Your Questions About Rotator Cuff Surgery Recovery Time Pain

Sandy asks…

What is the outlook of a torn rotator cuff left untreated?

I tore my rotator cuff, but do not plan on seeking professional treatment whatsoever. I have a job that is very laborious. Knowing that I must continue to do my laborious job and that I will not seek professional help (whether it’s surgery or physical therapy), what is the outlook of my shoulder? Will it be healed in say 3 years or could it hagger me for the rest of my life? How much mobility will I have in say 3 years. This is a complete tear, moderate.

admin answers:

There are many people who live with a rotator cuff tear and don’t even know it…especially if it is only a small or partial tear. However, as someone who has a laborious job with a full-thickness, moderate sized tear, the situation gets a little bit more tenuous. There is certainly a possibility for progression of the tear, to the point where it is massive and you are unable to raise your arm overhead. At that point in time, some studies have suggested that unless you do undergo surgery, there is a 90% chance you will never raise your arm over your head again.

However, to complicate matters even more, patients who undergo rotator cuff repair are often found to retear their cuff (some say as high as 50% chance) within 2 years…HOWEVER, they often do not even know it. So this lends itself to the notion of the role of a supervised post-operative rehabilitation program may play a huge part in recovery. So then it begs to question: could a progressive rehabilitation program be in order instead of surgery? I think many would argue yes.

Yet, I think we have to look at some other factors as well. First, what is the current function of your arm, what is the amount of overhead work you need to do, etc. Secondly, what is the nature of your tear: was is traumatic (such as you were otherwise healthy and had a fall and tore it) or has there been a history of persistent shoulder pain? The latter would suggest a more degenerative process. If so, anatomical variations such as a “downward sloping acromian”, bone spurring and chronic impingement of the shoulder is likely to lead to further and further degeneration of the cuff. These are some questions you really need to ask your surgeon. The way I see it, if it was a traumatic tear and the joint space otherwise looks healthy, the next three years you may continue to improve and never have an issue with it. However, if there are signs of degenerative tearing or other joint abnormalities, your may only progressively worsen….especially considering the nature of your work.

And here’s the kicker: the more degenerative and massive a tear is, the harder it is to recover even with surgery. As a comparison, someone with a small partial tear may be done with rehab in about 3 months if they have surgery. Whereas someone with a full thickness massive tear may be in rehab for 6-12 months and, even then, might never regain full use of the shoulder. In short, the more a cuff tears and retracts into the joint space, the harder it is to put back together. Colloquially, many surgeons refer to trying to put back a cuff at this stage as trying to repair it with “spit and a shoestring”.

So, I’d start by returning to your surgeon to ask these types of questions related to the nature of the tear and the integrity of the rest of your anatomy. However, I’d probably assume that even if you choose to forgo surgery, you are likely to still be recommended to have PT. I’d also get the opinion of:
A. At least one other surgeon and
B. A physiatrist who specializes in musculoskeletal medicine (this is a physician of rehabilitative medicine, they are not surgeons and, therefore, may be able to give you a more unbiased opinion than a surgeon.

In the end, however, only your physician should be giving you the recommendation as to whether to have further treatment or not and give you the full list of consequences for treatment versus non treatment.

Nancy asks…

What was your experience with Rotator Cuff Surgery combined with ACJ Arthroplasty?

I am having both procedures done at the same time. Has anybody got any information to share with regards to recovery time, pain level, physio and success rate? I’d be grateful for any input. Thank you!

admin answers:

Hi, I chose not to have surgery. Praise God, I found a Chiropractor
who specialized in sports injuries. He (including regular adjustments)
would stand in front of me and place his shoulder under my armpit. My arm over his shoulder and he would pull down as he slowly stood up which lifted and stretched that whole area. He had a team of providers he worked with including a massage therapist and physical therapist. They all met and discussed my
problems setting in motion my recovery. I have never had another
problem with that shoulder.
Good Luck,
Hope all goes well either way.

Richard asks…

Surgery next week wondering what to expect?

Having rotator cuff repair distal clavicle excision and subacromial decompression. I was wondering since I was already in pain sleeping and even lifting my arm already how much more pain is recovery? Do I push more than what the therapist suggests? I was told that if I didn’t I wouldn’t get full mobility of my arm again. Can someone tell me how their recovery went please.

admin answers:

Do not push more than your therapist suggests, by doing so you could do more damage. Always, always, always listen to your therapist. Keep open communication with them at all times about any unusual pain that you may be having. Even if you feel it might be a stupid question, always ask. Good luck.

Linda asks…

How long is the average recovery period after shoulder surgery?

My husband is thinking about having total shoulder joint replacement surgery and i like to hear from someone who has had this procedure as i have never talked with anyone who has had this done.
His Surgeon is not eager to do this. Thanks.

admin answers:

Take into account that total joint replacement surgery will ease the pain (this is what I suppose that he is considering this), but he must take into account that he will lose a significant amount of mobility with his arm.

I separated my shoulder, torn rotator cuff, torn cartilage, etc the whole thing and it took me 9 months to rehab.

William asks…

Can anyone rate the pain of recovery from an AC joint repair?

0-meaning none, to 10-meaning “just don’t bother to wake me up after the surgery.”
There is also a hole in the rotator cuff in the same shoulder that will be repaired as well. Being mentally prepared is half the battle, so help me out here folks! :) TY!

admin answers:

The difficult thing about your question is that everyone responds differently to pain. My reaction to pain, and judgement about the level of the pain, may not be the same as yours. I would rate the pain at about a 5 or 6 – I have experienced much worse pain in my life. I do have good tolerance for pain.

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