As a lot of you know, I had surgery for that on the last day of March. I did a lot of online research before I finally went to the doc about it. And what happened was pretty much right down the line of what I had read.
The usual procedure is that they want you to try physical therapy for a month or so. If that doesn't work they move on to injections, the purpose of which is to lubricate the joint, fill the void where the tear has left a gap, and reduce inflammation. Basically this reduces discomfort and gives them time to see if "you can live with it".
This is because it is a common injury that becomes increasingly more so the older a person gets, because the rotator muscles weaken with age and bone spurs appear over time. If any of you did the science experiment as kids where you make sugar crystals grow on a string in water, that's about the best way I can describe what the bone in my shoulder looked like in the pictures after the operation. It literally sawed through the tendon while I raked snow off my roof.
In the surgery they polished up the bone surfaces before they sewed the tendon back.
Another factor is age. They generally don't like to do surgery on this after age 60. This because the cuff muscles have weakened over time and are susceptible to re-injury and healing takes longer too. Sometimes there is too much other 'normal' wear in the joint that it makes improvement from the surgery hardly noticeable.
I also read where it is 'normal', if a tendon such as the biceps tendon is torn and atrophied beyond repair, to just cut it completely loose of the shoulder and leave it, creating what they call a "Popeye arm", referring to the unusual bulge. Apparently other bicep muscles compensate to some extent for the loss.
Now, all that said and being forearmed (no pun intended), I wasn't going to have any of that. I went through several of the first recommended therapy sessions, made sure when the therapist asked if I noticed any improvement I said NO. At one point while doing one exercise, I had her hold her hand on the shoulder so she could actually feel as well as hear the shoulder popping like bubble wrap. Bothered her enough that she called the doc and recommended they go ahead and get the expensive MRI right away. Mine cost the insurance company about $2500, almost more than the surgery, lol, so it's no wonder they pressure the doctors to do therapy first.
Anyway, two days later, MRI in hand, my doc set up an appointment with the surgeon and two weeks later I had the surgery. Another doc told me that as far as pain goes, shoulder surgery is the most painful (by far) that you can have done. Your mileage may vary. I've heard some real horror stories but maybe by expecting the worst, it hasn't been THAT bad in my case. The first week is the worst so take all the meds they give you. In my case I was in lala land for that week and in the second week I was pretty much off them. But as time and healing goes on, a different pain develops, at least for me. Reminds me of a broken leg ache I had once, a dull ache that just won't go away. You want to move and stretch but don't dare move the arm from the sling for fear of tearing the stitches.
Two more weeks and I should be out of this sling but still will not be allowed to use the arm for anything for a month more yet and will be back where I was, to begin with. Physical therapy.
One other thing I'd like to mention, frozen shoulder. If you do not do the exercises as prescribes the shoulder can freeze up due to scarring. I know two people personally this has happened to. One had surgery ten years ago and is finally going back in to free up the shoulder. The exercises are a pain (again no pun intended) because they must be done passively, that is the arm must be move by someone else or with your other arm, because the act of using that arm on its own will tear out the stitches.
Something I highly recommend, that my surgeon insists on as a matter of fact, is a passive motion chair. It's a rental type of deal that they bring to your house and set up for you. Costs about $6 a day but my insurance picked up the whole cost and is used for the first 6 weeks. Your arm is strapped to an articulated, computerized arm that automatically moves your arm a little further every day, until it is up over your head. The bad news is you have to be in it 4-8 hours a day! Plan on getting a lot of reading or TV watching done, lol. But can you imagine trying to exercise manually, either alone or with a helper, and get that kind extensive a workout? I do mine about an hour at a time and ice the shoulder after.
Sorry, I didn't mean to get so long winded, but I remember what I was like before the surgery, so many questions I wanted answered. So I hope I helped out a little. Like I say, this was only my experience, and is still ongoing. But if there is any thing in particular you're wondering, I'll be glad to help if I can.
