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View Full Version : rehab after rotator cuff tear/surgery



Marin
May 18th, 2012, 04:44 PM
Hi All - I'm a late onset adult swimmer, meaning I hadn't been in a pool for decades but a few years ago got turned on to open water swimming. For the past couple of years, I was swimming 2 miles/day freestyle about 3 or 4 days/week, with a few open water lake/river/ocean swims in the summer. Not that I go particularly fast (those 2 miles take me just shy of an hour) but it felt so good! And it's the only sport I figured was sustainable and not overly demanding on my bum knees...

But now my 50 yr old shoulder evidently has decided that may not be such a good idea, and I've got a massive rotator cuff tear (as documented by an unequivocal MRI) and have been advised to have surgery.

Does anyone have thoughts on this? Anything I should do before or after surgery to skew the odds to get back into swimming and avoid re-injury?

Does anyone know a good rehab in Westchester County or NYC with someone who knows about swimming? I'd prefer to rehab smart and targeted, rather than otherwise... And I really need to get back in the water... I'm getting fat and sad! All suggestions very very welcome!

msgrupp
May 18th, 2012, 05:46 PM
Whatever you do--don't rush getting back into the water and actually swimming.
While I haven't managed to tear the rotator cuff bad enough for surgery (I have a small tear but the surgeon doesn't want to operate) I'm a veteran of 6 shoulder surgeries. Most times you won't feel like rushing to get back into the water as the therapy will show you how little movement you have. On at least 1 surgery--I rushed back to swimming with the result of having to have a surgery about 12 months later for scar tissue (that we thought might be a tear per the MRI).
Depending on your surgeon--you may do some therapy before surgery and see if that helps but most surgeons do the surgery and then you're faced with months of recovery. I had one surgery in April, was able to be on the kickboard in late June and finally allowed some very light swimming in August.

good luck!

__steve__
May 18th, 2012, 07:54 PM
Nonmedically speaking, stop swimming and participate in therpy with lots of rest so surgery will be optimal. Once you fix your shoulder and it heals, see if you need to fix your stroke, which may be the cause of injury in the 1st place.

Did you second opinion?

MartyD43
May 19th, 2012, 09:42 AM
Hi All - I'm a late onset adult swimmer, meaning I hadn't been in a pool for decades but a few years ago got turned on to open water swimming. For the past couple of years, I was swimming 2 miles/day freestyle about 3 or 4 days/week, with a few open water lake/river/ocean swims in the summer. Not that I go particularly fast (those 2 miles take me just shy of an hour) but it felt so good! And it's the only sport I figured was sustainable and not overly demanding on my bum knees...

But now my 50 yr old shoulder evidently has decided that may not be such a good idea, and I've got a massive rotator cuff tear (as documented by an unequivocal MRI) and have been advised to have surgery.

Does anyone have thoughts on this? Anything I should do before or after surgery to skew the odds to get back into swimming and avoid re-injury?

Does anyone know a good rehab in Westchester County or NYC with someone who knows about swimming? I'd prefer to rehab smart and targeted, rather than otherwise... And I really need to get back in the water... I'm getting fat and sad! All suggestions very very welcome!

Recommend reading book "Treat Your Own Rotator Cuff" by Jim Johnson, PT (available used on Amazon and Alibris). This can't deteremine if you need surgery BUT the rehab. is THE SAME after surgery (if you need it) or for preventing re-injury in the future!
(I have to do the exercises at least 3 times per week to stay in the pool. They now call this "prehab.")
Also recommend DVD by June Quick "Swimmer's Shoulder: Prehab. and rehab. for Swimmers." It's part of Richard Quick's big series on Championship swimming - but this end of the series is VERY basic - truly a foundation. (It includes comments on engaging core muscles while doing shoulder rehab. - VERY important.)
(Other "basic" DVD's, for example, are on pilates and on posture, line and balance in the water. The DVD's on this end are about staying in the pool, relevant to all Masters, not about swimming faster.)
The DVD is available at Swimming World and Amazon and lots of other places - don't expect a price break but it's worth every penny.
Other suggestions - stick with light dumbbells (1, 2 or 3 pounds) and light therabands (yellow or red) no matter how easy this seems (i.e., no matter how strong you are).
You only need a few reps. for each exercise but they should be done slowly and with the best form you can learn.
If it seems too easy you are doing it right.
There are lots of other exercises you can add if you need variety.
You can find many books on shoulder rehab., strength training for swimmers, pilates on a balance ball, pilates with light weights - whatever looks interesting.
I suggest getting books that include anatomy of the shoulder so you can know what muscles you are working on (however "apparently" light the work seems). The 4 key muscles are called "SITS."
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
The proof of the pudding is that once you get back in the pool, you will not be knocked out again.
One other suggestion: do not do the "empty can" exercise recommended by other sources. Almost all other exercises that are demonstrated,and there are dozens of variations on the SITS theme, will help you IF you go slow, use light weights, good form, and learn to stabilize both your core muscles and your "scapulae" while exercising.

MickYoung
May 21st, 2012, 12:47 PM
But now my 50 yr old shoulder evidently has decided that may not be such a good idea, and I've got a massive rotator cuff tear (as documented by an unequivocal MRI) and have been advised to have surgery.

Does anyone have thoughts on this? Anything I should do before or after surgery to skew the odds to get back into swimming and avoid re-injury?



I've had rotator cuff problems.

You might want to get a non-surgeon's opinion on whether to get surgery or not. A physiatrist or a non-surgeon sports medicine doc could be helpful.

I've worked in an orthopedic OR. I would never get ortho surgery without the recommendation of a non-surgeon.

Physical therapy will be what makes or breaks you, whether or not you have surgery. (This seems to be my day to hawk PTs.)

Recovery is likely very slow - perhaps a matter of years, not weeks or months. For me it was about 2 years, when I was in my 30's.

If you get a set of PT exercises, keep doing them after the PT ends. At 50 y.o., you might be wise to make them habits for the duration.

I'm 59 and I would love to be able to get 2 miles in under an hour.

kgernert
May 24th, 2012, 11:22 AM
I had surgery the middle of January to repair a complete tear. I echo the others who say Physical Therapy will make or break you. Don't just go to physical therapy, but do the exercises at home consistently. These are key!

After being completely out of the water from my surgery date to the 3rd week in March, I just kicked in the water for the rest of March. I began swimming again in April. Of course, when I say "swimming", I mean that I might do 100-200 meters freestyle in an entire 3500 meter workout - and kick the rest of the way. Two months later, I'm up to between 1000-1300 meters of actual freestyle before kicking or doing one-arm fly drills for the rest of the workout. However, I will caution to not push too quickly. I sprinted for the first time last week (500 free in :37, which is good for me - especially all things considered). The next day's workout included a 100 free sprint, so I did it. BAD IDEA! Pain returned and I've drastically cut my freestyle swimming again and feel like I'm starting all over again. But... lesson learned.

When your shoulder starts to feel better, be thankful BUT CAUTIOUS. My goals are now long-term, like being ready for 2013 USMS SCY Nationals, instead of this year's LCM Nationals and open water events.

Just take it one stroke at a time....and be patient.

Good luck!

aquajock
May 24th, 2012, 08:28 PM
I tore my rotator cuff in 2009 and successfully rehabilitated with physical therapy, ice and rest. It takes a VERY LONG TIME to heal shoulder injury compared to most other muscles (mine took 8 months before I was back to fast swimming). As a personal trainer, it has been my experience that most people who get shoulder surgery get impatient and start doing too much too soon and never regain optimal function. I've worked in conjunction with PTs with many of my injured clients with excellent results. I think its always best to try PT first before going under the knife...A few rules I live by and try to pass on to clients who do a lot of shoulder activity:

1) Spend more time rehabilitating the body - stretching, getting massage, doing self-massage techniques. Don't be afraid to take a day off if you're hurting.
2) Work on core strength so the extremities don't have to do so much work.
3) Do 3 gentle workouts a week with bands that work the four rotator cuff muscles, move the shoulder joint in different directions and that improve scapular position and posture.
4) Apply an ice pack to the area where it hurts a few times a day. Back off on training until it feels better.

adsollm
May 25th, 2012, 10:24 AM
mine have always been slightly weak from swimming then about a year ago i dislocated my shoulder snowboarding - whoops. luckily no surgery. that still ended any swimming for the better part of a year. a couple of my favorite exercises was taking a medicine ball and holding against the wall with your palm and rotate clockwise for a while then counterclockwise. after that there was this small pvc pipe that was about 6 foot long or so with large washers fastened to the end of each side for weight. holding the pipe in the middle and shaking it vertically and then horizontally really worked out my shoulder.