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Subscapularis tear/recovery

Miguel75

15-Jan-2016
10:04:25 PM

Hey gang, anyone suffered a subscapularis tear? It would seem I've torn through ~95% of the tendon and the Dr is suggesting surgery. I'm meeting an orthopedic surgeon in a few weeks to discuss options.

Anyone have horror or success stories?

ajfclark

16-Jan-2016
8:48:11 AM

I apparently damaged my left subscap years ago. It didn't seem to cause significant problems other than being sore. I just let it do its thing. A while later at yoga, we found out that it had healed quite short. Physio and a lot of stretching later I had mobility back and thought that was the end of it.

Then around the start of 2014 I started having huge issues with pain in my left shoulder along the lower and medial margins of my scapula. Like a random pinching sensation when I did things (hanging clothes out on the line, grabbing something off the top shelf in the pantry, etc) and a generalised ache the rest of the time. Didn't sleep well because whenever I rolled over onto it I'd wake up or worse if I'd managed to put pressure on it and it not hurt, when the pressure was relieved it was super painful (eg. standing up after a long drive in the car).

After 6 months of ultrasound, xrays, MRI, another MRI, etc eventually I found someone that recognised the problem. Inflamation of the bursa under the shoulderblade. The guy that found this thinks the scarring/thickening of subscap tendons is part of why my left shoulder is so susceptible to scapulothoracic bursits. Fortunately it was a cortisone treatment success story for the most part.

It still flares up from time to time still and is quite painful. Fortunately, climbing doesn't seem to be a huge driver for it (not that I've climbed much that's difficult in the last year), it seems to mostly be things with the elbows pinched in close to the body and driving hands down with force - star picket driving, mattocking and sometimes shovelling.

IdratherbeclimbingM9

16-Jan-2016
3:08:44 PM

On 15/01/2016 Miguel75 wrote:
>Anyone have horror or success stories?

Yes, but none of them involve shoes, so I don't think you will be interested...
Oh, and hope you recover fully and sooner rather than later, and preferably don't have to undergo the knife...

Eduardo Slabofvic

16-Jan-2016
6:39:37 PM

Orthopedic surgeons always recommend surgery, as that way they get to render you unconscious then hack away at you with a knife while you're all compliant. They are sadists.

Exhaust the rehab options first, go for surgery as a last resort. Surgery doesn't make it as good as new.

I had subscapularis tear about 5 years ago (with additional tearing of labrum and the other whats-its-name tendon).

Surgeon said going under the knife would be expensive, painful, long recovery and high chance of failure.

I went the cortisone injection and the rehab route. A very slow recovery ensued.

But you're young, you'll bounce back.

Now bring on the dog whistle. Here Mucky boy, come on big fella.

Miguel75

16-Jan-2016
11:59:02 PM

Thanks gang. I'm looking to get a few extra opinions from medical peoples before I get the arthroscopic chop. Whichever way I look it'll likely be around 6 months of work to get it back up to scratch...

patto

17-Jan-2016
12:00:05 PM

Advice from numerous doctors I've know personally. Avoid surgery as much as possible.

My experience was a an avulsion fracture in the foot. Specialist recommended surgery, I declined. I healed fine with faster recover than having them cut my foot open.

That said 95% torn tendon sounds pretty bad. I have not concept of the self healing capabilities there. (Though I would question whether it really is 95% that sounds a bit extreme.)

If in doubt seek a second opinion preferably from a specialist.

IdratherbeclimbingM9

17-Jan-2016
12:36:57 PM

On 17/01/2016 patto wrote:
> (snip) That said 95% torn tendon sounds pretty bad.
>I have not concept of the self healing capabilities there. (snip)

Picking up on this flavour (but off topic to M75's original query), I recently had an interesting experience with dental procedures.
12 months ago I had a temporary filling done and was put on a 2 week course of antibiotics till an abscess under a tooth healed; prior to the recommendation (Dentist advice) of having the tooth removed, due x-ray showed its roots were effectively gone...

I didn't follow through with having the tooth removed because the abscess healed.

Went back recently for a 12 month check-up and Dentist got out his records, took another x-ray to see how it was going and was astonished to find that the tooth roots had regenerated.
He was so astonished that he rechecked his documentation to make sure he had the correct tooth, but the temporary filling was there to confirm it.
He told me he had never come across this before (though he has been in that game a reasonable while as a mid career professional by my observation), and called in his work colleagues to also observe this unusual phenomenon and displayed the x-rays up on a screen for all to see!

I had the temporary filling redone as permanent.

Hmm.
Self healing properties?
I'd say give your body a chance to do it's thing before going the knife treatment...
☺

Miguel75

17-Jan-2016
9:38:32 PM

On 17/01/2016 patto wrote:
SNIP...
>That said 95% torn tendon sounds pretty bad. I have not concept of the
>self healing capabilities there. (Though I would question whether it really
>is 95% that sounds a bit extreme.)
>
>If in doubt seek a second opinion preferably from a specialist.

Thanks for the advice gang. I'll be seeking a number of opinions around this. Both the work Dr and physio were pretty shocked at the damage shown in the MRI images. I'm 'lucky' it was a workplace injury and we have very good medical officers. The only issue with the non surgical path would seem to be the length of time required to full recovery, I haven't found anything online that speaks to a successful, non surgical recovery. Most everything I've found on the web talks about this injury requiring surgery for a full recovery. To date I've been very non invasive with any issues I've faced though this injury is sounding pretty brutal and really impacts everyday life negatively:(

I'll keep searching for non surgical solutions....

kieranl

18-Jan-2016
9:10:24 AM

When I hurt my shoulder last year my partner, who is a very experienced musculo-skeletal physio, explained to me that if it was a torn tendon then it wouldn't get better because they have virtually no blood supply - that's why they're white when you see them on animal carcasses.
I did the conservative stuff, rested for a few weeks, no impovement so had an ultrasound and an x-ray. Both showed nothing.
Went to an orthpaedic surgeon who decided it was inflammation and injected it. No improvement. Had an MRI and that showed a torn supraspinatus. Finally had surgery (tendon repair, screw and a bit of bone carved off) about 4 months post-injury.
I was incredibly lucky post-surgery in that I had no pain at rest - I gather this is not usual. I also didn't get a frozen shoulder - apparently a high percentage of people (?25%) experience this post-surgery. However, despite physioing the heck out of for 16 weeks I didn't have full range of movement. Then had 2 hydro-dilatations (basically pumping the shoulder full of saline to stretch it) which gave me back almost my full-range. Started climbing again 24 weeks post-surgery (my partner is conservative and believes in long rehab for climbers with shoulder injuries).

Jayford4321

19-Jan-2016
2:43:44 PM

On 15/01/2016 Miguel75 wrote:
>Hey gang, anyone suffered a subscapularis tear? It would seem I've torn
>through ~95% of the tendon and the Dr is suggesting surgery. I'm meeting
>an orthopedic surgeon in a few weeks to discuss options.
>
howd U manage that? been tryin tha buffalo wall again?

>Anyone have horror or success stories?
ive heard fearsome things about wot they do if they get inside Ur shell.
dont let em get inta Ur shell. keep it intact no matta wot.

miguel75

20-Jan-2016
8:52:42 AM

On 19/01/2016 gnaguts wrote:
...SNIP...
>howd U manage that? been tryin tha buffalo wall again?

Unfortunately not this time...

>>Anyone have horror or success stories?
>ive heard fearsome things about wot they do if they get inside Ur shell.
>dont let em get inta Ur shell. keep it intact no matta wot.

I'd be happy to let it heal without surgical intervention though there doesn't seem to be much in the way of options that I can find.

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