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    InfraspinatusTendon tear

    Hi I'm post 25yrs L1/L2 and I've been having shoulder pain for the past 8yrs and it's bicep tendonitis and I've been getting cortisone shots at least twice a year and sometimes it helps. The pains go away and sometimes it don't. I was referred to an orthopedic Dr and I had an MRI and it shows that my full thickness infraspinatus tendon tear and he said I need surgery and I ask him how long it will take for me to use my arm and he said right a way but I'd have to use a arm sling. Now I'm thinking after surgery how can I use my arm right away? It don't sound right and I'm just wondering if anyone had this problem and how did the surgery go?

    #2
    I'm assuming the doc thinks you mean the hand part of your arm. Do they have a good grasp on what YOU need your arm for?
    Rollin' since '89. Complete C8

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      #3
      No I don't think so. I'm just worried that if I do go for surgery I wouldn't be able to use my arm with a sling and to have a shoulder surgery I don't think I'll be able to use my arm right a way.

      Comment


        #4
        It is likely that you will NOT be allowed to move your shoulder, nor bear any weight through your arm for some weeks after any type of rotator cuff surgery. The infraspinatus tendon is part of the rotator cuff. In my experience, no shoulder weight bearing is allowed for at least 6 weeks post-op, although you can use your hand for small tasks such as opening a container or holding a pen. We needed to do transfers for our clients (with a mechanical lift), loaned them a power wheelchair with the controls on the opposite side, and had nurses or PCAs do their bowel care and most ADLs for them during this time. Driving is also out.

        You need to have a serious and detailed discussion with your surgeon about what you do now that puts weight on your shoulder (transfers, wheelchair pushing, crutch or cane use for walking, bowel care, dressing, other ADLs, etc.) and what you will be allowed to do post-op, as well as how long restrictions would last. It would be helpful to have your surgeon be experienced in this procedure for others with paralysis/SCI/D.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #5
          I'm gonna have to talk to my doctor again. I really don't want to do the surgery I' wouldn't be able to do my own bowels or do any transfer maybe another cortisone shot will help but it might do more damage to my shoulder.

          Comment


            #6
            Repeated cortisone shots can weaken the tendons and make more tears more likely.

            (KLD)
            The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

            Comment


              #7
              Originally posted by SCI-Nurse View Post
              Repeated cortisone shots can weaken the tendons and make more tears more likely.

              (KLD)
              Is this true only if there isn't enough time between cortisone shots or is it true regardless of the length of time between shots?

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                #8
                More than 2-3 injections can cause this problem, regardless of the amount of time between each injection.

                (KLD)
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                Comment


                  #9
                  I've had the shots in my shoulders when I was an athlete for many years. As KLD said, it takes it's toll and it did contribute to the deterioration of my shoulders. I feel they would have gone sooner had I not been in such good shape. Shots or no shots, the shoulders go over time. It's just the way it is. Both biceps are torn off the long head, Infraspinatus on both sides are ripped and torn and ulnar nerves feeling it also.. I still get around quite nicely considering

                  I never had the surgeries because after seeing what others went thru and then three years later, they were in the same previous condition or worse, I decided against it. Now it's too late. Last time I was evaluated, my surgeon gave me the low down. It was at least a 4 month rehab with weeks of being completely dependent due to the shoulder being strapped to the chest and then weeks if not months of it being in a sling. No independent transfers at all. He mentioned I could be three months in and if I fell over wrong on the shoulder; there's a good chance I'd tear out all his good work. This was about ten years ago.

                  Techniques may have changed. I had carpal tunnel release surgery a couple of weeks ago. It took eight minutes for them to do it endoscopically with no restraints afterwards. I did take it easy though until I got the stitches out. If I had the same surgery done a few years ago, it would have been an open palm type surgery with 6-8 week rehab in a cast. Now it's 4 or 5 stitches with a soft wrap for three days and fully functional 2 weeks later. Perhaps shoulder surgery has reached a similar advancement. Just remember once your cut your cut.

                  25 years in and you only have a tear; that's pretty good. Stay active and time to stop the cortisone shots. I find the gym with a trainer, massage and handcycling helps alot with the pain and weakness.

                  Comment


                    #10
                    I've read that it'll take a long time to heal and after it's healed their pain got worst and they couldn't use there arm for anything. Massages helps but it also cost a lot of money. Can this heal without surgery?

                    Comment


                      #11
                      If you have a complete tear is it unlikely to heal without surgery.

                      In my clinical experience, most people have a good outcome with this surgery, given the following:
                      • Surgery done by an expert surgeon (often the orthopedic surgeon used by your closest professional baseball team).
                      • Strict adherence to post-operative activity restrictions.
                      • Therapy provided by experienced OTs and PTs once passive (initially) and active (later) exercise of the joint is allowed.


                      Yes, there is a considerable downtime during the initial healing. If you cannot obtain sufficient assistance at home for this, some have gone to a nursing home for the first 6 weeks, then had a short (1-2 week) inpatient acute rehab stay for the beginning of their active exercise regimen.

                      (KLD)
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                      Comment


                        #12
                        I'm not sure if it heals without surgery. If you're younger and very active and depending what your surgeons skills are, I'd consider it... consider it. If you're inactive or old like me, no way. I've had these tears for over 30 years. I'm not sure if they've gotten worse or not.My shoulders are shot but I've been very, very active for 45 years post. Am now making changes to preserve what I have left. I use my ZX1 more now and added a Power Pod to my handcycle about 5 years ago for those steeper hills and wanting to go 30mph at the flick of a switch and no pedaling if I choose. Also use a sliding board more.

                        I made a deal with my chiropractor and masseuse twenty years ago for a better deal on costs to see how long we could go before surgery. That was twenty years ago last August. I saw them twice a week for many years and recently went to once a week for my massage and as needed with the chiro.

                        For myself, KLD is the expert as she's seen this many times. It's a personal decision with hurdles and challenges whichever way you decide to go. Like my recent carpal tunnel surgeries; years ago there was no way I'd have them done because of the risks and rehab times involved. Now, after they got to the point of surgery or losing function and the new techniques, I got them done and was easier than a root canal. Perhaps it's the same with tears in the spinatus.
                        Last edited by Patrick Madsen; 14 Dec 2018, 1:09 PM.

                        Comment


                          #13
                          I'm wondering if there are any new studies or any recent information about the effectiveness of the nonsurgical treatment of rotator cuff tears by injection of the patient's own blood growth factor that's obtained from the patient's blood platelets. Here is the article that describes the treatment in a 2015 issue of New Mobility magazine. It would be very interesting to know if this treatment has been used effectively since then.

                          http://www.newmobility.com/2015/07/n...oulder-repair/
                          There was an SCI targeted study mentioned at the end of that article:
                          • Use of Platelet Rich Plasma for the Treatment of Bicipital Tendinopathy in Spinal Cord Injury: A Pilot Study, www.ncbi.nlm.nih.gov/pubmed/23459023
                          If it works, it would reduce the post-op health risks from surgical remedy and lengthy convalescence, deconditioning tremendously..

                          Comment


                            #14
                            The thing is after the MRI I went to see my doctor and he didn't say much. He walk in the room and said you need a surgery he didn't say I will need therapy and said I can use my arm right away that's all he said and I read that some had the surgery and it didn't help the pain or after the surgery the pain is worst and it takes moths to heal. My shoulder pain is really not that bad but I'd rather have no pain all I do is stay at home hardly go out because of my leg pain that I can hardly take the pain. My shoulder hurts because I think I was using the computer for too long and now I hardly use it.

                            Comment


                              #15
                              I would consider seeing a different orthopedic surgeon who specializes in shoulder surgery, and who will take the time to take your needs into consideration when explaining the surgery, and answer all your questions. Most insurances will pay for a second opinion for elective surgery like this.

                              (KLD)
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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