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Rotator Cuff Injury
by Gary F. Zeolla
This article is continued from Rotator Cuff Injury: Part Two.
Surgery and Post-Surgery
My surgery to repair two rotator cuff tears and a biceps subluxation was scheduled for 8:30 am on Friday, August 20, 2021. I was there on time and went in very quickly. The nurses had me change into the embarrassing hospital gown, then more embarrassingly shaved the hair from my left shoulder, down into part of my chest and left arm. They then put in an IV, which really hurt. I’m not sure why, but they had a problem finding a vein. Again, I’m not sure why, as my veins are rather prominent.
But whatever the case, I then waited and waited. About 10:00 am, the anesthesiologist came and administered the local. That knocked me out for about 45 minutes. When I awoke, I still had to wait about half an hour until for them to take me back to surgery.
All of the waiting gave me a chance to get nervous. I had been so busy the previous two weeks, with ending my training plan in such a way that I could write up my Imaginary Contest 2 and with doing as much as I could around my home while I at least still had partial use of my left arm, that I really did not think much about the surgery. But now, all I could do is think about it.
My anxiety really increased when the surgeon came to talk to me for a minute. He said it would be no problem fixing the rotator cuff tear on the top of my shoulder and the biceps subluxation. But he said he wasn’t sure about the tear in the front of the shoulder. I think there the tendon was almost completely torn from the bone.
In any case, I was put under and do not remember anything until I woke up at about 2:30 pm. After a short wait, the surgeon came to talk to me for another minute. He said he was able to fix everything, including that front tendon. That was a big relief. But then he said I would not be able to do any heavy lifting for at least six months. I was not happy about that. I have an appointment scheduled for this coming Friday morning (8/27/21) with him. He said he would show me pictures and we would talk more then.
By the time I got changed, stopped by CVS to get a pain prescription filled, and got home, it was 3:30 pm. My dad had taken me and stayed the whole time, so it was a long day for both of us. Probably more so for him, as I was asleep half of the time.
That weekend, I was miserable. As I feared, I was stiff all weekend, barely able to walk, I didn’t sleep at all the first night and only a little better the next night, and my shoulder really hurt. I spent the weekend on the couch watching TV, feeling very bored and just plain miserable.
What made things especially difficult is I was told I couldn’t shower for two days. Due to my MCS, I always shower as soon as I get home whenever I go out. That helps calm down any allergic reaction I might be in. But without being able to do so, that’s why I felt terrible all weekend.
It also didn’t help they had me in a big contraption for an arm sling. It had a pillow in-between my arm and side and a band around my body. It was very uncomfortable and made doing anything difficult. I couldn’t even sit close enough to the table to eat. It was easier to use a tray and sit on the couch to eat.
I finally took a shower Sunday evening. Before I did, I had my dad help me take off the bandaging they had put on me. There was a lot of it, and it really hurt taking it off. That was especially so since they did not shave me enough, so I was pulling up a lot of hair. The worst was they had put tape in my armpit, which wasn’t shaved at all. Ouch!
For the shower, I put on an arm sling I had bought from Amazon. I bought two regular ones and two specifically for showering. I changed into one of the regular ones after the shower. I felt much better at that point and slept better that night.
I was leery about taking the prescription opioid they gave me. I took it once the first night, and that was it. I am taking ibuprofen and aspirin, and that works just as well.
The biggest problem is trying to get comfortable sitting on the toilet. Try as I might, I just can’t, so I am having problems, well, going, and that has me feeling all cramped up.
It is also very frustrating trying to do normal everyday tasks with one hand, like just brushing my teeth, but I am getting the hang of it. The same goes for the one-handed typing I am doing right now. Everything just takes twice as long.
As far as rehab goes, they gave me a small ball I’m supposed to squeeze occasionally through the day. It is about the size of a tennis ball, though a bit softer, though harder than a Nerf ball. I’ll start going for walks most days this week to try to stay in a bit of shape. But that will be it until they tell me otherwise.
It will probably be
weeks, maybe months, before I'll know if it is all worth it. But I should know
more after my appointment on Friday. I will post more then.
First Post-Surgery Surgeon Appointment
I had my first post-surgery appointment with the surgeon on Friday, August 27, 2021, at 9:15 am, a week after the surgery. But before it, I began to feel better as the week wore on. I had little pain, though I continued to take ibuprofen regularly. I was also supposed to task aspirin twice a day for five days to prevent blood clots.
I began to get used to doing things one-handed, though it was all still very frustrating and always tempting to use my left arm. I also began to go for walks, though very short and slow given it has been years since I went for exercise walks. But my plan is to follow my own advice in the article Training Routine for the Totally Out of Shape. Though I am not out of shape, I am not in walking shape. Therefore, I will do what I did back when that article was written and gradually increase the distance and speed of the walking.
However, I have noticed my fibromyalgia fatigue seems worse. I need to rest more during the day than I did before the surgery and seem to tire more easily when I try to be active or from just typing. But I am hopeful that is just my body getting over the trauma of the surgery, and I will return to “normal” shortly.
Meanwhile, the five small incisions in my left shoulder had mostly healed by the time of my appointment. All I had on them were five regular Band-Aids. But there was still a bit of bleeding.
That said, though my appointment was at 9:15 am, I didn’t see the surgeon until 10:20 am. It really irks me when I have to wait over an hour for a doctor. But before he came in the exam room, a nurse removed the Band-Aids, and the surgeon later told me I no longer needed them.
Otherwise, the surgeon said my shoulder was a “mess” (his word). But he was able to fix everything. He showed a series of pictures taken during the orthoscopic surgery, but I really couldn’t make much sense of them, not knowing what things are supposed to look like. He again reiterated that he wasn’t sure if he would be able to fix the tear in the front, but he seemed rather proud of himself that he was able to do so, for which I am very thankful.
I asked him a series of questions. To summarize his answers, he did not think this was an acute injury that was caused by the missed bench press back on March 14. Most likely, that incident was just a case of the straw that broke the camel’s back. The injuries probably developed slowly over time, though he couldn’t say if it was directly related to powerlifting or just normal wear and tear from aging. However, I have talked to several people who had the same surgery and only one was a powerlifter. The others, as far as I know, don’t even lift weights. One said it seemed to him it was a rather common surgery.
The thing that concerns me is a couple of them had to have surgery on their other shoulder shortly after surgery on the first. I sure hope that doesn’t happen with me. But it does make me wonder what an MRI would show about my right shoulder.
In any case, the surgeon confirmed it would be six months until I could get back to full heavy lifting. That will be February 20, 2022. I already marked the date on my calendar. Since I continued to do squats and deadlifts until the day before the surgery, it will “only” be six months since I did any heavy lower body work by then. However, it will be almost a year since I have done heavy benching or other upper body work. Between the extra time from heavy lifting and the injury itself, I suspect it will take a lot longer for my bench to come back than my squat or deadlift.
The surgeon said it would probably be best not to use my cambered bench bar anymore. I got it about a decade ago and thought it helped my bench, but it might have contributed to this injury, so it probably wasn’t a great idea after all.
He also said not to do overhead presses. But interestingly, he said upright rows would be okay, as long as I did not swing the weights, which I would never do, though lots of fools in gyms do so. That could why the standard advice is the reverse, that presses are okay but upright rows are not.
I asked him about incline benches. He said to only do them with less than a 45-degree angle. I told him with my cramped home gym set-up, I could only set my incline bench up one way in my power rack and wasn’t sure what the angle was. But when I got home, I checked my workout videos. The more recent videos are taken from the front, so they don’t show the angle very well, but I found an older one from the side that shows clearly it’s about a 30 degree angle, so I should be fine.
He said flat benches would be okay, which was a big relief and of course what I mainly cared about. I didn’t ask, but I assume decline benches would be okay as well.
I didn’t bother to ask him about any other specific exercises, since again, it will be months before I will be lifting again. But I will be starting physical therapy in two weeks, on September 10, 2021. I was given a series of sheets of the planned therapy program over the next six months.
I stopped by same rehab center I had gone to before the surgery and made an appointment for that date and for the next three weeks. I will use the same schedule as before after the first week of going once a week, on Thursday afternoons, then doing the prescribed exercises at home on most other days.
I had them copy the papers, so I would have a copy for myself. Looking them over, it looks like I will gradually add in some band and lifting exercises, including dumbbell benches at some point. But barbell benches are only at the end of the six months. I assume that’s because they want you to start with really light weights, far less than a barbell weighs.
Or it could be because dumbbells force each arm to work independently, so one arm cannot push or pull the other along. I had thought of that and that I should include dumbbell equivalents for most exercises when I start lifting again.
Whatever the case, I will let the therapist tell me when to start what. I have resistance bands I purchased previously, so I can do those exercises at home along with the weight exercises.
Squats and deadlifts are not mentioned anywhere, but I hope I can start them sometime before next February, as long as I only go light on them. Though, I got a feeling my definition of “light” will be different from the surgeon’s definition. We’ll talk about that later. But I asked him about doing bodyweight squats and deadlifts now, and he said that would be okay. I want to do especially the former to keep my lower body from tightening up.
I was hoping I could do some abs work, but he said that would not be a good idea because of the way you tighten up the shoulders when coming forward on a sit-up or crunch. He also said not to try to do one-handed exercises, as just balancing myself with my left arm could be a problem. I kind of figured that myself previously. But he said my walks would be fine.
I also needed to start moving my left arm some outside of the sling. Just minor movement up to the side, and bending forward, letting the arm hang down and moving it in circles. For the former, I could move it a bit upward, but not much. For the later, I could not straiten my arm fully and could only move it in tiny circles. But I am sure it will gradually improve.
I was also told to continue to wear my sling and to ice my shoulder occasionally. But the surgeon wasn’t pleased I wasn’t wearing the sling I got at the hospital with the pillow in it. I told him multiple people at the hospital told me I could use my own sling if I had one, and no one mentioned about needing to use a pillow. And besides, that pillow got in the way of being able to do anything and was very uncomfortable. I wouldn’t even be able to type, as I couldn’t get close enough to the keyboard for the one-handed typing I’m doing now.
But he said the pillow served a purpose of opening up the shoulder area to aid healing. We compromised by me saying I would fold up a towel and put it in my sling. He said that would be okay. It’s not as thick as the pillow, but it keeps my armpit opened up some. I hope it is enough, as I would go crazy if I couldn’t even type for the next month.
The sling I have found works best for general use is this one from Amazon, but this one works best for showers, though I wear it some around the house as well. But note, I limited myself to white ones, while most of the slings on Amazon are black. But I wanted white, just so that I could wash them with other clothes when I got them without the color running. With my MCS, I always need to wash new cloth items before using them. But it seemed ridiculous to do a load of wash with just a couple of slings in the washer. Although, I now have several of these two slings, as I keep ordering more. Due to my MCS, I need to change and wash my sling as often as I do my clothes, which is to say, a lot. That is another reason I couldn't have just used the one from the hospital.
A sling I did not like initially was this Ace one, as it is not possible to put on or adjust myself. But once I had some use of my left hand and could get it on myself, I grew to prefer it and ordered a couple of more. The reason is, preceding two slip and need to be readjusted through the day, while the Ace one does not.
That said, my plan now is to stay in shape with the walking, bodyweight squats and deadlifts, and therapy exercises. I’ll probably work up to 100 reps on the squats and deadlifts, maybe using both my normal medium stance and a close stance for both. And I’ll work up to as much as an hour on the walking. That will give me a good bit of leg work and keep me in shape. Then hopefully the therapy exercises will begin to give me some strength and flexibility back in my upper body.
As before, whatever exercises I’m told to do for my left arm, I’ll do with my right as well, as my right shoulder is not quite normal either due to my bicycle accident. Maybe that will help some with bringing it up closer to normal and to keep strength in it.
However, as I write this update the weekend of Saturday to Sunday, August 28-29, it has now been 9-10 days since I last lifted weights. That is the longest I’ve gone without lifting weights in almost 20 years. I say that, as since I started using free weights again back in 2002, the only breaks I have taken is the week after a contest. With a contest on Saturday, I would take the next week off, then start my new training routine the following Sunday, eight days later.
That consistency is how I’ve managed to stay in decent shape over the past 20 years, despite my myriad of health problems. It has also given me the incentive to follow a healthy eating plan, so that my training and competitions would go as well as possible. But now, without that incentive, it will be hard to not fall off of my diet and other healthy habits. But I will try to maintain the mindset that I need to continue my normal healthy eating plan, so that I can progress in my rehab and recover as quickly and efficiently as possible.
Finally, I am glad I got this surgery in the heat of the summer. I say that, as I have found it best to wear the sleeveless T-shirts I normally only wear for lifting around the house, at night, and even when I go out, as they are easiest to put on and take off. But if it were winter, I would need to wear long sleeves and even a jacket, all of which would be very problematic to get on and off.
In any case, I’ll probably wait until after my next appointment with the surgeon in four weeks (9/24/21) to post another update. That will give me time to see how things are progressing. But until then, here’s praying all goes according to plan, and I am able to make a full recovery over the next six months. Please continue to keep me in your prayers. As I think these updates make clear, this whole ordeal is not just difficult physically but emotionally as well.
First Physical Therapy Session
I was going to wait until my second post-surgery appointment with the surgeon at the end of the month to post another update, but so much is going on, I figured I’d post one now after my first physical therapy session on Friday, September 10, 2021.
But first, I have been getting frustrated having to do things with one hand, such as typing this update. But whenever I do, I remind myself there are people who only have one arm, such as our brave soldiers who came back from Iraq and Afghanistan with limbs blown off by IEDs. If they can handle that for the rest of their lives, I figure I can do so for a few weeks.
However, as I feared, without being able to work out with any kind of intensity, my health is faltering. I actually injured my left side making my bed this past Sunday (9/5). Yes, you read that correctly, I injured myself making my bed! I was pulling the blankets with my right hand when I felt a sharp pain in my left side. Initially, I thought it was a cramp. But hours later, it was still hurting, so that was not the case. Therefore, I began to treat it as a muscle strain. Now, a week later, it is still bothering me, so have it to rehab too.
This incident shows how fragile my body can become if I am not working out. The worst part is, this injury probably wouldn’t have happened if I could have done the abs work I wanted to do, as that would have included oblique work. For that matter, weighted squats and deadlifts would have prevented it, as they strengthen the entire core.
Somewhat ironically, I had just stopped taking ibuprofen regularly, as the pain in my shoulder had mostly subsided. But I needed to start taking it again due to pain in my side and to keep any inflammation down. I have continued to use ice on my shoulder, but now I need to ice my side as well.
The problem is, I am losing muscle fast. I weighed myself this morning for the first time since the surgery. It made me sick to see I have lost five pounds, with half of that being fat free body weight, at least according to my body fat scale. That is 2-1/2 pounds of muscle lost in just three weeks. For someone my size (normally about 120 pounds), that is a lot.
Meanwhile, I only lost 0.8 pounds of fat free body weight in the six months between the injury and the surgery. That means, the heavy squats and deadlifts I continued to do mostly preserved my muscle mass, despite not being able to do heavy benches and other upper body work. But now, without being able to do those heavy squats and deadlifts, I am losing muscle mass.
But I am doing all I can at this point. I am doing the bodyweight squats and deadlifts I mentioned about previously, along with a few other bodyweight lower body exercises. And I am continuing to go for walks. But that does not make up for doing heavy, weighted squats and deadlifts, hence the loss of muscle and oblique injury.
I haven’t gained bodyfat, despite the relative inactivity as compared to what I was doing previously. That is because I consciously cut back on how much I have been eating compared to previously. That has been easy to do, as I have not had much of an appetite without working out. For a long time before the surgery, I would often marvel about how much greater of an appetite I would have on workout days versus non-workout days. But now, all days are non-workout days.
I am trying to maintain my normally healthy eating plan, though it is difficult to just not care and turn to junk food. But I really don’t want to gain body fat. That would make coming back later that much harder. I’d rather be in a position of having to gain weight than lose weight once I can get back to hard training.
Meanwhile, my fatigue is still worse than it was before the surgery, though not quite as bad as initially. I am also sleeping less well than I was before the surgery. Of course, those two issues are related and both again due to not working out. Also related is I am still dealing with constipation. Yes, that is related to not working out, as I know I have an easier time “going” the day after working out than after rest days. But now, all of my days are comparatively rest days.
With all of this to deal with, even though I am not spending near as much time exercising as before, I am getting less work done than I was before. This is what I have been trying to explain to people for years, that my powerlifting training not only kept me in shape but kept my health problems at bay enough that I could be productive otherwise.
Cutting further into my work time will now be having to go to physical therapy (PT) once a week for the foreseeable future. For my first session, the therapist mostly just went over the papers I had gotten from the surgeon and had dropped off there. They detail what I should be doing at this time, and it is not much. It is mostly just moving my hand a bit more. Thus, I am still nowhere near doing rehab exercises of any significance. As a result, my lost of muscles in my upper body will continue unabated for some time.
I told the therapist about my oblique injury, but she could not prescribe anything for it unless I get a doctor to update my PT prescription. I have an appointment with the surgeon and my PCP in two weeks. I’m not sure if I can wait that long or not, but I really cannot handle yet another doctor appointment, so I probably will just wait. In the meantime, I’ll do what I know to do, which is the ice and ibuprofen, and side bends for rehab. But I can’t do the side bends with added weight, until I get the okay from the surgeon, so all I can do is add reps as I have been doing with squats and deadlifts.
Meanwhile, as I feared, it bothered me at PT in terms of my sensitivities, even more than before. Making matters worse, I met with a friend afterwards at a local park to go for a walk together. It was nice seeing her, as I hadn’t in almost a year. But walking near her bothered my sensitivities and being outside in a wooded area caused my “regular” allergies to flare up.
To explain, autumn is always my worst time of the year as far as pollen allergies go. That is another reason I gave up walking for exercise years ago. I’d be okay in the spring and summer, but come fall, I’d start to have problems. And trying to walk now that it is autumn is probably another reason I have been having problems sleeping.
All of this is to say, my shoulder injury is leading to a host of other problems. Also, it is why I always try to plan ahead to do any social activities, as I know I will fear terrible afterwards and possibly into the next day. As a result, I plan ahead and be sure I won’t have much I have to do afterwards. I simply can’t do spur of the moment activities. I try to plan a week or two ahead, just as I do my doctor appointments.
In this case, after I got home, as always, I showered and put on clean clothes and mostly rested the rest of the day. Again, even though I am exercising far less than before, I am getting less done workwise. That is all very frustrating, as I have multiple projects going I have gotten behind on. But at this point, all I can do is to trust in the LORD to pull me through this ordeal.
8/11/21 (20 years, and it still brings tears to my eyes to think about that tragic day)
Rotator Cuff Injury: Part Three. Copyright © 2021 by Gary F. Zeolla.
The above page was first posted on this website August 23, 2021.
The individual updates were added as dated.
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