Lower Trapezius Tendon Transfer

Posted by ltsally @ltsally, Apr 3 11:27am

Has anyone had this surgery? I was scheduled this week, but delayed due to Covid-19. Interested in long term prognosis. My right shoulder is where the surgery will be done and I know I'll have 6 weeks in a brace with my arm at a 90 degree angle to my body. Anyone?????

Hi @ltsally, I can imagine the disappointment with having your surgery delayed. But this is a good time to think about 1) what you can do before surgery that might help recovery and 2) what will recovery be like.
I'd like to ask fellow members @basslakebabe19 @starfirey2k @dtwo @ellerbracke @artscaping @mayoclinic4sale and @anncgrl who have all had shoulder surgeries to join this discussion and share their recovery experiences. They have perhaps not had the exact surgery you're about to have, but can still offer some tips.

You may also be interested in this discussion
– Shoulder replacement: Post-surgery suggestions https://connect.mayoclinic.org/discussion/curious/

Sally, have you thought about what you might have to change in your home to accommodate your arm being in a brace for 6 weeks, like which side of the bed you sleep on or having commonly used items moved to the left side of the sinks in the bathroom and kitchen, like your toothbrush? Will you be recovering on your own or will someone be with you?

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Thank you so much for your reply. At this point I am doing physical therapy to try to build up the muscles in my shoulder. Of the four rotator cuff‘s two are completely severed and one is partially severed. The Achilles tendons from the cadaver are going to be placed over the top of my shoulder connecting near my collarbone. I have had rotator cuff surgery with pins in both shoulders prior to this and have a pretty good understanding of rehab and recovery. I will get to that stage after six weeks with my arm in a brace. Your suggestions are very thoughtful and I certainly am trying now to use my left arm as much as possible to get it trained. Thankfully, I have a husband who is a 15 on a scale of 1 to 10. He will take very good care of me and we have adult children and grandchildren nearby to help also. Any suggestions are always appreciated. Take care. Sally from Oregon.

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@ltsally

Thank you so much for your reply. At this point I am doing physical therapy to try to build up the muscles in my shoulder. Of the four rotator cuff‘s two are completely severed and one is partially severed. The Achilles tendons from the cadaver are going to be placed over the top of my shoulder connecting near my collarbone. I have had rotator cuff surgery with pins in both shoulders prior to this and have a pretty good understanding of rehab and recovery. I will get to that stage after six weeks with my arm in a brace. Your suggestions are very thoughtful and I certainly am trying now to use my left arm as much as possible to get it trained. Thankfully, I have a husband who is a 15 on a scale of 1 to 10. He will take very good care of me and we have adult children and grandchildren nearby to help also. Any suggestions are always appreciated. Take care. Sally from Oregon.

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Good afternoon @itsally, from Oregon. Greetings from Minnesota and welcome to Connect. it sounds like you have had an accident at some time. A tumble down the mountain left me with what my surgeon called the grandfather of holes in my rotator cuff. So, my vision is pretty clear about this process which for me took three surgeries and a lot of moaning and groaning.

Will this be your second surgery? In this case, it appears that evidence of the cadaver fusion is required before you will be free of the immobilizer. I do recall that with fusion in the thoracic area I had to wait 3 months in a brace to assure a good "glue" job.

If I recall correctly, for daily hygiene, my shoulder and arm were wrapped in a plastic bag and my angel caregiver made sure my hair got washed.

It was good to read that you are working on strengthening the left arm. I did that also. Still to this day, I eat left-handed and am considered to be ambidextrous……..can't read my handwriting from either hand. One day as I showed up to hand address envelopes for a charity, I heard someone say……"Oh, there's Chris, let's find something else for her today. She doesn't write well enough."

Here is a link to a physical therapy protocol that looks informative.
https://www.josefeichingermd.com/pdf/lower-trapezius-tendon-transfer-physical-therapy-protocol.pdf
What are your must-haves and expectations for post-surgery movement, stretch and lift? Are you working? What is included in your daily routine? This surgery is a Mayo innovation which is showing progress and applicability for situations like yours. Mine left me with no rotator cuffs and a pretty big lot of titanium. So my pre-surgery physical therapy work was all about the deltoid muscle substituting for the rotator cuff.

I am fascinated with this concept and would so appreciate it if you would keep me and Connect updated especially about your rescheduled surgery. Your posts about your surgery and rehab can help lots of folks who may be facing the same repair/replacement.

May you be free of suffering and the causes of suffering.
Chris

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Thanks for the response and I'll share the PT protocol with my surgeon and therapist. Sounds like you've been through the ringer. I've had rotator cuff surgery with pins in both shoulder about 15 years ago….about 2 years apart. My right shoulder and arm have been painful for over a year, but until November I was still able to play tennis pain free….then nothing traumatic that I know of, I couldn't play tennis at all due to pain. The surgeon said my ball and socket didn't play nicely with each other. In December I dislocated my shoulder….and after relocation the arm was almost pain free. MRI shows the two rotator cuff pieces that are supposed to cover the top of my shoulder are completely severed and are hanging out at my collar bone. The front cuff is torn and will be fixed with pins….the back is intact. In terms of post surgery hopes, I'm a tennis player…. play on teams….and hope to get back to that. My surgeon does a couple of these surgeries a year and admits they are a bit unusual but provide a better prognosis than the original reverse shoulder replacement we were looking at doing. I'm a retired school principal but do contract work for the department of Education in the state…. not difficult work and mostly on the computer. We travel a ton, I walk a lot, and just am anxious to get back to normal. Also, ya sure, you betcha…. I'm from St. Paul, Mn. When my Minnesota friends would say, "Don't you get tired of the rain in Oregon?" I'd let them know I've never had to shovel it! Take care and look forward to staying in touch. Sally

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@ltsally

Thanks for the response and I'll share the PT protocol with my surgeon and therapist. Sounds like you've been through the ringer. I've had rotator cuff surgery with pins in both shoulder about 15 years ago….about 2 years apart. My right shoulder and arm have been painful for over a year, but until November I was still able to play tennis pain free….then nothing traumatic that I know of, I couldn't play tennis at all due to pain. The surgeon said my ball and socket didn't play nicely with each other. In December I dislocated my shoulder….and after relocation the arm was almost pain free. MRI shows the two rotator cuff pieces that are supposed to cover the top of my shoulder are completely severed and are hanging out at my collar bone. The front cuff is torn and will be fixed with pins….the back is intact. In terms of post surgery hopes, I'm a tennis player…. play on teams….and hope to get back to that. My surgeon does a couple of these surgeries a year and admits they are a bit unusual but provide a better prognosis than the original reverse shoulder replacement we were looking at doing. I'm a retired school principal but do contract work for the department of Education in the state…. not difficult work and mostly on the computer. We travel a ton, I walk a lot, and just am anxious to get back to normal. Also, ya sure, you betcha…. I'm from St. Paul, Mn. When my Minnesota friends would say, "Don't you get tired of the rain in Oregon?" I'd let them know I've never had to shovel it! Take care and look forward to staying in touch. Sally

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@itsally, Now I know even more about your situation. I so appreciate the details and I think they are helpful as other members run into a similar situation. So your ball and socket don't play nicely together. Neither did mine so they switched positions. The socket is at the top of the femur and the ball is crewed into my shoulder blade.

Tennis is calling you back. Golf was my addiction and I was relegated to the putting green or miniature golf. I hold out hope for your return to tennis because you are very aware of what it will take and you know that if you do fall, you risk not being able to be "fixed". I can tell you truthfully that I have never had any pain in that shoulder other than when I tried to double the weights I was lifting. Ouch…too much weight, too fast. Freedom from pain is the biggest reward.

You may wrinkle your nose at this statement and yet I will say it anyway…….have you tried Pickleball?
Be safe and protected.
Chris

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🙂 Pickleball is not a 4 letter word…. just not what I hope to do. I've played it and it's fun…prefer the tennis court. Sounds like you had a reverse shoulder replacement which is what I was in line for until they discovered I didn't have arthritis in my shoulder so was a candidate for the trapezius transfer. Let's stay in touch. How is Minnesota doing? Is Amy Klobuchar a good VP candidate?

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Also… Be safe and protected. Happy Easter

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@ltsally

🙂 Pickleball is not a 4 letter word…. just not what I hope to do. I've played it and it's fun…prefer the tennis court. Sounds like you had a reverse shoulder replacement which is what I was in line for until they discovered I didn't have arthritis in my shoulder so was a candidate for the trapezius transfer. Let's stay in touch. How is Minnesota doing? Is Amy Klobuchar a good VP candidate?

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@itsally, Oh my goodness, I have been looking for the pickleball response and here it is. Thanks for the humor. I understand. How old are you? That may make a difference in how well you are able to let go of preferred activities. You really do need to grieve for the loss of a special talent or skill that brought you joy and a different kind of reward.

From my experience, it is best to have done a little research on a replacement. Let's see. gave up riding horses and tennis. Replaced those with golf. That was after 3 days in a sling hung over my hospital bed and a promise of lifetime neck issues from the neurologist if I didn't calm down. I was 28 and on my way to my first back surgery. To golf, I added "inn to inn" hikes of 40 miles or more and pinochle. That's kind of how it goes. Let one go….find another option. Conquer new challenges and find new friends. Like you, I cannot just stagnate.

Are you ready for this……here is what I have left at 78. Don't laugh.
Mahjongg with the girls……
Mindful meditation with the girls……
Restorative yoga with the girls……
Caretaker volunteer to my neighbor
Substitute grandmother to a 12-year-old.

The highlight of the day
Training chipmunks……yep….don't train my special Cavaliers anymore.

What else does Oregon have that would challenge you?
May you be free of suffering and the causes of suffering,
Chris

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