Torn rotator cuff - is surgery inevitable?
Hey all, I've been putting this post off in hopes it wouldn't come to this, but looks like I need to figure some stuff out. Just had feedback on an MRI for a bad rotator cuff (FWIW, work related. I`m a school psychologist and lug around a ton of stuff from school to school and it has caught up with me....). Anyway, I had a brief phone consult with the sports med doc who ordered the MRI today, and she said the MRI showed a "low grade" tear of my sub-scapular muscle, some tendonosis in my supraspinatus muscle, and mild degenerative changes in my AC joint. Her first thought was I might be OK with physio because lots of people walk around with crappy rotator cuffs, but then when I reminded her that I need to swim to do triathlons, she became a bit more hesitant and said she could line up a surgical consult for me. She also said to come back in four weeks after starting some physio and my response to physio might also be prognostic. She couldn't really offer me anything further (she's a very recent grad and hasn't worked with a ton of athletes).
Living in Manitoba Canada, our health care system crawls at a snail's pace for matters like this. I will be looking at a 2 month wait (if I'm lucky) before I can even consult with a surgeon. Then if its surgery, I will be getting in line again for several months for a surgery date. I was able to arrange a second opinion with another sports medicine doctor who is a shoulder guy and multiple ironman finisher, but that isn't until April. I don't even have a copy of my MRI report yet. That will arrive by mail sometime next week.
Would really like to hear from anyone who might be able to shed some light on what I am realistically looking at here and whether surgery is something that will need to happen before I can race again. I'm also not opposed to travelling out of province to get a decent consult within a more reasonable time frame. If I need surgery, so be it. I'd like to fix it and move on. I don't want to do physio for months on end if it will be to no avail.
A secondary question (perhaps better posted elsewhere) is whether there is a good EN maintenance plan out there in the Wiki? I've been finishing up my OS plan, more for sanity than anything else, but its been tough knowing racing is not really an option. I had planned to do Kansas 70.3 in June, but since I cannot swim a stroke right now (too painful, no strength) that doesn't seem reasonable. Once the OS ends in a few weeks, I'd really like to stay on some sort of plan...
Any input would be greatly appreciated! Thks Jenn
Comments
Sometimes I think it's easier when the is a complete tear and surgery is the only option. Right now I am able to swim, but I do hurt. Hoping things improve by summer as I was planning to do Louisville.
In your situation, I'd suggest trying the physio and seeing if it makes a difference. Surgery should be a last resort and you may see some improvement from the physio - they should also give you exercises to do at home. At the worst, you'll know that it hasn't helped and that surgery is what you need....
As for the maintenance plan, I don't think I've seen one...but you could easily take parts of the OS and combine it with the early parts of a race plan and go with it...My advice would be to just do what's fun and not get too serious - just do what you like to maintain...
Best of Luck...
Jenn,
Sorry to hear about your issues. I'm at the very tail end of my own shoulder issues, having had surgery 5 weeks ago and been in a sling.
My broad advice is that all of this is just a game. You shouldn't think twice to put your swimming on hold for a year or more to get this fixed and fixed right!
Regarding a plan:
But the broad guidance is to heal up. This is all just a game....
Jenn,
This sucks and as you mention the speed of health care could be much faster.
I don't have any suggestions on the medical side but don't just go in to maintenance mode. Various thoughts are :
- look for an early season 1/2 marathon and do a focus run block, follow that up with a cycling block and hit a century ride if one is available.
- any duathlons? I know we have one here early season because the water's too cold yet.
- Hook up with the tri club and do a relay, bike at one race and run for the other.
- Any bike races in your area, not sure you have a road bike but this could be an option. A quick search brought up the MB cycling assoication. They had some interesting races on the 2011 schedule including a two day road race 86 km 1st day, then an individaul time trial on the 2nd day. Also in July is an individual TT. The cat 5 early season road race of 60km would be good as well.
For me I think its easier to get running races on the calendar the bigger challenge will be to have some cycling stuff to keep motivated, even if that's just something like MS ride for the cure.
http://mbcycling.ca/
Good luck with the shoulder.
Gordon
Thank you all for your responses. I really appreciate it. Good to hear consensus that physio is a good first step. Although I'm frustrated by the injury, the slow pace of health care here is even more frustrating. So hearing that starting with physio is a good approach anyway (rather than jumping to surgery, which isn't even an option unless I travel) is helping to put my mind at ease a bit.
As for racing/training, yeah I know not to take this too seriously and I'm ok with taking the time to heal up. Shoulder permitting, I will do some duathlons this season (we have a good weekly series starting in May). Then in July my hubby and I have a cycling tour in Napa/wine country planned, so I will definitely keep up the biking. Like I said, my biggest frustration is just wanting to get a good consult to know what I'm dealing with. Sigh. Patience.
Anyway, once again thanks for taking the time to share your experiences/opinions...
I do work injuries and see this regularly.
I have not seen surgery unless the tear was full rotator cuff OR good size partial and work abilities would be impacted for extended period (think construction worker).
On top of that, I have seen work comp refuse aggressive treatment for lifestyle choice if work is not impacted.
It sucks.
Avoid the things you know aggravate the shoulder. Maybe get a rolling bag instead of carrying items.
Therapy is definitely the way to go.
Best of luck.