From Therapy to Surgery

[Overproof]

Had an injury to my shoulder sustained from Boxing. Physiotherapy mixed with acupuncture and 3 x steroid injections hasnt assisted over the last 4 months.

My specalist has given consent for surgery called, arthroscopic subacromial decompression. Sounds like something that happens in a plane when you prepare for landing but it's basically shaving your shoulder bone away to make things in-between move better. This procedure might or might not assist and like every operation, it comes with risks but they are pretty low.

I know this is not a life threatening or invasive procedure however, I've never had surgery, I'm kind of nervous and down about the whole situation of 2 weeks off work and a 3 month recovery period, probably never boxing again, cost out of pocket etc...

I'm sure there are many on this forum who have come to this road in their life, so I'm just putting it out there. Has anyone had this type surgery? Did you look for an alternative prior to having it done? what you may have done to prepare pre/post surgery..

I look forward to any thoughts or insight you all have, cheers.

[...]

Hang in there mate, pain and the idea of surgery is never something to take lightly.

I am in no way a health professional and so my comment should be taken as such. However, I do help people make decisions for a living...

I have seen and heard about many choosing surgery to correct inflamed joints and associated injuries.

I'd suggest you have your case looked at by at least a few recommended chiropractors and osteopaths just to make sure nothing can be done about it through mechanical decompression.

Then, if all fails, it'll always be time to let the surgeon look at it again. Once you cut or grind, there is no going back. Injuries may take years to heal and remain sensitive throughout one's life so managing them should involve lots of planning.

Whatever your choice, I wish you the best of luck and hopefully you learn to be satisfied with the result. Cheers!

[Webbo]

Yes mate I've had that surgery 4 years ago. I tried all sorts before but the pain got so bad I could not sleep, the closest thing to describe it would be like toothache in the shoulder, truly horrible. It was caused by General wear and tear of my shoulder from 35 years of sport, I also took a couple of falls on it whilst skiing which didn't help. As I understand it the process helps free up the shoulder which is a complicated part at best. They did the op with keyhole techniques and I was out within the day, it ached like hell for a few days after and being in a sling for 3 weeks with the whole thing imobolised was no fun but after 3 months rehab it was almost as good as new. I'm absolutely glad I had it done but it was hard work for a while, depressingly I think the other shoulder now needs doing also. Bugger!

[Jeremy Festa]

Awww man! All the best. This day and age, and in Oz, you'll be apples.

I had to have something similar, but in my ankle. They shaved a couple mill off my talus. The key is your rehab. Don't go hell for leather the first few months. But when given the all clear, really push yourself.

Sent from my iPhone

[Overproof]

Yes mate I've had that surgery 4 years ago. I tried all sorts before but the pain got so bad I could not sleep, the closest thing to describe it would be like toothache in the shoulder, truly horrible. It was caused by General wear and tear of my shoulder from 35 years of sport, I also took a couple of falls on it whilst skiing which didn't help. As I understand it the process helps free up the shoulder which is a complicated part at best. They did the op with keyhole techniques and I was out within the day, it ached like hell for a few days after and being in a sling for 3 weeks with the whole thing imobolised was no fun but after 3 months rehab it was almost as good as new. I'm absolutely glad I had it done but it was hard work for a while, depressingly I think the other shoulder now needs doing also. Bugger!

It's such a hard thing to describe it to people especially when nothing is torn or broken, but your spot on describing it as a toothache in the shoulder. clicking and jamming up. Could be worse..cheers.

[earthson]

No experience with that surgery, but I feel for you. Here's hoping for that new alternative to pop up. If not, speedy recovery from the knife!

Try to enjoy the resultant downtime. As an armchair fatalist, I have found peace in the injury/rehab cycle knowing that the Creator meant for me to take some down time. It's offered me time to begin a book, reconnect with the people who matter, and get loads of reading done.

Good luck!

[MrGTO]

I'll tell you my Dad let an old shoulder injury go too long and ended up having a total shoulder replacement. I can tell you from seeing my Dad go thru it it was horrible recovery. My Dad is one of those old tough guys and it knocked him down a few pegs. He had all the symptoms Webbo described.

I think your on the right track taking care of it early! Good luck and I hope you heal fast.

[PapaDisco]

Sounds like you're heading in the right direction, and it's always good to ask around about these things. The doctor is your consultant and works for you remember! ;-)

A couple of thoughts, tangentially related, since my experience is more with knee and back docs rather than the shoulder:

1. Making space in a joint by shaving means that you're reducing the cartilage usually. This was a common procedure in knees 20 years ago when you had a clicking joint. Your surgery usually involves making space by clipping a ligament and then removing any bony bits (bone spurs) that might be irritating the muscle, but you want to make sure they aren't going to nip and tuck any cartilage (unlikely, but ask the question). The issue is that your cartilage is made up of fibro (base) and hyaline (surface) layers, the hyaline being on top is the smoothest and also the toughest cartilage and is known now to be metabolically active (can repair itself, particularly in those under 30). So when the docs would go in and scrap and smooth joints they'd be taking off all the hyaline cartilage and leaving the softer, less smooth (but still smooth enough for our purposes) fibrocartilage. Not surprisingly, the patient frequently needed additional procedures later as the softer cartilage slowly degraded over time.

2. You need space in your joints. Tight, compressed joints will destroy cartilage. So docs are stuck with shaving the joint to prevent cartilage damage, or protecting as much cartilage as possible (leaving a tight joint to slowly ruin itself, etc.) or cutting ligaments. No perfect solution you just have to make the best call you can.

3. A professional rock climber friend of mine is having great success with PRP autologous injections for her back injuries. Platelet Rich Plasma therapy uses a small amount of your blood, centrifuged down and mixed with secret herbs and spices and then injected back into the injured part to stimulate the body to repair the area. With younger folks they've been able to trick knees into re-growing cartilage (even the hyaline type) and PRP gives us older folks a similar (hopefully) regenerative capacity.

4. Kooky dietary supplements. I have a creaky shoulder that gets better whenever I consistently take (1 tsp 3x day in water, tea, whatever) of hydrosylate gelatin (hydro-thingy is just something they do to make it dissolve easily), the gelatin protein is the building blocks of cartilage. I still have a hard time believing it works (and only took the stuff originally to get a ballerina friend to stop pestering me about it). Anyway, about a week into a regimen of this stuff, my achy shoulder loosens up and works like normal again. Weird. I don't believe it, but I do it anyway now.

Anyway, just treat this as interesting stuff to talk to your doctor about and see what he says. Particularly the PRP is something I'd focus on. Like the other guys have said, best to get broken bits healed or fixed sooner because later they mostly just get worse.

Oh yeah, one other thing; my Dad's favorite thing for talking to doctors was to always ask, "If you had a busted [whatever], who would you see for surgery?" And then he would go consult that doc and repeat the procedure, many times maybe if it were a critical issue. For his ruptured disks (L1/2 and neck too) he went through 4 docs before he found one that said it could be treated without a spinal fusion. That therapy ended working for him for over 40 years and kept him running, skiing, etc. So it worthwhile, if you can afford it, to investigate this stuff thoroughly.

[CaptainQuintero]

Glucosamine and Chondroitin supplements have really helped both my dogs with really bad hip dysplasia to after a couple months of taking it they literally have zero problems where before they limped everywhere at age 6 even from walking on the flat.

Dad played football for decades and has shot knees but saw the reaction of the dogs joints and again after a couple of months he feels like he has new knees. Same dosage and brand/bottle that the dogs have; its all human standard.

Obviously this might not work at all for you but might be worth looking at, even in addition to the surgery to keep things oiled and ticking over

[Ken Gargett]

Had an injury to my shoulder sustained from Boxing. Physiotherapy mixed with acupuncture and 3 x steroid injections hasnt assisted over the last 4 months.

My specalist has given consent for surgery called, arthroscopic subacromial decompression. Sounds like something that happens in a plane when you prepare for landing but it's basically shaving your shoulder bone away to make things in-between move better. This procedure might or might not assist and like every operation, it comes with risks but they are pretty low.

I know this is not a life threatening or invasive procedure however, I've never had surgery, I'm kind of nervous and down about the whole situation of 2 weeks off work and a 3 month recovery period, probably never boxing again, cost out of pocket etc...

I'm sure there are many on this forum who have come to this road in their life, so I'm just putting it out there. Has anyone had this type surgery? Did you look for an alternative prior to having it done? what you may have done to prepare pre/post surgery..

I look forward to any thoughts or insight you all have, cheers.

good luck.

be interested to know which doc doing it, if you know. my uncle was head of qld orthopods for years so i know a number of them.

had friends with various knee and hip surgeries recently. to be honest, not fun and they were in a lot of pain at the time and for some time after but they all now say best thing ever. get it sorted properly. hopefully you'll be good as ever in time.

[gcman68]

I had a procedure very similar to what you are describing and after it was done I looked back and wondered why I was so worried. I know the anxiety in advance was a big issue for me as well so I did as much research as possible and trusted what my body was telling me needed to be done after therapy didn't work. I went to one of the best hospitals in my area for Orthopedics and had a doctor that worked for major professional sports teams so it lowered my anxiety level going in. Assuming you are comfortable with you doctor and hospital the biggest thing I would advise is to take your therapy after surgery very seriously. Ask your doctor if he/she advises to strengthen the muscles pre surgery if possible and get them as strong as possible as it may help speed recovery. Also, if you do decide to have the surgery don't get down there will be days you feel better than others until gradually it gets better.

As far as being worried about never boxing again I would ask my doctor about that. In my case a year after I had no restrictions on what I could do.

Good luck!

[Overproof]

Thanks very much for everyones advice and suggestions, really helpful.

[Overproof]

good luck.

be interested to know which doc doing it, if you know. my uncle was head of qld orthopods for years so i know a number of them.

had friends with various knee and hip surgeries recently. to be honest, not fun and they were in a lot of pain at the time and for some time after but they all now say best thing ever. get it sorted properly. hopefully you'll be good as ever in time.

Dr Kevin Huang at the Marter

[markmurase]

I highly recommend Dr James Fardoulys at St Andrews hospital. He is the top gun shoulder & knee surgeon in Brisbane and specialises in sports injuries. He did a fantastic job on my shoulder AC joint reconstruction about 12 months ago after a mountain bike accident. It's perfect now - good as new. Dr Fardoulys has a 'minimum intervention' approach so doesn't do any more any more surgery than necessary. He's done work for lots of top athletes. It may take a while to get an appointment. Worth the wait.

Best of luck with the surgery & recovery,

Mark

[Ken Gargett]

dr huang i don't know but jim i've known for decades. very highly regarded and has done quite a lot of sports stuff. did a lot or the lions. he and his brother robin both friends from school. jim a bit older than i am but we played a fair bit of cricket together. top bloke.

[Nedule]

I blew my knee out skiing when I was a teen, acl 90% torn with some cartilage torn. Within 2 years I had arthritis setting in because the joint was loose, so when I had the acl rebuilt the also shaved the bone down to free up the joint & hopefully correct the arthritis. The pain after the surgery was extremely painful but made a difference. I don't know what alternative surgery options are available now, but as barbaric as it seems, I'd be way worse off & less mobile today if I chose no surgery.

Sent from my iPhone using Tapatalk

[markmurase]

dr huang i don't know but jim i've known for decades. very highly regarded and has done quite a lot of sports stuff. did a lot or the lions. he and his brother robin both friends from school. jim a bit older than i am but we played a fair bit of cricket together. top bloke.

Ken, great to hear you know Jim Fardoulys: it's a small world. I agree he's a really top bloke.

[PapaDisco]

Glucosamine and Chondroitin supplements have really helped both my dogs with really bad hip dysplasia to after a couple months of taking it they literally have zero problems where before they limped everywhere at age 6 even from walking on the flat.

Dad played football for decades and has shot knees but saw the reaction of the dogs joints and again after a couple of months he feels like he has new knees. Same dosage and brand/bottle that the dogs have; its all human standard.

Obviously this might not work at all for you but might be worth looking at, even in addition to the surgery to keep things oiled and ticking over

I saw the exact same effect with one of my dogs years ago. She had a knee reconstructed with 7 pins and came away with a perpetual limp. Put her on Chondroitin and within a week she walked and ran completely normally. Took her off and the limp came back, put her back on and the limp disappeared. With humans one is always skeptical that a result may be from the result of the placebo effect, but with a dog that's impossible.

[mash]

Had an injury to my shoulder sustained from Boxing. Physiotherapy mixed with acupuncture and 3 x steroid injections hasnt assisted over the last 4 months.

My specalist has given consent for surgery called, arthroscopic subacromial decompression. Sounds like something that happens in a plane when you prepare for landing but it's basically shaving your shoulder bone away to make things in-between move better. This procedure might or might not assist and like every operation, it comes with risks but they are pretty low.

I know this is not a life threatening or invasive procedure however, I've never had surgery, I'm kind of nervous and down about the whole situation of 2 weeks off work and a 3 month recovery period, probably never boxing again, cost out of pocket etc...

I'm sure there are many on this forum who have come to this road in their life, so I'm just putting it out there. Has anyone had this type surgery? Did you look for an alternative prior to having it done? what you may have done to prepare pre/post surgery..

I look forward to any thoughts or insight you all have, cheers.

If you have this surgery, you should have realistic expectations. I'm not sure what the surgeon told you, but depending on your age, your shoulder may not improve a lot in terms of function. If you're young (less than 40) and you work hard on your rehab, your range and strength may get significantly better. Otherwise, the real goal of a subacromial decompression is pain control. Your rotator cuff tendons will continue to deteriorate as you age regardless, though the vast majority of people with degeneration have no symptoms.

[Overproof]

If you have this surgery, you should have realistic expectations. I'm not sure what the surgeon told you, but depending on your age, your shoulder may not improve a lot in terms of function. If you're young (less than 40) and you work hard on your rehab, your range and strength may get significantly better. Otherwise, the real goal of a subacromial decompression is pain control. Your rotator cuff tendons will continue to deteriorate as you age regardless, though the vast majority of people with degeneration have no symptoms.

I'm 33 so I'm hoping with the right work post I'll bounce back. He's told me exactly this.

[Nedule]

I'm 33 so I'm hoping with the right work post I'll bounce back. He's told me exactly this.

You'll be fine, I'm 36 & going for my 4th knee surgery soon, just a little "maintenance" work to clean out some floating debris. I couldn't imagine another 40 years of faulty joint. Surgery seems drastic but really, until they can inject stem cell into your wrecked shoulder, knee, etc, it's really the only option to try & make life more enjoyable & mobile.

[Overproof]

I have a holiday booked for Fiji in April. I'm going to do my best to elevate the inflammation as best I can until then and then consider surgery. Its a tough decision, either way I'll be in pain or have discomfort of some sort and It certainly wont be the holiday I had planned but being laid up on the beach with a cigar in hand, jacked up on codeine and cocktails should be pretty damn good!!

I've noticed since an MRI 2 weeks ago and not being able to go for physio for 2 weeks, my shoulder impingement has gone from bad to really bad, not sure if this normal?

This has been really informative and has given me a realistic approach to it all. Feeling a little more positive about things.

[mash]

I'm 33 so I'm hoping with the right work post I'll bounce back. He's told me exactly this.

You're young, healthy and motivated. Just what a surgeon wants. Good luck with the procedure.