where adolinium in injected into your joint which would be better able to show a labral tear/bankart lestion etc. what do your plain films look like? you sound like you are describing impingment but there should be some changes on the undersurface of the acromion. if you don't like your surgeon shop around. i would suggest a guy who is a fellowship trained shoulder surgeon (someone mentioned elattrace who i've never seen operate but have heard talk-- he's fellowship trained and does shoulder and elbow, the usual combination). best of luck!
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caliclimber88
Jun 23, 2005, 6:36 PM
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Hey guys, thanks for all your feedback. It helps to get some advice from other people who can relate to the NEED to have a shoulder in good condition.
Talus,
I got the MR Arthrogram -- the combined contrast medium injection and MRI. I never got to see the results, but I probably wouldn't have been able to interpret them anyway. The surgeon said that there was some "irregularity" around the labrum, but nothing clearly torn.
Roboclimber, you wrote:
"I have always tried to get by with paliative care (ice, rest, massage) until surgery is an absolute necessity."
I guess my whole problem is that it's not an absolute necessity right now. I can climb, and I can be active. But I know that something is messed-up in there. I read a post like madgey28's, where it sounds like there was some deterioration over time that contributed to the overall damage to the shoulder, and it makes me think that maybe if I suck it up and deal with some pain now, it will save me a lot of trouble [and a potential inability to fully recover] later on down the line.
It's a tough calculation to make -- do the long-term benefits of getting it dealt with sooner rather than later outweigh the risks of potential complications and the immediate pain of the operation? Right now it sounds like having it scoped by a specialist somewhere like Kerlan Jobe or SOAR (the Nor-Cal equivalent) might be a relatively good way to go.
I suspect that I've got something approximating a stable type I SLAP tear -- if I wait for five, or even ten years, I'm worried that I might end up with something more significant that will be impossible to bring back to full strength...
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polishbob
Jun 23, 2005, 7:42 PM
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there is no reason for the surgery. unless you fit a very specific guidelines for surgery, it's not going to help you with pain. it's superspinatus issue. shoulder is 80% muscle oriented joint. so you'll have cuts through the tissue that holds it together. if you are serious about a recovery pm me.
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roboclimber
Jun 23, 2005, 7:43 PM
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caliclimber88, all of the pros and cons that you are weighing are things which only you as the patient can decide on. For me and my injury, I chose to prove the doctors wrong (I hate going to doctors for anything, even though I will be graduating from med school in two years!) by opting out of surgery and any surgical intervention. That was my personal choice and one I will ultimately deal with. I probably will need surgery when I hit about 40, but who knows, maybe I'll be able to get by without it. Like I said, surgical intervention is best for those that need it i.e. there will be a definite gain of function from the surgery, or chronic pain will be greatly decreased. I would hold off as long as you can unless the injury is severe and you have persistent instability i.e. constant pain with movement or chronic dislocation. One thing to consider is that the injury and damage can get more severe if there is initial damage that causes structural instability. One of the climbers above mentioned that he dislocates his shoulder with frequency; every time the head of the humerus dislocates from the glenoid, all of the muscles that attach to the head of the humerus (i.e. the rotator cuff) get strained and can be set up to tear, or worse yet, avulse the head of the humerus. Once this happens, you are no longer looking at making a full recovery from your injury. You are looking at regaining a percentage of your prior function and living with a lifelong disability. Bottom line, speak with a professional and weigh all of these issues carefully. You are young, and young bodies bounce back from injuries and surgery quickly.
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blankflag
Jun 23, 2005, 8:09 PM
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In reply to: Hey guys, thanks for all your feedback. It helps to get some advice from other people who can relate to the NEED to have a shoulder in good condition.
Now, granted, I'm not a physician or a trained sports medicine-type person, and I don't know what a bunch of the words that you folks are using mean. Here's my question, though -- why do you feel that you NEED to have your shoulder in good condition? Does your livelihood depend on it in some way? It sounds to me more like your continued ability to engage in enjoyable types of recreation might depend on your shoulder being fully functional, but that isn't something you NEED to survive. Its probably something that you want, though, and as such, you probably want to act in a way that is going to enable you to have it far into the future. It certainly seems possible that surgery might be the best solution in this case, but it seems just as likely (to me) that it might not. I feel like your original pro's and con's could all get switched around to mean something different.
In reply to: BIG-Anti) I'm scared that if they go in there, they might mess it up worse, and I'll be left with a seriously f*ed up shoulder at 20.
Your shoulder might be seriously f*ed up all ready, in which case getting it fixed would be a good thing.
In reply to: Anti) If I let it ride until something goes *seriously* wrong, like a dislocation, the surgery techniques might improve between now and then.
This seems kind of like leaving your house on fire instead of calling the fire department because fire-fighting techniques might improve in the near future. If you wait until it is worse, then fixing the problems will be more difficult even for, and the whole recovery process will likely be longer. Prevention is usually the best cure.
In reply to: Anti) I might seriously injure it post-surgery, putting me on the slippery slope to a f*ed-for-life shoulder.
You may well do this, surgery or no. You may have done this already.
In reply to: Pro) I'm young, and might be able to recovery from surgery well.
By the same logic, you may well be able to recovery entirely without surgery.
In reply to: BIG-Pro) If I wait on it, I might just grind things down and irritate them to the point where the problem can't ever be fixed.
I feel like this would mainly be true if you wait on it and continue to engage in the types of activity that caused the problem in the first place. with time, ice, rest, and proper therapy it may return to normal.
I'm not taking any position on whether or not you need surgery or not -- I don't know enough about the medical issues involved. Maybe it will set up the "slippery slope" to chronic shoulder pain and underperformance or maybe not. I just feel that perhaps a slippery mental slope exists as well, in the way that we relate to our recreation, and mindset as much as anything can propigate the cycle of injury and re-injury. And it sounds to me like you might already be travelling down that one. I don't mean that as a criticism, because I've travelled the same route, but I'm beginning to think that it isn't the way to go.
Best,
--Brad
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cchildre
Jun 23, 2005, 8:12 PM
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Get a 2nd.
Damage - follow Dr. orders.
No Damage - Do more exercises to strengthen you shoulder and roator cuff. Do some release training as well not just climbing specific. Overly strong muscles with weak release muscles can result in major injury. Do some push ups or shoulder presses to get you opposing muscles strong to counter the ones you used to pull down.
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retardreach
Jul 11, 2005, 7:25 AM
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Hey Polish Bob-Dude-you seem to know a lot about shoulders. I'd been climbing for awhile and then decided to join the marines and somewhere along the way tore my rotator cuff due to learning to ski in the half pipe after a lot of shoulder falls, navy docs told me I had to go under the knife (don't really give you an option), so I just had it repaired two and a half weeks ago, I asked the surgeon who fixed it about the recovery time before I could climb hard again, and he didn't really have an answer-sort of an old guy who saw no reason for climbing at all-and so I come to you. How long does an open surgery really take to heal, I'm 22 now, I've got 2 a-scope holes on the front and back and 3 inch cut on the outside of the shoulder. I'm stationed an hour away from the buttermilks and getting sort of depressed that I can't climb right now, and curious if anyone knows how long something like this takes to heal-any info would be reassuring.
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