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rotator cuff partial tear, non surgical treatment?

telephunk

9-Jan-2008
10:24:21 PM

I have recently, after much messing about with doctors, found i have a partial (not full) rotator cuff tear, that for some time i thought was tendonitis. I have been incapable or training or climbing for over 4 months now, and whilst day to day symptoms have lessened, they have not subsided, and a return to climbing is out of the question at this point. Since i have only recently discovered its a partial tear, im wondering if anyone has any advice on the non surgery treatment options for a rotator cuff tear. Ive read some info on this forum and others, but am not completely clear, im currently living overseas and dont have access to any decent sports med doctors who speak english (nor chiros, osteos, etc), hence seeking advice here. Im wondering about strengthening excercises and stretching, complete rest vs activity modification, how the tear might (or might not) heal, and what my chances are of recovery etc. all the info ive read on the net points to surgery, which id like to avoid. but ive also read that whilst tears really struggle to heal with time, that partial tears may be able to completely recover. for how long does one sit idle? when can you be convinced its time to start trying to train? what excercises are possible in the interim? appreciate any information from people with experience or knowledge on the subject! cheers!

evanbb

10-Jan-2008
9:43:42 AM

I've got a pair of dodgy rotator cuffs, and while I've never had a tear, I've dislocated them a few times and done a lot of rehab.

I previously had the same thoughts on surgery, but you've already been out for 4 months now, so what have you got to lose? A shoulder injury is a serious compromise for a climber and one that needs to be fixed properly. Imagine you're on a rap in route somewhere and it goes? Or at Frenchmans Cap? Helicopters can't get in everywhere.

As for rehab, there's heaps of exercises to do and all are well illustrated on the web. Definitely better to see a professional though, as the shoulder is uber-complex. I've been doing rehab on my shoulder for 5 years now, and it just never ends. It's this constant balancing act between the strength in your arms and the ability of your shoulder to contain that strength.

I find mine tell me quite clearly when not to train and the pain is quite acute. But, with a healing tear, I would think there's a real possiblity of it feeling okay, until the day something surprising happens and you're back on the bench for 6 months. That's what's happened to me, 4 times now. Just when I think I've 'got it fixed', I find myself back in hospital begging for morphine. So, softly, softly is my recommendation, and don't rule out surgery until you've spoken to someone smart.

Otherwise, plenty of ice and rest. Frozen peas are the business.

belayslave

10-Jan-2008
10:43:03 AM

As Evan has said, the shoulder (to us non-medically trained people) is an incredible complex joint
which needs to be treated in the right way. It's now a complete year since i've climbed anything. and
for the 3 years previous that i was on and off climbing, considerable more off!

I've had two surgeries in 2007 and am now nearly a month post my last surgery (well not really
surgery, it was a Hydro and MUA) i'm not fairing much better. seeing a physio once or twice a week.
strength and ROM are improving but pain and inflammation are still there.

Mine is not rotator cuff based so i can't give you any specific help unfortunately other then maybe it's
worth a phone call from where you are to a trusted doc/physio in Australia to get their opinion. My
advice would be give it more then adequete time to heal, otherwise you'll end up in my boat of no
climbing for a very long time (i've got another 6months to a year ahead of me too!)

Good luck with it all mate, i hope you can get back on the rock soon.

dougal

10-Jan-2008
4:09:29 PM

Bummer. DO you know exactly what is torn? The cuff is a collective term for four different muscles and their assoc bit and pieces.

Eduardo Slabofvic

10-Jan-2008
5:17:20 PM

Rotator Cuff injuries are like haemorrhoids, eventually every @sshole gets one. Try lots (and lots and
lots) of exercises where you lock your shoulder into a closed position. Various permutations of the row
action, or a piece of bungy onto a door handle, elbow bent at 90 degrees so forearm is level, elbow tucked
into your torso, and grab the bungy in the affected hand and pull through the range of motion. Start light
and work up and if pain persists resort to cortisone injections.

You may also like to try taping, as we all know tape solves every injury worry. Tape first and ask
questions later. Start by taping your mouth closed, so everyone else climbing with you doesn’t have to
hear you scream and carry on about how much your shoulder hurts.

Alternatively, you could give up climbing and go and study corporations law.

regards

Dr Eduardo

P.S. and my favourite part was when they gave me the money.

Chuck Norris

10-Jan-2008
7:37:52 PM

I had a similar problem at one stage and I found that OD'ing on anti-inflammatory drugs really helped - I
could train twice as hard with no pain. If you have a doctor in the family it helps to get the good stuff. As
an added side benefit it also helped with my finger and elbow tendonitis. It didn't help with my haemorrhoids.

Eduardo Slabofvic

10-Jan-2008
9:28:13 PM

On 10/01/2008 stugang wrote:
>It didn't help with my haemorrhoids.

An apple corer or a small blow torch will help with those.

Anti-inflammatories should be substituted for sugar in your normal diet. They are considered to be one of
the 5 basic food groups. The other 4 being (1) steroids, (2) amphetamines, (3) alcohol, and (4)
hallucinogens.

Chuck Norris

10-Jan-2008
9:35:25 PM

On 10/01/2008 Eduardo Slabofvic wrote:
>On 10/01/2008 stugang wrote:
>>It didn't help with my haemorrhoids.
>
>An apple corer or a small blow torch will help with those.

I always gained immeasurable comfort from a cold spoon....alone in the tent and flicking the 'roids in
and out for hours on end...what a blast...so much better than hanging around the campfire with all
those wierdos.
>
>Anti-inflammatories should be substituted for sugar in your normal diet.
> They are considered to be one of
>the 5 basic food groups. The other 4 being (1) steroids, (2) amphetamines,
>(3) alcohol, and (4)
>hallucinogens.
>

whadda bout coffee - Dr Eduardo Smartee Pants.

Eduardo Slabofvic

11-Jan-2008
8:35:25 AM

On 10/01/2008 stugang wrote:
>whadda bout coffee - Dr Eduardo Smartee Pants.

What! Are you crazy? That stuff will kill you.

Bel

11-Jan-2008
11:12:45 AM

Shoulders generally are nasty things to treat and however on the whole dont get better without treatment. Your body may or may not be capable of functioning with a partial tear depending on size location and your basic anatomical features. Tendons dont ever repair without surgical intervention the blood supply just isnt good enough. Treatment is focused on optimiseing shoulder, cervical and thoracic biomechanics. Without any ability to seek treatment i would say the best you can do is keep it moving, avoid things that make it ache especially repetitive overhead stuff. You could try and tape your shoulder to deload the tendon (tends to work magically) not easy to describe but would give it a go if you were keen

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