Rotator Cuff full tear and retraction of supraspinatus tendon

Hi wwalker,

I just had an anatomical TSR 5 weeks ago. Because I waited too long, some of the muscles in my upper back near my bad shoulder weakened/atrophied. I didn't notice because it can only be seen from the back. My PT showed me. I'm 70 y/o and otherwise in excellent health. I should have had the surgery 6 months to one year earlier. Lesson learned.

As for your husband, I suggest asking his surgeon about doing RC surgery versus a reverse TSR versus PT for now. It seems that joint replacements heal faster and better than RC repair.

I hope that helps. My best to you and your husband.

Joe

Hello, Joe,

Joe happens to be my husband’s name too.

I am undergoing anatomical shoulder replacement surgery on Halloween and would like to dialog with someone who has had that… I have questions about how the different stages of recovery went for you and how you are presently doing.

Thanks,
Lynn

Hi Lynn,

Well it's good you're having an anatomical TSR. That means your rotator cuff muscles are intact. The Dr will need to free your subscapularis muscle and the tendon for the long bicep head. This allows access to the joint. The subscapularis is then stitched back onto the scapula and humerus. This makes the first month of rehab difficult, but certainly doable. (My surgeon did not reattach the tendon for the long biceps. I'll be interested in what your surgeon suggests. Sometimes surgeons will re-arttach this tendon, but it has to be lower on the humerus.)

My Dr. had me do nothing but easy arm swings while bent forward and simple bicep lifts, palms up for two weeks, then two weeks in a continuous passive motion chair, and then in-person PT.

What I found is that there is a lot of swelling and bruising/blood trails in the bicep, blood trails and bruising down the bicep and forearm and down the operated side. It looks worse that it is. My swelling went down within two weeks, but the day after surgery, my bicep was twice its normal size.

You will also work with a therapist to deal with getting dressed and a few other things. I was limited to one arm, but was surprised at the easy way to put on a t-short and take it off. The therapist will go through that with you.

You will probably also spend the first night in the hospital, I did. I think the reason is the nerve block administered before surgery. I couldn't feel my arm or shoulder for 18 hours after the shot.

As for icing, they may give you an ice machine, but that didn't get cold enough for me. I suggest using some decent sized gel packs that you can place on and around your shoulder on top of a wash cloth.

Sleeping is a bit tough - best position is on your back, back propped up at an angle with support under the operated arm, all while wearing your sling. My first two nights home were really painful, and then that stopped pretty quickly.

The best thing you can do with an aTSR is have patience. I had my shoulder replaced two months ago and have about three weeks left of PT, but my shoulder is now pain-free and it is glorious.

Anyway, please let me know if you have any questions. And please also remember that no two operations for the same joint are the same, especially in different patients. I do a lot of work at the gym, and did some work a theraband to strengthen my rotator cuff pre-op. It's not that important to do this. I did it because it's part of my normal exercise routine.

So yeah Lynn, good for you for getting this done! I hope your experience isn't as bad was what you may be thinking. I was pleasantly surprised at the recovery. The hardest part was adjusting to sleeping on my back!

All the best.

Joe

@lzamarra I had full tear shoulder repair a few years ago. I agree with all the tips that hey Joe gives. I actually followed a woman on YouTube that journaled her full recovery and even though it was a few years old, I really followed. My tip is when you are recovering with a PT, try Dry Needle procedure when a few weeks in. Also, the rented “ice” machine was a must for sleeping! A good recliner is the key!

@amywood20 I too have a full thickness tear, right shoulder, had great results with PT and holding for 2 yrs. Just found out i have another full thickness tear on left shoulder. 1 cm tear. Ortho says it is larger than the first tear ( MRI did not give measurement of the first tear) With this tear i have no pain and full ROM. First instinct is to resume PT for this new tear as I really want to avoid surgery. But then the doubts creep in :/ Ortho shoulder Doc says I may never have pain or weakness snd never progress to the need for surgery while also making me aware of the dire sounding end results of waiting too long, muscle atrophy , total shoulder , yadda yadda . As a worrier I go to the worst scenario in my mind . Reading your comment gives me hope . How do you know your tear is holding ? Are you basing it on absence of pain and good ROM or have you had follow up MRI’s ? And is that even s thing to get follow up scanning to check ? Thanks !

How long should pt be givened a change. I thought as time goes on muscle atrophy and fatty infiltration will set in.

@greekgal56 . Are you sure you have a full thickness tear. That means it's pulled away from the bone.

@bdemasi
This is my personal opinion. My right rotator cuff had 3 tears to tendons (1 was off the bone.) and 2 torn muscles. I had gone undiagnosed for a year before seeing an amazing surgeon. After surgery, he said he had done the best he could but only worked on reattaching the tendon to the Bone. My PT wasn't a good fit for me but I did go to several PT appointments and then stopped. Meanwhile I had started drinking protein shakes because when I researched it, the only thing I could find that would repair tendons and muscles was protein. I also had the surgeon release me but didn't go back to work for a while due to personal reasons. 3 years ago I injured my left rotator cuff while turning a wheel. I did have surgery and recovered well. A year ago I injured shoulders and both arms hurt. The images showed I did not have any tears and did not need surgery. It was workers comp and it was a nightmare.
My main point is that personally the tears healed up to the tendons and muscles of a rotator cuff.
The first surgery left two tendons and two muscles without surgery. They did all heal on their own, during the time my tendon reattachment took to heal. I do believe that my Whey Protein Powder shakes did help in the healing. But only a good surgeon will know what needs to be done in your particular circumstance. To this day, none of my images have shown atrophy anywhere in the rotator cuffs. I am 75 years old. My lesson in all of this is that just because I can do something, doesn't mean I should do something. I will not be using extreme force to turn any wheels in the future.

@heyjoe415
As I posted somewhere else, I had right and left rotator cuff repair surgeries which were excellent. The surgeon did tell me that if I had another tear, I would have to have total shoulder replacement. If that surgery is anything like my girlfriends have experienced with knee replacements and hip replacements, we are talking serious work in the recovery process. Probably with any surgery, you get what you put into it in the recovery. Thank you for all of the helpful information regarding shoulder replacement surgery.