You know you have a rotator cuff injury, if you can bench press past your body weight, but can’t unload clean plates to a shoulder-height cabinet shelf. 😔 All the years of adventures – roller blading, rock climbing, skiing, kayaking, lifting, running (and falling) – has eventually caught up with my rotator cuff in the last 3 years. First, I took a fall during rock climbing a couple of years ago, just a few days before my Boston qualifying run! I ran the Jack & Jill marathon with KT tape holding my shoulder “intact” and got my BQ. I tried PRP (Platelet Rich Plasma) a couple of months later and it seemed to make things better. I was lifting again and getting stronger (or so I thought).

Until another fall last year, this time running downhill, tripping and unable to brace myself. So now I have a dislocated bicep tendon, a torn supraspinatus tendon and bursitis in the rotator cuff joint. Silver lining? Muscles, bones and overall structural integrity all intact! After meeting with a couple of orthopedic surgeons and getting advice from a few athlete/doctor friends (thanks Jen & John!), I’ve decided to go in and get Humpty Dumpty patched up.

Rotator Cuff Injury: Surgery or Not?

I went through a similar decision making process when I busted by ATF ligament and decided to get the Brostrom Procedure. The bottom line is the tendons are neither gonna go back to the groove nor heal by themselves. If I don’t do anything, I maybe able to “manage” the pain but have to really scale back on an active lifestyle. However, the damage continues eventually leading to arthritis, further tears and a possible full shoulder reconstruction, but when I’m a lot older. So the call was to get this done now, when I’m active, healthy, fit and able to focus on rehab (retired & empty nested helps here!) to hopefully come out stronger. There are three parts to the 2 hour surgery under full anesthesia: the splice, the patch and the drain.

Bicep Tenodesis – The Splice

Funny (not funny) how you learn about anatomy only after when something breaks. Bicep Tenodesis (apparently) involves making an incision (6cm?) in my bicep, cut the tendon that’s flapping around and re-anchor it to the humerus bone. Normally this tendon is attached to the top of the rotator cuff and has to handle a lot of torsion stress, with twists and turns of the shoulder. As my orthopedic surgeon said, biologically and evolutionarily, we don’t really know or understand why the bicep tendon has to be attached all the way to the top of the rotator cuff!

Supraspinatus Tendon Repair – The Patch

This is done arthroscopically through a small hole coming in from the back of the shoulder. But since this tendon is anatomically “behind” the bicep tendon, the MRI doesn’t fully reveal the extent of the tear and the surgeon will only know once they are “in there”. Depending on the what they find, it’s gonna be do nothing, patch in some bovine collagen (which apparently the body will integrate without an immune response as there are no live cells in the patch), or a full Humpty Dumpty repair with screws (anchors), duct tape (brace) and staples (kidding!).

Subacromial Bursitis – The Drain

The MRI showed inflammation and fluid in the subacromial space (under the top of the collar bone). During the arthroscopy, the surgeon is going to drain some of the fluid and check & remove possible born spurs that might cause impingement. Usually you’ll feel this when you lift something overhead or doing lateral lifts. This seems like minor of the three, but hey why not address it since they are looking at that region of the shoulder anyways.

Rehabbing from this surgery

This, for sure, is gonna take longer than my ankle surgery. From my understanding, it’s 4 weeks in a sling, but physical therapy (PT) starts a couple of weeks in. Stationary bike and walking should be ok after a couple of weeks. But post 4 weeks is when PT starts in earnest with possible full range of motion and strength returning 4-6 months later. Leading up to the surgery, I’m actively prehabbing, strengthening everything around the injury, but also prioritizing hobbies (riding my Vulcan 650 in the mountains 🤩) that require two functioning hands! Not to mention, learning and getting accustomed to doing everyday things, pretending my left arm is in a sling.

As I was telling a friend, one ankle and one shoulder surgery is enough for one lifetime! Hopefully no more major injuries from now on out.🤞🏼But have a surgery to get through first.