T Nation

Torn Rotator Cuff


#1

I tore my rotator cuff, and I'm not gonna get surgery for it. So what are the best things. Can do to help it heal and get back to lifting.

I'm able to still do basic stuff like bend and lift stuff up but pushing and pulling at chest level is pretty painful. I just tried to do a couple things to test myself like pullups and curls, able to do pullups but it hurts at the bottom and able to do curls but ithurts at the top. My shoulder ( the right one ) has a bump where my clavicle comes over and ties in and is very tender. My left shoulder doesn't have this.

Any advice, I went to the doctor and was told nothing is broken or torn but also did they any x rays or anything as they are too expensive. I think it's more severe than diagnosed.


#2

i believe i also tore my rotator cuff. did dead lifts just fine, but cant even sleep because of the pain.
ill be watching this post, advice would be great, i too cannot afford medical attention.


#3

There’s no way to know whether you’ve torn your cuff without an MRI or exploratory surgery.

Having symptoms does not necessarily mean a tear. Could be tendonitis, impingement, or a strain.

There are many exercises for rehabbing/strengthening the cuff.


#4

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#5

[quote]bushidobadboy wrote:
You can certainly diagnose an RC muscle tear, either full thickness or partial thickness, through orthopedic testing. Surgery??? No thanks, lol.

[/quote]
That wasn’t my experience. After hurting my shoulder I had full-on ortho testing from two top surgeons. Both said I had no tear based on my diagnostics. An arthrographic MRI eventually revealed a full thickness U-shaped tear with retraction. I went the surgery route and am now pieced together with five anchors. Without the surgery, I would have had major atrophy and arthritis since there was no tendon/bone attachment left.

I know you are an expert in your field, BBB. But because I had no bruising and still had decent ROM after I tore it and passed all diagnostics, I was told that it was just a strain. So I like to share with people that diagnostics are good for the majority but not everybody.


#6

Hope this helps:

Hard to say without that MRI. If it is a full-thickness tear, then just know that those don’t repair themselves, unlike partial-thickness tears, which can be rehabbed. If you have a full-thickness tear and are very athletic, you will likely eventually need surgery. I had a full-thickness tear for years before finally getting that MRI, and just thought that it was tendonitis. I stayed away from overhead activities, upright rows, and jogging (the jarring aggravated it, for some reason), and it was somewhat manageable for quite a while. I had surgery in 3/2010 (sub-AC depression, distal clavicle excision because of AC joint arthritis, and RC repair in the way of titanium sutures), and was 100% about 5-6 months after (pushups/pullups/jogging was a breeze), although I didn’t go really heavy again for about 9 months.

As for exercises, my ortho told me: 45 degree raises (halfway between front and lateral dumbell raises) with thumbs down, and the traditional external rotation exercise.

Additionally, a wide bench-press grip and coming all the way down to the chest can be stressful on the RC’s for some people.


#7

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#8

[quote]bushidobadboy wrote:

[quote]kpsnap wrote:

[quote]bushidobadboy wrote:
You can certainly diagnose an RC muscle tear, either full thickness or partial thickness, through orthopedic testing. Surgery??? No thanks, lol.

[/quote]
That wasn’t my experience. After hurting my shoulder I had full-on ortho testing from two top surgeons. Both said I had no tear based on my diagnostics. An arthrographic MRI eventually revealed a full thickness U-shaped tear with retraction. I went the surgery route and am now pieced together with five anchors. Without the surgery, I would have had major atrophy and arthritis since there was no tendon/bone attachment left.

I know you are an expert in your field, BBB. But because I had no bruising and still had decent ROM after I tore it and passed all diagnostics, I was told that it was just a strain. So I like to share with people that diagnostics are good for the majority but not everybody. [/quote]
Ok, thanks for your counterpoint, I’ll definitely take it on board.

I’m a little puzzled though, since a full thickness tear means that the muscle is effectively completely out of action and disconnected. How then could two top surgeons miss the fact that in the muscle-specific joint action performed by said muscle, you had zero active ROM?

Can i ask which muscle it was? In theory ALL the RC muscles have a specific action that can be directly tested for and if absent, would indicate a full thickness tear.

And I should have mentioned that whilst I consider surgery as a diagnostic tool, to be unnecessary, the use of an MRI is most definitely warranted.

Anyone will need surgery to correct a full thickness tear, just not to diagnose. Maybe I misunderstood you though :wink:

BBB[/quote]

Hi. ‘Full thickness’ doesn’t mean a complete detachment, but rather, a tear in some of the fibers all the way through. Here is a little better image of a full-thickness (top) tear: http://www.howardluksmd.com/shoulder-faq/how-do-i-know-if-i-have-a-full-thickness-rotator-cuff-tear/ Some of the fibers can still hold on with a complete detatchment of others.


#9

[quote]driftingbamafan wrote:
i believe i also tore my rotator cuff. did dead lifts just fine, but cant even sleep because of the pain.
ill be watching this post, advice would be great, i too cannot afford medical attention. [/quote]

I have full range of motion, just sharp pain in certain positions. Like I posted originally, there is a sort of bump right where the clavicle comes over to the shoulder. Right where the trap meet the anterior deltoid, the other shoulder doesn’t.


#10

What about the acromioclavicular ligament, from looking at pictures it seems like that is where the lump is.


#11

I think this is what I have going on, either type 1 or 2 sprain.

http://emedicine.medscape.com/article/92337-overview#4


#12

What was the mechanism of injury?

Does it hurt to abduct your shoulder (lateral raise)?


#13

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#14

Patricio’s right about the definition of “full thickness tear.” But I had a complete detachment of the supraspinatus. Somehow, I was able to “pass” the diagnostic tests because I was able to move my arm in ways that I should not have been able to move it based on what my surgeon found (tendon off bone rolled up and retracted like a fruit leather). Like Patricio, I also had subacromial decompression.

When I said “diagnosis” with surgery . . . all I meant was that it’s difficult to know exactly what will be found until the surgeon gets in there. An arthrographic MRI is the most definitive test because the dye will only leak into areas where there are tears. There’s very little interpretation to it, unlike mobility diagnostics, which leave room for error (like in my case).

It just bothers me when people say they’ve “torn their cuff” when they don’t really definitely know what they’ve done. The shoulder is an extremely complicated joint. And like Patricio said, full-thickness tears can’t simply be “rehabbed.”


#15

[quote]patricio2626 wrote:

[quote]bushidobadboy wrote:

[quote]kpsnap wrote:

[quote]bushidobadboy wrote:
You can certainly diagnose an RC muscle tear, either full thickness or partial thickness, through orthopedic testing. Surgery??? No thanks, lol.

[/quote]
That wasn’t my experience. After hurting my shoulder I had full-on ortho testing from two top surgeons. Both said I had no tear based on my diagnostics. An arthrographic MRI eventually revealed a full thickness U-shaped tear with retraction. I went the surgery route and am now pieced together with five anchors. Without the surgery, I would have had major atrophy and arthritis since there was no tendon/bone attachment left.

I know you are an expert in your field, BBB. But because I had no bruising and still had decent ROM after I tore it and passed all diagnostics, I was told that it was just a strain. So I like to share with people that diagnostics are good for the majority but not everybody. [/quote]
Ok, thanks for your counterpoint, I’ll definitely take it on board.

I’m a little puzzled though, since a full thickness tear means that the muscle is effectively completely out of action and disconnected. How then could two top surgeons miss the fact that in the muscle-specific joint action performed by said muscle, you had zero active ROM?

Can i ask which muscle it was? In theory ALL the RC muscles have a specific action that can be directly tested for and if absent, would indicate a full thickness tear.

And I should have mentioned that whilst I consider surgery as a diagnostic tool, to be unnecessary, the use of an MRI is most definitely warranted.

Anyone will need surgery to correct a full thickness tear, just not to diagnose. Maybe I misunderstood you though :wink:

BBB[/quote]

Hi. ‘Full thickness’ doesn’t mean a complete detachment, but rather, a tear in some of the fibers all the way through. Here is a little better image of a full-thickness (top) tear: http://www.howardluksmd.com/shoulder-faq/how-do-i-know-if-i-have-a-full-thickness-rotator-cuff-tear/ Some of the fibers can still hold on with a complete detatchment of others. [/quote

my pain is the worst at night while tryin to sleep. i have full range of motion, just with slight pain while reaching behind me. the link mentioned puttin on a belt. that hurts.


#16

I’m thinking you probably injured your subscapularis. Try doing some internal rotation strengthening exercises, don’t go higher than a 3 or 4 out of a 10 point pain scale though.