AC Arthrosis Surgery Experiences?

Captnoblivious · August 18, 2013, 1:13pm

I’ve had chronic shoulder pain for quite some time. Ice, celebrex, rest, cortisone injections, didn’t really touch this injury. I am not able to barbell press or flat DB press. I train around these especially when training the chest. After an MRI my ortho, confirmed the arthrosis. I am going to try rehab, however it looks like surgery is definitely an option.

My question is this. Those who have had the surgery. Was the shoulder back to pre injury functionality? Was the pain gone?

Has anyone just trained through this with success?

Thanks.

clinton131 · August 21, 2013, 1:05am

I had a distal clavicle resection and a subacromial decompression. Took about a year to get back to what you call “pre injury functionality” . I am assuming you are considering “pre injury functionality” to be the amount of weight you were pressing before your injury. It took a little longer to get to the point that I could press weights that I once could pre injury without pain. Therefore I slowly increased the weight, and as soon as I had any pain I would back off. Did not want to injure it again. I used Wendler’s 531 to, shall we say, rehab it back. Instead of a true training max I used a weight that did not cause pain as my training max. I could press significantly heavier weights then this training max, just not pain free. It took me probably two years to get to the point that I could press weights that were close to my true 1RM with out pain.

I ran the same course that you did, Ice, rest, ibuprofen, numerous cortisone injections, rehab, etc…none of it worked. Not sure how bad your injury is but mine was affecting my day to day life outside of training. I got to the point that it was affecting my sleep and even simple things like reaching out for items in front of me and lifting them caused pain. This was the deciding factor in me getting the surgery.

Also, If you do elect to get the surgery, make sure you do your rehab. I am fortunate to have a wife that is an occupational therapist that gave me a rehab plan that I could work on daily. I attribute this to the quick recovery that I had. I am a LEO and only had to be off work for six weeks before I was back to full active duty.

Good luck, shoulder problems suck.

Captnoblivious · August 31, 2013, 11:51am

[quote]clinton131 wrote:
I had a distal clavicle resection and a subacromial decompression. Took about a year to get back to what you call “pre injury functionality” . I am assuming you are considering “pre injury functionality” to be the amount of weight you were pressing before your injury. It took a little longer to get to the point that I could press weights that I once could pre injury without pain. Therefore I slowly increased the weight, and as soon as I had any pain I would back off. Did not want to injure it again. I used Wendler’s 531 to, shall we say, rehab it back. Instead of a true training max I used a weight that did not cause pain as my training max. I could press significantly heavier weights then this training max, just not pain free. It took me probably two years to get to the point that I could press weights that were close to my true 1RM with out pain.

I ran the same course that you did, Ice, rest, ibuprofen, numerous cortisone injections, rehab, etc…none of it worked. Not sure how bad your injury is but mine was affecting my day to day life outside of training. I got to the point that it was affecting my sleep and even simple things like reaching out for items in front of me and lifting them caused pain. This was the deciding factor in me getting the surgery.

Also, If you do elect to get the surgery, make sure you do your rehab. I am fortunate to have a wife that is an occupational therapist that gave me a rehab plan that I could work on daily. I attribute this to the quick recovery that I had. I am a LEO and only had to be off work for six weeks before I was back to full active duty.

Good luck, shoulder problems suck.[/quote]

I appreciate the detailed reply man! I am going to try rehab, but I honestly think it’s time to get cut!

jj_dude · September 10, 2013, 7:39pm

[quote]Captnoblivious wrote:

I appreciate the detailed reply man! I am going to try rehab, but I honestly think it’s time to get cut!
[/quote]

If you are heading there anyway then by all means get it done. I’ve had bad osteoarthritis and treating it conservatively really just means you get tortured for years before getting it done anyway. You don’t know what the future holds. In 10 years will your life let you have a couple of months of downtime? How well will you heal then? Getting a bit of hypertension then might mean things don’t heal like they do now. Are you looking at degenerative changes? Having a fair sized repair now would be a lot less traumatic than, say, having to have a massive intervention later. Also, does this predispose you to injury?

Remember Dave Draper? Ripped one of his rotator cuff muscles and continued to lift heavy for years, slowing chewing up the shoulder until one day he got a grisly dislocation and needed 6 hours of emergency surgery. They really couldn’t fix it fully since it was too far gone. He has great advice on his site about how to train with messed up shoulders. Read there for more.

Finally, the truly dirty secret of orthopedic surgery is that surgical skill is probably the decisive factor in a successful outcome. Seriously. Knowing where to put that extra internal stitch or shifting something that last few crucial millimeters is the difference between a passable repair, suitable for an office worker or getting back out on the playing field pain free. Do your homework. Go with someone who has worked extensively on pro athletes. Success leaves a big audit trail. Google is your friend. Then do what s/he says for rehab.

Hope this helps…

– jj

EDIT: I had arthritis and my point is that conservative treatments don’t really work in the long run unless you are willing to sit down and quit doing anything. Maybe when I’m 90 I’ll think about doing one. Maybe. I am now 12 days out from a simply massive shoulder repair, so I’ve been thinking about this an awful lot. One other thought is that they don’t know the full extent of what goes on inside a body until they get in there. Most people have other things wrong that are only found in the OR. Are you sure arthrosis is all there is here? My local doc missed 3 full muscle tears and an impingement issue. Course I just didn’t trust him (nice guy, but I live in the sticks) so the real pro I had do the surgery had the final say.

56x11 · September 11, 2013, 1:37am

[quote]Captnoblivious wrote:
I am going to try rehab, but I honestly think it’s time to get cut!
[/quote]

Can you honestly say that you’ve tried all viable options?

If the answer is no, keep surgery as a possibility and not the only recourse. If you’ve convinced yourself that surgery is in the cards for you, your actions will follow to validate the self-fulfilling prophecy.

I’m often left speechless with the number of people who swear that they’ve tried everything to fix their situation (be it rehab, hypertrophy, fat loss, etc.) when it’s abundantly clear that they have not.

And, in the interest of full disclosure, my objectivity is tainted because I’m in the business of doing everything possible to keep a person away from the knife IF there are alternative solutions. Nevertheless, I maintain that surgery should be very last option.

56x11 · September 11, 2013, 1:38am

[quote]jj-dude wrote:

Finally, the truly dirty secret of orthopedic surgery is that surgical skill is probably the decisive factor in a successful outcome. Seriously. Knowing where to put that extra internal stitch or shifting something that last few crucial millimeters is the difference between a passable repair, suitable for an office worker or getting back out on the playing field pain free. Do your homework. Go with someone who has worked extensively on pro athletes. Success leaves a big audit trail. Google is your friend. Then do what s/he says for rehab.

Hope this helps…

– jj

[/quote]

I don’t disagree with this. However, the OP and anyone else considering surgery need to be aware that even the best, in any profession, are not perfect.

These orthos that work on superstar athletes know what a high-profile case it will be. They will do everything and anything to make sure that all goes as planned.

Unfortunately, it is naive to think they will bring the same level of focus to all their patients.

Are the odds more in one’s favor by going to a highly respected surgeon with a stellar track record? Of course. Is it a guarantee of success? Of course not.

Ultimately, the patient who signs the stack of waivers and gets cut is playing the odds. And one can and should do everything possible to stack the odds in his favor. The reality is, surgery is always a dangerous wager to make with one’s own body.

This is why I asked the OP, in an earlier post, whether or not he has honestly tried all other options.

56x11 · September 10, 2013, 9:13pm

[quote]jj-dude wrote:

Remember Dave Draper? Ripped one of his rotator cuff muscles and continued to lift heavy for years, slowing chewing up the shoulder until one day he got a grisly dislocation and needed 6 hours of emergency surgery. They really couldn’t fix it fully since it was too far gone. He has great advice on his site about how to train with messed up shoulders. Read there for more.

[/quote]

Interesting you bring up Draper as I’ve seen him train, on several occasions. There is a gym in Santa Cruz that he once owned; and still visits to lift.

Now I don’t know exactly what he did to rehab his shoulders. I can tell you, from direct experience, how he trained back in 2011.

One of the exercises he did regularly, which made me cringe, was an explosive type of the lat pull down with a wider-than-shoulder-width grip. He did this full range, meaning at the top of the movement his shoulders were near his ears. He rarely utilized the eccentric portion; in other words he relied on the stretch reflex with the common body english many use on the movement.

That entire stack of weights, because the eccentric was completely neglected, yanked his shoulders upward on each and every rep.

The sad part was that many impressionable lifters at that gym (some of whom were not exactly newbies) copied his methods because…surely, if this is how Dave trains it must be the right way. (There were people there who even argued that he competed without chemical assistance.)

I can - but will not - write an article on why Draper’s variation on the lat pull down is a horrendous way for anyone with shoulder issues. If you or anyone disagrees, so be it. I won’t waste my time trying to convert.

Now, I don’t know if he had this shoulder surgery you mentioned before or after those sessions I saw back in 2011. If it was prior, then regardless of what he did for rehab, he’s back to performing a movement in the worst way possible for someone with his set of issues. Older but certainly not much wiser.

This is an example of why I advise people to first examine the fundamentals such as how they lift in addition to exercise selection before focusing on the band aid cures or even surgery.

(edited for clarity)

Captnoblivious · September 11, 2013, 12:37pm

[quote]jj-dude wrote:

[quote]Captnoblivious wrote:

I appreciate the detailed reply man! I am going to try rehab, but I honestly think it’s time to get cut!
[/quote]

If you are heading there anyway then by all means get it done. I’ve had bad osteoarthritis and treating it conservatively really just means you get tortured for years before getting it done anyway. You don’t know what the future holds. In 10 years will your life let you have a couple of months of downtime? How well will you heal then? Getting a bit of hypertension then might mean things don’t heal like they do now. Are you looking at degenerative changes? Having a fair sized repair now would be a lot less traumatic than, say, having to have a massive intervention later. Also, does this predispose you to injury?

Remember Dave Draper? Ripped one of his rotator cuff muscles and continued to lift heavy for years, slowing chewing up the shoulder until one day he got a grisly dislocation and needed 6 hours of emergency surgery. They really couldn’t fix it fully since it was too far gone. He has great advice on his site about how to train with messed up shoulders. Read there for more.

Finally, the truly dirty secret of orthopedic surgery is that surgical skill is probably the decisive factor in a successful outcome. Seriously. Knowing where to put that extra internal stitch or shifting something that last few crucial millimeters is the difference between a passable repair, suitable for an office worker or getting back out on the playing field pain free. Do your homework. Go with someone who has worked extensively on pro athletes. Success leaves a big audit trail. Google is your friend. Then do what s/he says for rehab.

Hope this helps…

– jj

EDIT: I had arthritis and my point is that conservative treatments don’t really work in the long run unless you are willing to sit down and quit doing anything. Maybe when I’m 90 I’ll think about doing one. Maybe. I am now 12 days out from a simply massive shoulder repair, so I’ve been thinking about this an awful lot. One other thought is that they don’t know the full extent of what goes on inside a body until they get in there. Most people have other things wrong that are only found in the OR. Are you sure arthrosis is all there is here? My local doc missed 3 full muscle tears and an impingement issue. Course I just didn’t trust him (nice guy, but I live in the sticks) so the real pro I had do the surgery had the final say. [/quote]

Thanks for the reply. I don’t think AC problems will lead to huge shoulder issues, just pain as my ortho explained. I remember swole saying AC problems will fix themselves over time, I was hoping he would post in this thread.

I am uneasy with my ortho. He is very flippant, and I read about him botching a hip surgery. I also have quite a big of other pain in my back on the same side. He has been very evasive about answering the question if this will solve problems with my scapula and back.

Captnoblivious · September 11, 2013, 12:44pm

[quote]56x11 wrote:

[quote]Captnoblivious wrote:
I am going to try rehab, but I honestly think it’s time to get cut!
[/quote]

Can you honestly say that you’ve tried all viable options?

If the answer is no, keep surgery as a possibility and not the only recourse. If you’ve convinced yourself that surgery is in the cards for you, your actions will follow to validate the self-fulfilling prophecy.

I’m often left speechless with the number of people who swear that they’ve tried everything to fix their situation (be it rehab, hypertrophy, fat loss, etc.) when it’s abundantly clear that they have not.

And, in the interest of full disclosure, my objectivity is tainted because I’m in the business of doing everything possible to keep a person away from the knife IF there are alternative solutions. Nevertheless, I maintain that surgery should be very last option.

[/quote]

At this point no. I have a very knowledgeable physical therapist. So I am will be working with him trying to rehab the shoulder. I may try this for a while, and see how it goes.

Thanks for the reply.

thehebrewhero · September 13, 2013, 7:27pm

Had my right AC done 3yrs ago and Im doing my left in 2 weeks… Also I had a slap tear left shoulder before… Rehab coritzone shots… Just a waste of time and putting off the envitabe surgery… No reason to prolong it the faster you get it over with the better… Theres never a good time to be healing…What can I say lifes a bitch…As far as surgeons go I’d say make sure you go to a place where they work on athletes and dudes that are into fitness… If the guy or place doesnt scream sports injury then walk…

56x11 · September 13, 2013, 8:55pm

[quote]Captnoblivious wrote:
I am uneasy with my ortho. He is very flippant, and I read about him botching a hip surgery. I also have quite a big of other pain in my back on the same side. He has been very evasive about answering the question if this will solve problems with my scapula and back. [/quote]

Trust your gut.

There are many shit stains out there who unfortunately happen to be board certified. He is being “flippant” and “evasive” because he either does not know or doesn’t really care.

[quote]Captnoblivious wrote:

At this point no. I have a very knowledgeable physical therapist. So I am will be working with him trying to rehab the shoulder. I may try this for a while, and see how it goes.

Thanks for the reply. [/quote]

Glad to hear.

This debate (not just for you but for anyone who is on the fence regarding surgery) can be polarizing. Therefore, I want to add a few more thoughts on the subject.

Too often, people find themselves in a revolving door of weight room to surgery to weight room to surgery due to:

a) Incompetent PT. Indeed, I suspect there are many surgeons out there that exploit this in order to create a paper trail of failed PT visits. They can leverage this to justify surgery to the patient and insurance companies.

b) Non-compliant patient. The PT can be very knowledgeable and caring; yet if the patient simply goes through the motions and ignores the advice of the PT, well…of course the success rate diminishes.

c) Neglecting the all-important bridge from rehab (i.e. what you’re doing with your PT) to the weight room. This is not usually the patient’s fault. In other words, even if you get the green light from the PT, it is EXCEPTIONALLY dangerous to jump right back into what you’ve been doing prior to the injury. Most PTs I’ve encountered are relatively competent in terms of rehab. However, they are woefully inadequate in designing a solid stength/conditioning program AFTER the PT sessions have run their course. A first rate PT and a first rate strength/conditioning Coach take similar yet different skill sets.

Obviously, there are injuries traumatic enough where surgery is the only logical option.

However, if someone comes to me and gives a history of injury in one shoulder, has surgery, then later has a similar injury in the other shoulder, I strongly suspect there have been incorrect programming which led to the second surgery.

In other words, after the first surgery, something should have been revised in order to allow the patient to continue in his goals without aggravating the opposing side.

To give an example, I consulted a woman last week that fits this description to a T. She’s in her mid 30s, college educated professional. In her early 20s, she made the classic mistake of taking up marathons in order to stay slim. By the time she was in her late 20’s, she was diagnosed with degenerative meniscus in her right knee.

What did she do…? She took up half marathons, this time using different models of shoes and various types of braces.

And how is she doing now…? In addition to complaining about being slim but having no muscle tone (shocker, I know), she is having issues with her left knee.

It’s easy to be on the outside and see the fallacy of her reasoning. However, when you’re the one that’s in a world of hurt, it’s difficult to be objective. So I advise you to do what’s necessary to maintain that objectivity as you navigate through this.

At this point, it appears to me that surgery on your shoulder is still in the elective stage. Therefore, as I stated in an earlier post, explore all viable options. And as I stated in this post, absolutely respect that bridge from the PT visits to what you do in the weight room.

Otherwise, you will be just another card-carrying member of the those who could have addressed a surmountable problem before it became insurmountable.

Captnoblivious · September 17, 2013, 11:47am