Rotator Cuff Surgery

Hello Fellow Crossfit Maniacs:
You want the real deal on ROTATOR CUFF SURGERY?
You came to the right place! Read on my friends.

Background: 52 y/o MALE masters Crossfit Athlete for approx 6 months. I was a top level athlete before getting laid up. Could do muscle-ups, hspu's, legless rope climbs, du's and lots of other stuff.  My best workout was Murph in 39:00. Thats me on left!

 Lots of other good results of course. And usually could run like the wind. My big weakness was OLY AND ANYTHING OH. Wanting to compete in Open and beyond, I only had a 6 month ramp up to the Open--too little time which had me pushing way too hard and ultimately did not help the situation. Keep in mind no OLY experience at all before Crossfit. I actually achieved quite a lot in a short time.

Incident: I know for many people their RC injury occurred while engaged in something specific, like opening a door or taking down stuff from the rafters and then BOOM! Contrary to many others, my rotator cuff injury was mainly due to wear and tear over time. I have been working out hard for over 30 years. Some of the Crossfit junk certainly made things a bit worse, but surgery would have been inevitable even without the Crossfit. The Dr. described my injury as a worn and frayed climbing rope. A rope that needed fixin'!

In Jan 2013 I was no longer able to do bench press or military press, dips, muscle-ups or anything OH from a static position. I was preparing for The Open and wanting to compete so knowing this wasn't possible, it was nonsensical to spend $175/ month. So, I quit Crossfit and got an MRI. Diagnosis: Full thickness retracted tear in the supraspinatus and other damage . In May 2013, met with Dr./ Surgeon who informed me that surgical intervention was required, but not urgent. I didn't want to spend a beautiful Colo. summer laid up so I was given a reprieve of sorts. I decided to take a *cortisone shot to get me through the summer. I kept working out hard and set PR's in many exercises. And I had just nailed down TTB's and BFPU's and was really stoked. There was a risk of worsening things with the shot and that turned out to be the case somewhat.

HINT #1: GET A SECOND OPINION!: You can easily take your CD of MRI pictures to another Dr. I got a 2nd opinion via a consultation with a specialty surgeon at the Steadman/ Hankins clinic. These guys do the top athletes and world class competitors. Dr. at SH was not informed of previous diagnosis. Anyway, the opinions in my case turned out to be the same. Except for the cortisone shot.

*CORTISONE SHOT: There is a 50/50 almost exact division on whether to do it. Some Dr.s say no way, while others support it. It all depends too on whether the surgery can be, or needs to be performed immediately. Some professionals oppose it because it provides false security and license to do stupid things and make the situation far worse. I decided to take it, because it would give me relief for several months and allow me to enjoy activities during the summer. Though I was pretty aggressive with some stuff, I was also sensible. As an example, before surgery I couldn't bench press or do b/w dips at all. The same for military press. The cortisone shot provided enough relief such that I could have performed these exercises, but I chose not to as it would worsen things considerably. Bottom Line: Be prudent and sensible. If you couldn't do it before, don't do it on the shot.


HINT #2: SET YOUR PR'S NOW: A rotator cuff procedure is going to take you out of action for about a year, so if you want to nail some workouts and set some benchmark scores, do it now. I chose to do Murph (39:28) Griff (11:19), Jerry (21:48) and Jackie (9:44). Wanted to do Helen too, but time ran out. My Griff was really ugly and in Jackie, the thrusters took me a whopping 5:00. Disgraceful! I completed the row and the pullups in 5:00 give or take.

Anyway, my carefree summer 2013 came to an end and surgery date was set for just after Labor Day Sept. 4, 2013.

PRE-SURGERY: Lots of stuff. Can't take Tylenol for one week prior. No food after midnight the day of the surgery. Pre-anesthesia appt. Surgery orientation one on one session. Many appointments in any event. They are serious about the "no food" thing--if you admit to eating anything after midnight, the surgery is cancelled on the spot!

THE BLOCK: Some of you may be offered a "anesthetic block" where they numb the entire shoulder area before the operation. This helps manage the post op pain greatly and you will be somewhat comfortable for 12 hours post op until the real pain kicks in. I elected to do it and it was fine.

THE OPERATION: Let's be clear, rotator cuff surgery is a MAJOR surgery and a major trauma to the body. And it's painful too. Dr.King repaired the infra, supra and bicep tendonesis. I have like 8 anchors. Don't remember much. It is GENERAL ANESTHESIA so be forewarned. Lucky for me I got a bonus! During the procedure my cornea was scratched because eye covering came unstuc or something. Folks, the eye pain was 10x worse than the shoulder pain. 2 days of that too! Make sure your eyes are oiled and sealed! While in post-op, they kept asking how my shoulder felt...I responded, "I don't know, but my !#%$!!% eye is killing me." I remember grabbing the nurse by the arm and saying "Opthamologist... NOW!" Finally, one showed up, confirmed the scratch and told me I would have to deal for 24-48 hours. It was awful when added to the surgery itself.

INITIAL RECOVERY
HINT #3: HAVE FAMILY MEMBER, SPOUSE OR FRIEND STAY WITH YOU FOR 1 WEEK AFTER SURGERY.
Luckily, my brother had agreed to stay for 1 week. If you can get someone like this--DO IT! You can do it alone, but it's very, very difficult. Food prep, cleanup is all very tough. House cleaning and other stuff. The basic chores are a real challenge. And before they leave, have them prepare stuff in advance--cut up fruit, hard boiled eggs and any shopping.

The first 48 hours were a nightmare (with the eye thing added in) and I don't remember much. Just popping Oxys like m and ms--JK and drifting in and out of sleep. Takes a while for the anesthesia to wear off too. And the sling which you have to wear for about 6 weeks.
<picture of sling> Try and get the sling dialed in--it takes some work, but then you can take it on and off easily. Some people quit the painkillers right away and really, I can't believe that because they are needed especially trying to sleep at first and for PT sessions. And in fact 6 weeks in, still needing them. Anybody who says they got off them right away is full of BS.

HINT #4 ALWAYS USE ICE AFTER PT SESSIONS AND AFTER YOUR HOME EXERCISES.

HINT #5: GET A RECLINER. YOU WILL BE SLEEPING IN IT! IT'S A LIFESAVER. I BORROWED ONE FROM A FRIEND. TRY TO GET ONE IF YOU CAN. You can also set up the couch for something similar.

When sleeping during first few weeks, I would switch between bed and recliner and back. Bed would be comfortable then I would awake in great pain and unable to sleep. Switched over to recliner and immediately felt better and was able to sleep.

JOINING THE LIVING:
Two days after surgery I was able to leave the house. I drove and did some shopping. Already I had learned to do a LOT of stuff left handed (my non-dominant good arm).

HINT #6: Practice doing stuff one handed before the operation. brush teeth, floss, clean house, cook, open  jars, drive, dress, shower, etc. As many things as possible

HINT #7: YANKZ LACES: Equip as many shoes as possible with Yankz laces. Those are the elastic laces that allow you to slip on a "pre-tied" shoe, because you won't be able to tie shoes. Tri geeks use them and other athletes. I took 5 pairs of shoes to running store and had the guy install them. And you'll need a shoe horn too!

Showers are difficult--you will need to do everything one handed. Get a long handled scrubber if you can.

Dressing: Murder and it takes twice as long. Put belt on pants BEFORE you put pants on. Try to wear button shirts and other loose fitting clothes. T shirts very tough--don't bother unless you want pain.

Sling stays on ALL THE TIME for first MONTH or so--except for showers and rehab exercises. And YES, you need to sleep in it. I did begin taking mine off several times a day for brief period and did light motions to keep it active. You don't want to baby it, but you don't want to strain it either. Absolutely you have to keep the shoulder area mobile. Do all the exercises the PT gives you several times per day.

COMPUTERS: Having my own online store, I'm on the computer a lot. Unfortunately this means a lot of typing and mousing. Your mouse will need to be moved to opposing hand and typing should be kept to a minimum for 3 weeks. I had one day where I had to type a lot and it was very painful and needed to be iced down. Typing with sling is difficult, so I was taking mine off a bit so I could type more efficiently. This made me more sore as mentioned above and was uncomfortable

BEDROOM ACROBATICS: I would highly advise against it for one month or more. And really with the sling on (you are wearing it, aren't you dummy?), you can't do much. Its easy to lose track of your injury and cause further and unnecessary damage. The results can be fairly painful. One night about 5 weeks in, my "friend" flopped down on my bad arm and for the rest of the night the shoulder was throbbing and kept me up. I finally had to take a pill and resort to my old friend, the recliner (see above). You may wish to try other ways of, er, entertaining yourselves.

As a funny aside, there is nothing less romantic than being at a nice candle light dinner, when you lean over to kiss your loved one, and instead hear the tear of the velcro and plastic buckles clacking together as you reach over in your sling (you are wearing, aren't you dummy?) Oh and always make sure, your sig other is on the good side so you can hold hands or put your arm around him or her easily.

WORKOUTS: (finally the GOOD part)
This is an example of how motivated I am to get back to workouts: Had surgery Wednesday and on Friday went on run with Spirit, my border collie. About 5k (very stupid as we shall soon see). And by Saturday I was in the gym doing spin cycle, b/w squats, and other lightweight stuff.

Like many of you, I couldn't wait to get started with training again. My enthusiasm was short lived. Several days after the surgery and well before my Dr. follow up and physical therapy even began, I ran 5k with my dog at a good pace. I did this several times thinking it was okay. It wasn't! Both Dr. and PT scolded me and said NO as the jostling and risk of fall were too great. I thought running would be fine. I was freaking out because I thought I had blown it. Dr. assured me that no damage done, but NOT to do it.
So stuck with walking! UGH!

Like the running I was anxious to hop on my friendly Concept C2 rower and see if one handed rowing was possible. It was! By wearing a heavy glove and gripping the holes in the handle, I was able to row pretty well lefty. My splits were slower--1000m in 4:30, but most recently, I broke 2:00 for 500m. I was proud of myself and had a picture taken.
Showed it to my PT--he was not impressed and neither was  the Dr. and again I was read the riot act! They said rowing was out too as it will engage the right shoulder and put strain on the stitches/ anchors.

WHAT TYPE OF WORKOUTS CAN A CROSSFIT MANIAC DO?

1)Spin Cycle--It's stationary and safe. Try and get a good cardio worout out of it. Go hard as you can and tax your system. I was doing 5k or 5 miles. for me, boring!

1.25) Treadmill: Recommend using incline to increase resistance. Keep speed moderate, because agan you could fall. You can even do tabata. BE VERY CAREFUL HERE!

1.5) Plain old walking no path or park. NO HIKING as risk of falling is too great.DOGS? Yes, but I highly recommend a waist (hands free) leash. If you have a big rowwdy dog, I wouldn't chance it. One good pull and you could pull the stitches.

2) Squats: Start with B/W squats. Do as many as you want and the more the better. Nows the time to work on that form--hip crease belwo the knee, etc.
After a few weeks, I was adding weight by hoisting (carefully) a DB up to opposite shoulder and doing the squats that way. You have to clean the DB so be careful of too much weight.

2.5) Pistols: You can do these, but balance is a factor and you don't want to fall.

3)Box Step-ups: Using 18" do brisk step-ups. Super fast and alternating legs every 10. Do 50 or 100 or whatever. You want to show control at top just like regular box jumps. Go hard and watch your step. Be careful, if you fall on that shoulder--you ccould tear your shoulder again.

4) Lunges: I did walking lunges with KB or DB overhead, start b/w and work up to light weights. Or you can do them with weight at chest height. Also standing lunges.

5) KB Snatches: Only after about one month with good arm and use light weight.

6) One-handed wallballs: Using your good arm do lightweight wallballs. Surprisingly difficult to catch. I was using 2# and 4# mostly.

7) KB Push Jerks: After about one month, use good arm to do light push jerks.

8) Weight assisted pull-ups. Some gyms have those machines--use the good arm to do one armed pullups

Sit ups, crunches and low back raises.

******FOR ALL THESE EXERCISES AND WORKOUTS, KEEP YOUR INJURED ARM, BUTTONED DOWN AND STABLE.  USE THE SLING/ PAD THEY GIVE YOU AND KEEP YOUR ARM LOCKED IN TIGHT TO PREVENT SHOULDER MOVEMENT. IF AT ANY TIME YOU FEEL YOUR INJURED SHOULDER ENGAGING OR FIRING, BACK OFF.*****


THE BIGGEST PROBLEM AND WORRY OF ROTATOR CUFF SURGERY:
During the 6-9 month recovery period, you won't know if the repair has been successful, paritally successful, or has completely failed, unless you want to pay for another MRI. Generally speaking, a completely successful r/c surgery doesn't happen often. There are sooo many variables, sometimes a patient will be perfect and do everything right and the surgery will fail, just...because. There are many reasons why a repair will fail--the skill of the surgeon, the procedure performed, the physical state of the patient, and the unknown. Very rarely was I able to find a surgery failed becuase of "user error". Meaning Alex tried to snatch 95# three months after surgery, etc. I asked the obvious question: Wouldn't you be able to tell if the repair had come unstitched or unanchored or failed? Nope. You won't know until the very end.

All you can do is do what they say. Honestly, since I started out a fairly elite athlete, I have been a little more aggressive,yet not stupid in my approach.

Now, and here's where I disagree with the the Dr's and other experts: It is widely stated that nobody heals faster, recovers faster or is back to regular activites sooner than anyone else. After R/C surgery it takes x amount of months to be back to "normal" and that's final. MMMM, I don't see it that way. There are many variables going in, how healthy the indivdual was, what type of surgery and importantly how they take care of themselves. I went in, pretty much as an elite athlete and in execllent shape. Plus sticking to the PT home exercises and keeping all PT appts. This coupled with desire, bleief and determination equals being able to get the recovery phase much faster and into resistance type exercises sooner. Like I said, I'm in the minority.

THATS MY STORY AFTER 6 WEEKS.