the shizzle > diet, training and injuries
Full tear rotator cuff.
Andy W:
--- Quote from: old cheese on March 22, 2024, 08:31:33 pm ---Hey Andy. What were your symptoms?
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It's been a few months with some initial bad pain after slapping for a hold at full overhead stretch. Initially very painful for a week or so, reaching for things, sleeping, pain reaching over head. I started some rehab my self based on thinking it was SIS. This definitely helped, I climbed conservatively for a month or so and felt things were on the mend. Then a few harder sessions climbing and a bad moment on a teliski/draglift, seem to set me back again. That prompted me to get the scan (echograph, in France, is that ultrasound, I think so) which showed the tear. I trained the day before the scan and to be honest I still think bouldering as long as I avoid slapping overhead, doesn't cause any pain.
Andy W:
--- Quote from: webbo on March 22, 2024, 08:51:39 pm ---
--- Quote from: Andy W on March 22, 2024, 08:14:11 pm ---Has anyone any experience of this. I knew something was wrong, carried on regardless, climbing ok albeit with some discomfort and pain on certain moves. Anyhow got a diagnosis today of an 11mm x 6 mm full tear of my supraspinatus tendon. Online reading seems a bit bit gloomy, suggesting it won’t repair, even with physio, surgery sounds like recovery is long and not guaranteed. Anyone offer me any glimmer of hope. It’s day one and my wife is sick of my self analysis already 😕
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I had a 21mm tear fixed 6 years ago which I gather is huge as when I saw the consultant who operated 2 weeks ago about my other shoulder. His words were “ you were the one with huge tear” I also had other tears in the other tendons plus a bone spur.
It was 6 weeks in a sling, then rehab very gentle at first but building up to weights then finger boarding. I had the op in March and climbing in again in August.
I might have to have my other shoulder done as I’ve a couple of small tears, osteoarthritis and my bicep tendon is out of place, this is from the ultrasound scan I had yesterday. I now need to go back and see the consultant to see what can be done.
I don’t where you are based but I’m seeing Simon Boyle in York, he also works in Leeds and Harrogate. Len Funk in Manchester is highly recommended by lots of people.
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I live in the Arielle, so I need to find a good sports physio I think. Good luck with your treatment, like you my scan revealed a hots of other stuff...long head bicep tendinopathy, effusions etc.
Andy W:
--- Quote from: Oldmanmatt on March 23, 2024, 04:39:13 am ---I tore mine, with complete separation, right shoulder, around six years ago now. No surgical intervention as I was advised it was more likely to exacerbate and prolong recovery.
Obviously it has never repaired itself. However, I function quite well. I have bouts if pain, usually triggered by some innocuous movement, like pointing at something. Feels like something “clicks” (twangs, maybe) then I’ll have pain for a couple of days. Can be severe. Rarely has exercise or climbing triggered it, where it has, it’s been after a slip or sudden loading.
With the physio at the time and since, I started to develop and maintain a very strong shoulder, keeping the muscles around the damage sufficiently strong to take the load off in all but the most specific positions. Mostly callisthenics, bar work and rings, distally unstable where possible.
Like the arthritis in my foot, I class it as minor disability and because it makes me nervous to pull in certain positions, it has drastically affected my climbing. Possibly I should have considered surgery, however getting back to work (which was climbing at the time) asap, seemed the right route.
Fucking ridiculous that I can hold an Iron Cross in the rings, but can end up almost in tears after reaching for a pen on my desk.
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Thanks for the details, it is weird because I am still bouldering at full strength without pain, unless i reach directly overhead, but that isn't as bad as pain I might get from reaching into a cupboard or reaching into the back seat of the car.
duncan:
Full thickness tears are quite common in older people who don't have shoulder pain, which suggests that it's not always necessary to 'fix' the actual tear to have good function. Having said that, the older people in these studies are not decent standard boulderers. Studies comparing surgery with rehab. in sportspeople have slightly better outcomes for surgery overall but these average results conceal huge variations: some people do well with rehab. and others not at all. Likewise surgery.
In your shoes, I would try rehabbing it for 6 months or so with advice from a good specialist physio. and seeing where you were after that time before considering surgery. Perhaps in parallel with seeing a surgeon (though in France you'll probably not need to wait that long?). The downside of this is potentially wasting 6 months. The upside is potentially not wasting at least six months extra you'd spend recovering from the surgery.
--- Quote from: Oldmanmatt on March 23, 2024, 04:39:13 am ---Fucking ridiculous that I can hold an Iron Cross in the rings, but can end up almost in tears after reaching for a pen on my desk.
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This sounds like the classic 'strong but slow' muscles. Like being able to hang big weights off a 20mm edge but lacking contact strength. Do you do any work that encourages speed of 'switching on' unpredictably? Throwing and catching? Crawling on all fours?
Andy W:
--- Quote from: duncan on March 23, 2024, 07:41:25 pm ---Full thickness tears are quite common in older people who don't have shoulder pain, which suggests that it's not always necessary to 'fix' the actual tear to have good function. Having said that, the older people in these studies are not decent standard boulderers. Studies comparing surgery with rehab. in sportspeople have slightly better outcomes for surgery overall but these average results conceal huge variations: some people do well with rehab. and others not at all. Likewise surgery.
In your shoes, I would try rehabbing it for 6 months or so with advice from a good specialist physio. and seeing where you were after that time before considering surgery. Perhaps in parallel with seeing a surgeon (though in France you'll probably not need to wait that long?). The downside of this is potentially wasting 6 months. The upside is potentially not wasting at least six months extra you'd spend recovering from the surgery.
--- Quote from: Oldmanmatt on March 23, 2024, 04:39:13 am ---Fucking ridiculous that I can hold an Iron Cross in the rings, but can end up almost in tears after reaching for a pen on my desk.
--- End quote ---
This sounds like the classic 'strong but slow' muscles. Like being able to hang big weights off a 20mm edge but lacking contact strength. Do you do any work that encourages speed of 'switching on' unpredictably? Throwing and catching? Crawling on all fours?
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Hi thanks for your reply. I just started translating the rest of the scan report, it looks like there are few other things wrong! But i imagine they all related and can't be separated, my guess is that they are all chronic, degenerative, with maybe a recentish acute phase. I do wonder if it is the bursitis that is actually causing the pain. I've pasted the translated report below.
"ULTRASOUND OF THE RIGHT SHOULDER
Tendon of the long portion of the biceps in place in its groove without effusion.
Subscapularis tendon difficult to visualize but appears correct.
Supraspinatus tendon of pathological appearance, thickened, heterogeneous with full-thickness fissure extending over 11 mm transversely, 6 mm anteroposteriorly
Correct infraspinatus tendon
Effusion of the bicipital groove intra-articularly and blade of effusion of the
subacromiodeltoid bursa.
Absence of significant acromioclavicular conflict To be compared with MRI"
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