As I write this update, I have now been back to work for a month. The first 3 days back were challenging, as I had not done that much with my arm in quite some time. I was sore by 5 pm each day, but no significant pain. The soreness resolved by the next morning. I quickly realized how weak I was as I attempted to stretch a client’s hamstring lifting the right leg up with my left arm.
With that said, going back to work also facilitated me moving the arm more frequently and using it against gravity. This has allowed me to regain more functional mobility and strength the past month. I have been careful to avoid any heavy or overhead lifting. I have not encountered something I could not do yet in patient care, but I have had to be aware of my body mechanics and positioning to reduce strain on the left arm.
MD follow-up
I saw the doctor this past Friday. He was pleased with my progress and encouraged me to keep working on regaining the last portion of my ROM. I will go back for one final appointment in 6 weeks. Of note, I had previously asked him to image the right shoulder to see if I had a tear since I have been having some right shoulder pain that has worsened since the left shoulder surgery. The MRI revealed a partial tear (30-40% of mostly bursal-sided fibers), some degeneration in the anterior labrum, biceps inflammation and a sizable bone spur. In essence, the doctor says I need to have the bone spur taken out in the near future to avoid a full tear on my right side. Not great news, but I am relieved it was not fully torn.
Rehab and Exercise
I am continuing to get stretched 2x/week, while doing my pulley and ROM exercises daily at home. I am performing scapular and rotator cuff strengthening about 3x/week. I returned to the gym for the first time on Labor Day. This was a humbling day to be sure as I cannot even do 50% of my previous weight with pull downs, rows and other lifts. But, Rome was not built in a day, and I know it will likely take up to a year to get back to 100% again.
With the information about my right shoulder, I plan to be very cautious with future lifting in order to avoid further impingement. I will continue to avoid any overhead pressing and be very careful with any horizontal pressing at all (restricted range of motion). My goal is to avoid having a rotator cuff repair on the right shoulder to be sure.
4 Month Post-op Reflections
- It took about 3 months for the majority of the daily pain to resolve
- Sleeping gets much easier between weeks 10 and 14
- Strength gains jump about every 3-4 weeks (big change between week 12 and 16)
- Motion continues to improve in small increments after 3 months post-op so don’t stop doing your home program as this rehab is a marathon and not a sprint
- Always listen to your body and let pain guide your progression or regression with activity
Going through this surgery and recovery has taught me how vulnerable the shoulder really is. In fact, being active in the gym, playing sports and injuries or micro-trauma over the years may eventually catch up with us all. I thought modifying how I lifted two decades ago would have all but guaranteed I would not suffer this fate. I was wrong. My type 2 acromion (natural bony anatomy) coupled with lifting weights for years likely contributed to my rotator cuff tear on the left side (wear and tear over time), while the same activity and years of throwing baseballs and footballs caused degeneration in my right shoulder.
I do not regret a single minute of sports or my time in the gym. In fact, I would probably do the same thing all over again, aside from doing as much barbell bench pressing as I did. Unfortunately, my left shoulder did not give me any warning signs. It just started hurting once it was already torn.
In the end, my advice to all who read this is to simply listen to your body and seek medical counsel if you start to experience persistent aches and pain in the shoulder. Awareness, imaging and early intervention may help prevent a rotator cuff tear and allow for a faster return to whatever you enjoy most in life.