Partially Torn Rotator Cuff, Acromion Decompression Surgery

Training Injuries
1

Hey T-Nation,

New member to the board, looking for some advice on my situation as I see there are many helpful members on this particular board.

Recently got an MRI of my left shoulder which revealed the following:

-partial rotator cuff tear
-bone spur on my acromion
-severe tendonitis of my supraspinatus
-some inflammation in the joint capsule

I have a noticeable “crack” when lifting the effected shoulder out and over-head, along with instability and definite weakness. However my WORST symptom BY FAR is a sharp, dull pain I feel shooting down my arm, concentrated just below the left bicep in the bend of my arm. Is this pain due to the rotator cuff tear? Or is it a separate bicep issue? I also have some pain if I sleep on the effected shoulder.

I also have tightness in my upper trap, which I understand to be tendonitis of my supraspinatus??

Long story short, I originally got diagnosed with impingement syndrome. Went to PT 2 separate times with no long term relief. Post therapy the pain started shooting down my arm and has really effected my training for the past year and a half. I took time off, did a lot of eccentric work, ART, Graston etc to no avail. The shoulder itself doesn’t hurt much, only when I do over-head work at medium to heavy weight (which I have been avoiding now).

I most recently got a cortisone shot in the shoulder, this has not helped and to be honest the pain shooting down my arm has been worse since the shot (2 weeks ago.) Before the shot it would only hurt when I did direct bicep work or certain other movements, now I feel a heaviness in that arm no matter what.

I have a follow up appointment in a couple weeks and the doc said if there’s no improvement then surgery would be the next step since I’ve been dealing with this for well over a year.

My question are as follows:

-What is causing the pain shooting down my arm? I’m guessing its the bone spur impinging the long head bicep tendon???

-There is a lack of blood flow to that arm, I’m very very worried about my tendons and long term damage. Should I expect the surgery to fix all these issues??

-Is it best to stay out of the gym until I get this surgery? Or perhaps I should only train legs and abs in the meantime? Or… still workout and just be smart and avoid any exercises that I notice pain from? I ask because I know its possible to do damage without feeling pain necessarily.

Any help from someone who’s been through what I’m experiencing would be awesome as well as some feedback for my questions.

Appreciate it very much!

2

Anyone???

3

hey man,

i’ve had numerous shoulder issues over the last 3 yrs, due more to contact sport than lifting wgts… i’ve had:

  • Bankarts repair & capsular tightening (surgery)
  • Supraspinatus impingment
  • Biceps tendonopathy
  • Multiple ‘stingers’
  • Sprained AC joint

currently all my shoulder issues are resolved and have been for the past 6 months, although it is still uncomfortable to sleep on that shoulder & my arm goes numb very quickly if i lie on it and i get occasional shooting pain down my biceps tendon (but as long as i keep on top of my soft tissue work this isn’t a problem)

i’ll try to answer what i can from my knowledge:

-re: tendonitis of suprasprinatus, for me this was easily solved by not lifting upper body for 3-4 weeks, with constant physio on soft tissue focusing on upper traps, rhomboids, pec, pec minor & subscap… my rehab consisted of lower trap strengthening, scapular patterning and stability and returning normal ROM throughout shoulder range - no direct cuff work during this period.

-re: partial rotator cuff tear - from the experience of other people unless the rotator cuff is 80-100% torn then it’s better to avoid surgery, as the recovery time from repairing a rotator cuff is at least 6 months & the rehab is a nightmare.

-re: the gym, i personally have some exercises i don’t go near: upright row, BB bench press (BB floor press/DB bench is fine), i only OH press once a week (and take care not to externally rotate shoulder too much), BB curls… i also do a lot of pulling movements (at least 2:1, pull:press).

to be honest what i have found is that if i’m on top of my soft tissue work around the shoulder & i do my rehab 3 times a week my shoulders fine and i have no real pain or problems… but to get to a point where all i need is maintenance soft tissue work i had 2-3 weeks solid with a physio for 45 mins - i’ve never known pain like it.

it’s pretty muddled, but hope some of this is helpful…

J

4

Thanks for the reply JRugby!

Been doing a lot of research lately and have answered some of my own questions. I feel fairly certain the long head bicep tendon is also getting impinged from the bone spur on my acromion and most likely the lack of blood flow to that area is causing the pain.

I also agree with you about the tendonitis in my supraspinatus. I’ve laid off the gym for the past week, focused more on core work for the time being, foam rolling and the tension I felt in the upper trap area has subsided noticeably, although its still there.

To be honest I’m just a little scared to work out for the time being, don’t want to do more damage and fight through the pain when obviously my body is telling me something. The face that 50 lbs on a straight bar was pretty painful is concerning for me.

So they will most likely just shave the bone spur off to create the necessary space then? Hopefully that fixes everything.

Like you I’ve also been reading up on good rehab exercises to strength all these areas that I have most likely neglected in my training and making extra sure to focus on good form. I know for years I never use to retract my shoulder blades when benching, which likely put a lot of pressure on my front delts and rotator cuff. I also am working on my posture because I tend to round my shoulders from years of working out.

I go in next week to talk with my doc and see if surgery is my best bet, so I will keep you posted.

thanks for the reply!

5

My symptoms were very similar to yours. Had a sharp pain shooting into my elbow when attempting any pressing movement. My MRI revealed:

-partial rotator cuff tear
-bone spurs on my acromion
-torn labrum

I wanted to use surgery as a last resort, but now I feel like I should have skipped the cortisone injections and went straight into getting it fixed. If you haven’t had surgery yet, don’t do anything that might create further damage. Work your legs, maybe some light back work, but avoid the movements that hurt. I had my surgery on 3/25. I’m pretty sore right now and was a little concerned about the muscle I’d lose, but I’d say getting out of the long-term pain will be worth it.

I hope this info helps.

6

[quote]mrjones1914 wrote:
My symptoms were very similar to yours. Had a sharp pain shooting into my elbow when attempting any pressing movement. My MRI revealed:

-partial rotator cuff tear
-bone spurs on my acromion
-torn labrum

I wanted to use surgery as a last resort, but now I feel like I should have skipped the cortisone injections and went straight into getting it fixed. If you haven’t had surgery yet, don’t do anything that might create further damage. Work your legs, maybe some light back work, but avoid the movements that hurt. I had my surgery on 3/25. I’m pretty sore right now and was a little concerned about the muscle I’d lose, but I’d say getting out of the long-term pain will be worth it.

I hope this info helps. [/quote]

Thanks for the reply Mr Jones! Very helpful!

Yeah I accepted the cortisone shot since I knew my doc wanted to follow standard procedure before resorting to surgery. I go in this Thursday and I fully expect him to say surgery is needed.

Did you get a regular MRI or an MRI with arthogram?

Reason I ask is I’ve actually been wondering if I might also have an tear of some sort in my labrum since I have read numerous accounts of regular MRI’s not picking up labrum tears and how they are fairly hard to diagnose unless its pretty bad.

I have completely shut down my lifting since after the cortisone shot since I had a good amount of pain in my elbow/bicep area.

Any advice you can give me as far as questions to ask my doc when I go in on Thursday? He’s pretty open minded and he is a lifter himself.

Thanks so much,