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Brace for torn rotator cuff
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PeconicPuffin



Joined: 07 Jun 2004
Posts: 1220

PostPosted: Thu Jul 03, 2014 9:40 am    Post subject: Reply with quote

I have had three rotator cuff tears over the years. Two were repaired by surgery, one the surgeon wanted to leave alone. All three times they were followed by physical therapy (which becomes part of our lifetime exercise routine.)

If you're going to try to avoid surgery, then get physical therapy at a "sports physical therapy" center, which is essentially high performance PT. (Regular PT goal: "I can reach overhead to grab a can of soup". Sports PT goal: "I can particpate in my sport" (though I will have to take more frequent breaks, for the rest of my life.)

Go full-bore PT. Forget braces, IMHO. What works for shoulders is making them as strong as possible, particularly all the weird little muscles that working out don't get. Go for sports physical therapy. If that doesn't work, it's surgery. Good luck!

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isobars



Joined: 12 Dec 1999
Posts: 14321

PostPosted: Fri Jul 04, 2014 10:04 am    Post subject: Reply with quote

stevenbard wrote:
combined with advil etcetera can work wonders on your joints.

But NSAIDS (and ice) dramatically impede healing and recovery. They are best reserved for fresh, swollen, acute injuries.
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isobars



Joined: 12 Dec 1999
Posts: 14321

PostPosted: Fri Jul 04, 2014 10:09 am    Post subject: Reply with quote

SHMUCK wrote:
I am also a carpenter general contractor working full time so constant "rehab" Is not a problem.

Actually, it may be a problem. Rehab exercises are very specific in what they target, how they are performed, and how they work. They should still be performed regardless of what else you do.
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konajoe



Joined: 28 Feb 2010
Posts: 177

PostPosted: Fri Jul 04, 2014 10:52 am    Post subject: Reply with quote

So, is windsurfing hard on rotator cuffs? Or is it good for them? Is it just a matter of windsurfing causing over use? If certain exercises are prescribed for RC injuries, how are they different from the workout they get while windsurfing?
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beallmd



Joined: 10 May 1998
Posts: 1074

PostPosted: Fri Jul 04, 2014 11:06 am    Post subject: Reply with quote

Okay, I know I risk sounding like I'm from the planet Ork here, but I really think rehab is overrated. The body naturally heals and does it very well, that is indisputable. When football (old fashioned American tackle football) players get injured they get "treatment" right away and then return, often surprisingly quickly, to the field. It should be clear they are not "rehab'ed" but are simply playing injured and risking further injury. They get paid millions and often are irreplaceable for the team. We are not that, nor do we have to pretend we are healed and good to go. We have injuries where we can go on and windsurf, where we risk further injury and where later surgery is needed or where immediate surgery is indicated (e.g., torn Achilles). Many orthopeds are actually not that big on PT, mine said about my shoulder, I could do a couple of visits with his in-house PT and then work on my own. Second opinions and even third opinions are routine for pro athletes and are a good idea in my opinion, altho I just go to my guy and trust him, but then make up my own plan, surgical or rehab wise.
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beallmd



Joined: 10 May 1998
Posts: 1074

PostPosted: Fri Jul 04, 2014 11:09 am    Post subject: Reply with quote

Konajoe; RC injuries are part of aging, esp in males and esp in your dominant arm.
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PeconicPuffin



Joined: 07 Jun 2004
Posts: 1220

PostPosted: Fri Jul 04, 2014 12:14 pm    Post subject: Reply with quote

konajoe wrote:
So, is windsurfing hard on rotator cuffs? Or is it good for them? Is it just a matter of windsurfing causing over use? If certain exercises are prescribed for RC injuries, how are they different from the workout they get while windsurfing?


Windsurfing is RC neutral, barring an unusual crash. The exercises for RC in sports PT target a number of smaller muscles that are not normally built up (in addition to working some major muscles.) It's quite specific. Those muscles help support the joint in ways it otherwise wouldn't be. It's common for recovered shoulder patients who take a few weeks off from exercising (including the PT) to feel shoulder pain as if they've overworked the joint. It's counterintuitive, but the specific exercises need to be resumed in order for the shoulder pain to subside. Teaching yourself quality PT for the shoulder is not easy...on the other hand once you've learned it you can keep it up. I've been at it 23 years now.

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isobars



Joined: 12 Dec 1999
Posts: 14321

PostPosted: Fri Jul 04, 2014 1:40 pm    Post subject: Reply with quote

When a doctor tells me I don't need to do any prehab or rehab, that she and her scalpel (or pills) are all I need, I change surgeons. I've had too many well-regarded sports medicine orthopods give me lousy advice on both. I expect ego, sometimes even arrogance, from doctors, but not at my expense. I'll spare you guys my many personal examples in which PT enhanced or even replaced surgery or meds altogether.

But even though the pro and school team sports PT who prehabbed and rehabbed my knee said I was one of the most knowledgeable and self-motivated patients he's ever had, he was indispensable to my preparation for and ongoing recovery from my knee surgery. I've heard about and witnessed many examples of crappy outcomes due to bad rehab/prehab.

I'm going out on a limb here, but that's nothing new. The RC in particular presents a somewhat unique challenge to the expectation that physical play or work will keep it strong. Age escalates that myth. We can lift and WS and circuit train like robots, but if our form is not kinesthetically perfect or our exercise does not challenge the muscles that stabilize our scapula, they (especially the supraspinatus) weaken and even atrophy, even to the point of disappearing if neglected long enough. As they weaken, they allow the scapula -- the bedrock foundation of all that our shoulders do -- to drift out of place when WSing ... or tying our shoes or flipping a light switch. When that happens and if it is not successfully treated with very focused, specialized, evidence-based, properly executed strengthening exercises, the entire shoulder complex, and it IS complex, is at risk of pain, then acute injury, then chronic, and at some point permanent, injury. 6 or 8 minutes of those light exercises a few days a week beats the hell out of pain, disability, damage, surgery, and/or chronic disability.

Many of us here are more active than 99% of the population; I know I am. But by late summer my scaps start drifting, allowing impingement and local or referred pain; my recently added, year-round, RC-specific exercises -- NOT the outdated ones my previous sports med specialist orthopedic surgeon prescribed -- have prevented that for a year or two now. My NEW orthopedic surgeon said creating a new ACL is his job and takes just an hour or two; everything else -- the one or two thousand combined hours of pre-op prehab (nearly three months of intensive, evidence-based exercises to prepare my knee for surgery) and post-op rehab is up to me and a carefully chosen PT. My surgeon -- a former university football team orthopedic surgeon -- deferred all my questions about exercises and progression thereof to my PT. Progression from each recovery and exercise stage to the next before and after after my ACL surgery required that I pass physical performance tests; I presume the same goes for RC surgery (my shoulder impingement surgery was long ago). Just as I wouldn't even think of WSing before PT evaluation says it's relatively safe (patients -- hell, many doctors -- are not qualified to make that judgement), there are still PT- and surgeon-imposed limits in what I can do in controlled conditions in the gym with my leg, let alone on the water. Second surgeries can be a self-imposed nightmare if we tear up the first attempt by doing too much too soon.
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zirtaeb



Joined: 03 Jul 2009
Posts: 2407

PostPosted: Fri Jul 04, 2014 1:41 pm    Post subject: Reply with quote

In my mid 50's, my rotator cuffs were sooooo bad I couldn't shave or brush my teeth with one hand alone. Always need elbow bracing from the other hand to reach my face with my hands.
Too many years of surfing and throwing sports, 4 collarbone breaks, several separations each shoulder, and one dislocate.
Well, around 61, things started getting better. I could just shave and brush with one hand, and I resumed playing tennis again.
Now 65, things have gotten somewhat stable, I can still have and maintain my teeth, and my tennis serve is almost as good as 30 years prior.
All that time, from age 35, was windsurfing at least 80 days a year, more usually, closer to 130.
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swchandler



Joined: 08 Nov 1993
Posts: 5890

PostPosted: Fri Jul 04, 2014 2:21 pm    Post subject: Reply with quote

Speaking for myself, I surfed a lot. 30 solid years, followed by another 10 surfing more occasionally. Overall, I think that my RC problems are deeply rooted in the time spent surfing. The dynamics of windsurfing, on the other hand, isn't really that hard on my shoulders. However, it's the crashes in windsurfing that greatly increase the risk of shoulder damage. You know, getting catapulted hooked-in into the sail or mast at high speed. All you have to do is hit a dense clump of seaweed, a good sized plastic bag full of water, a sizable piece of wood lurking about, or a turtle while sailing in Maui. It doesn't matter how good of a windsurfer you are. Unseen floating, or barely submerged debris is all it takes to blow anybody up. Getting older doesn't help, but my opinion, it's the accidents that dole out the damage. With the bone spurs I have in my shoulders, all it takes a good hit to tear into one of your shoulder tendons.
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