rotator cuff surgery

I don't know how accurate this is, but I have read that the extent of shoulder injuries can be hard to judge through x-ray, MRI, etc. Basically, these techniques can be used to get an idea of damage, but that often times the extent of the damage isn't determined until the doctor is inside the shoulder. This post isn't mean to scare or discourage you, but just to say that I think it would be pretty impossible for any one on this board to give a guess as to recovery time.

Pretty wise advice from Emanski's. Some shoulder injuries can only be diagnosed 75-80% of the time through non invasive techniques, which means false negatives for injuries register about 1 in 4 players.

Lack of ability to diagnose the true extent of the injury is not only limited to shoulders however. Have also heard of a great many elbow surgeries where more or less damage and collateral injuries were discovered during surgical procedure.

My son (mid-level D-I college starting outfielder, junior) had both rotator cuff and labrum surgery on August 1. He's coming up on 4-month post surgery. Just now regaining full range of motion. Has not started throwing or swings yet. Maybe in a few weeks he'll start. No significant complications and pain level is minimum. But, all indications are that he'll have to do a medical red-shirt for the '09 season, since he won't have regained all his strength or hitting skills.

So, it's a long recovery after surgery. Can't be rushed and can't guarantee that he'll ever be back to 100% pre-injury level. But, he'll do his best and, I'm sure, you'll do your best to bounce back.

Stay positive!

Thanks to everyone for their help. Looks like soft toss to my son will be left handed this off season

lodi, these bone spurs are troublemakers. My son had TJ when he was only 15, and Doc Andrews came out after surgery and gave me a small bottle with a bone spur in it. Said that this was rubbing and tearing his ligament for probably a couple of years, and then on one day and one pitch it was over.

OhComeOn, best of luck to your son during his recovery.

Lodi,

As someone said before, don't trust the x-rays and MRI. I just had surgery last Friday. My x-rays and MRI showed bone spurs and inflamed bursa and rotator cuff tendon. After going through the cortisone/PT process, it didn't get any better so I was scheduled for the standard decompression surgery.

When the surgeon scoped me Friday, he found a 50% tear in the tendon and some fraying of the labrum, neither of which showed up on the MRI. So I got the bone spurs shaved down, the bursa cut back, the tendon sewed up, and the labrum cleaned up. And my shoulder hurts like hell.

Major discomfort...definitely get the nerve block. I'm sure there are horror stories about it but there was a guy in recovery when I was and he didn't get the block and he was thrashing around in so much pain he couldn't take it. They took him back in and gave him the nerve block post-surgery.

It's a huge needle but it's not that bad. They gave me some anesthesia so I was a little foggy but still awake, then they stick the needle in at the base of your neck to find the right nerve. I didn't even feel the injection.

I started PT yesterday and we're planning on 6 weeks of standard PT, then moving slowly to the interval throwing program if I'm ready at that point. Now, I'm a dad and a coach, so my only concern is being able to throw BP for my sons and our teams. I just won't be able to throw BP on consecutive days now. There will be a lot more ice and rest between practices, that's for sure.

Best of luck with your procedure. If you have questions let me know.

Had Rotator Surgrey and labrum as well. The X-Rays and MRi proved wrong prior to my operation. It took me just under a full year to return to the mound in college and almost a year and half before I felt fully recovered. Rehab is slow and tedious.

YHF yours sounds just like mine. Had the cortizone shot yesterday and start the PT next week.Surgeon said he felt I would have to have surgery. Insurance requires him to go this route first.Also everything is so imflammed and the range of movement is so limited that he felt the PT would be better prior to having surgery. Thanks for the advice on the nerve block also.

Just a brief update to demonstrate recovery time. My DI outfielder son had labrum and rotator cuff repair on July 30, '08. He has rehabbed since then without complication. Yesterday, the surgeon gave him clearance to begin throwing lightly --- 5 months post surgery.

He was told to ease into a throwing routine over a few weeks, but not to throw at full effort until April --- 8 months post surgery. He will redshirt in the '09 college season and hopes to play summer ball starting June, roughly 10 months after surgery.

So, it's a slow process. The surgeon says the repair should be strong and that my son should be able to return to pre-injury form for the '10 season.

My son is fine mentally, but I'm a wreck worried about surviving my first no-baseball Spring in 12 years!

To those players facing the surgery, keep up the spirits and perseverance. For their parents, there's always something to do in the Spring --- knitting, planting begonias, watching paint dry.

Who was the Surgeon. My Son has to get labrum /rotator surgery ASAP . We are looking for the right doctor. The university (coach) wants him to use the school Doctor.I have an appt today in Phila w/ Dr. Mark Lazarus (Rothman). We are a wreck any Advice?

Gary, my son's surgeon is in DC. He's the Washington National's Team Orthopedic Surgeon. If travel to DC is an option for you, let me know and I'll pass along the information to you.

quote:

Originally posted by Gary DiBart:
Who was the Surgeon. My Son has to get labrum /rotator surgery ASAP . We are looking for the right doctor. The university (coach) wants him to use the school Doctor.I have an appt today in Phila w/ Dr. Mark Lazarus (Rothman). We are a wreck any Advice?

Gary, I would urge you to get your son to Dr Andrews in Birmingham. In a certain sense, there isn't anything urgent or having the surgery ASAP. The damage to the labrum/rotator cuff won't change unless your son plays or something of the like.
It is far more important to have the surgery done right, not to have it done ASAP.
It is equally important to have it done by someone with a track record of success, to the extent there is a record of success with labral tear repair.
In my opinion, the words "team" orthopedist should not carry much weight in making these decisions. If you want to send me a PM, I would be happy to explain why I make those types of comments.
You will find that many MLB teams/players send their very toughest surgeries to Dr Andrews. You will also find that when the "team" orthopedist does a surgery and the results are not as expected, the team sends the player to Dr Andrews.
This surgery is very critical and needs to be done by the best. Dr Andrews should be your very first call, in my opinion.

Thanks for the thoughtful response and comments, IFD.

Well, shucks. I sure should have known better. Sometimes you just can't trust world-renowned hostipals like Johns Hopkins not to allow inferior surgeons to use their facilities. Now that I'm warned, I'll watch out for those arthroscope-weilding amateurs at Duke and Stanford, as well.

Next time I'll know better!

I'm sorry my input was interpreted as a "slap."
It was not meant that way so I will try and explain.
Recently, a team orthopedist published an article on labral tears/repairs.
Studying about 50 or so patients, it concluded that roughly 25% get back to compete at the level of baseball they did pre-injury/surgery.
That article concluded there is much to be learned about shoulder surgery/rehab even amongst the team physicians/ortho's.
Baseball is a sport that stresses the shoulder like no other. That combined with the lack of success of labral repairs led to my recommendation to find the best surgeon with a track record on successes with baseball players.
My son's career was ended by a labral surgery that ended up requiring a second one, done by Dr Andrews.
Recently, I read of two very high profile local pitchers who had their college careers ended before they actually got started, by shoulder surgery complications.
My input was to find the very best surgeon who has some record of success with baseball players who compete at the highest levels. Dr Andrews is one.
I am not aware of a single one at Stanford and I deal with a number of doctors in their facilities. Maybe there are some at Duke and JHU. If so, they would be options.
I am sorry if you interpreted my post as a slap. It was not intended that way. It was intended only to suggest looking behind the "team" doctor affiliation to find the surgeon with experience and success with this surgery for baseball players.
I wish someone told me to ask those types of questions and get that type of information before our son had this surgery. That is all I wanted to communicate to Gary.

i agree with infielddad

every year 6 surgeons from around the country (i'm sure a few from jh,as well as stanford) go to birmingham to learn from the best. that should tell you something.

I agree completely with Infielddad. Some myths about team doctors, including college and pro team doctors, all are not equal and using the word team before the word doctor doesn't mean the best.
This past summer my son was experiencing pain with nothing major to be found on two MRI's. Before he went to see the team doctor my husband made a call to Alabama regarding the team surgeon. Unfortunetly as a milb player, there are many things that you can't control, and who you first must see was not an option for him. But we still called to ask questions and in the meantime found out that if major surgery was to be done he would be in good hands.
You might want to call down to Andrews who will recommend a doctor in your area. You have complete control over the situation, use that option.
JMO.

$urgery a second option. First option intensive shoulder PT Work. Hopefully this will work. Thanks for all the Info. This is a Great site! GOD BLESS.

Did weeks of PT,range of motion got better but pain became more centralized. Tomorrow at 6 am is the big day.Removal of spur and repair and anchor the supraspinatus

Best of luck to you... Please let us know how it turns out...

went well,removed spur and smoothed surface.repaired rotator anchored it and cleaned up frayed labrum,only thing the Dr forgot to do was to completely cut out the nerve bundle man it hurt when the nerve block wore off

when do you start therapy?

in 5 more weeks,Glad I dont throw batting practice.We have our 1st practice tonight.Believe me these kids are going to get the speech about arm care.

Lodi- I found this site when I was looking for answers to questions for my rotator and labrum operation I had one year ago tomorrow. Stick with the physical therapy. I think I went 80 times and worked on it every night. I played catch with my son the other day for the first time and it was worth all the work. I know people that slacked on the pt and they still have pain today. I gave the arm care speech many times as I was in agony. They seem to listen when they see the scars.
Good luck.

It is interesting to see the various thoughts on when to start therapy

I had both shoulders done a few years back, my left had a rotator cuff situation as well as a torn labrum---three hour surgery procedure--in and out on a Friday---next morning, Saturday, in the PT office at 8 AM to begin therapy---OUCH--- they did like to wait--even had me doing exercises 4 times a day in my office and then to them at night---the therapiast handled the Jets and the Rangers, Devils and Islanders so I had confidence in him

Both shulders are fine now---full mobility and use

Does anyone remember the painful walk up the wall, post surgrey. I to this day still think that was the most painful thing I did in all of rehab.

My therapist called himself Dr Pain and he was not kidding but I have full mobility back in both shoulders and have been pain free since the end of therapy

quote:

It is interesting to see the various thoughts on when to start therapy

This is very true. While I can't (thankfully) speak with experience about shoulder rehabs, both my son and wife's cousin's husband (he pitched briefly with Tampa and Detroit) have had Tommy John surgery. They had completely different rehab guidelines. Cousin's husband, we'll call him JJ, was operated on by the surgeon his MLB club sent him to. After surgery, he went home to California with instructions to stay in his bandages and splint for 4 weeks. My son was operated on close to home, in San Francisco by Dr. Ken Akizuki, and he was told to begin moving his arm to the degree he could without any pain or strain, 48 hours after surgery. My son was in to the Physical Therapist within 10 days of surgery, and moving his arm quite a lot within 4 weeks. At the same point post-surgery, JJ was still in his splint. My son had a relatively effortless and very successful rehab, while JJ had more difficulty and his pro career ended at 28 years old. Looking back, he has wondered if having his arm imobilized for so long made the initial part of rehab slow and somewhat painful.

While I in no way am suggesting that one method is better than the other, I will suggest you ask which protocol is right for you. When you're having your surgery done far from home, it is tough for the surgeon to do much for you post-op. We were able to drive to my son's surgeon every couple weeks for follow up checks. That might be something to consider for people faced with arm injuries. Another thing I'd suggest is finding a PT who is very familiar with rehabbing arm injuries for baseball players. I am convinced that will make a difference.