Partially torn bicep and rotator cuff - surgery needed?

[torredcuda]

 I`m by no means in great shape but I do try to get some exercise in like walking the dogs and since I can`t do anything impacting my bad such as jogging I try to ride my mountain bike occasionally. Back in late October I ended up hitting a wet root coming down a slight hill and went over the bars landing on my left shoulder. I just got MRI results and it shows a partially torn ligament to my rotator cuff and a partially torn bicep ligament. Right now I`m doing PT with the hope I can get my movement and strength back but I may end up getting surgery on it. Anyone else have this type of injury, did you have surgery or not and what was the outcome? I hate having to do surgery as I won`t have use of my arm for a few months killing most winter projects on the cars but I don`t want to lose strength in my arm.

[Fern]

My son was a college pitcher. I saw a lot of injuries and when your dealing with rotator cuff, it's a difficult decision. I will say if your active and want to stay active, you will probably need surgery. I'm no doctor, see a sports therapist, they can give you great advice and access the injury.
Depending on your level of use, that will make the decision easier

[Mopsquad]

I am a doctor and I'd be happy to view your MRI report to give you another professional opinion.

[torredcuda]

I am a doctor and I'd be happy to view your MRI report to give you another professional opinion.

Thanks, that would be great. I actually have to call tomorrow and get a copy of the report as for some reason they haven`t sent it to me yet although I do have a cd of the MRI images. I have seen the orthopedic after the MRI was done and they suggested to continue with PT and see them again in three weeks to review the progress.

[JH27N0B]

I took a bad slip and fall a number of winters back, landed on my left shoulder on the concrete driveway and had trouble for a few weeks afterward even putting on a shirt or my coat.
I had a physical not long afterwards and my doc had me lean against the wall then slowly feel my way up the wall with my hand until my arm was fully raised.
He said that should mean nothing was torn. He offered to refer me to a specialist but I said I'd hold off for the time being.
I never saw a specialist but I had some pain persisting for a long time afterwards.
My director of engineering at work had a bad slip and fall around the same time, he was hosing salt residue off his garage floor or something, the floor was still freezing so the water turned to ice, he slipped and fell on his butt.  The jarring from that was enough to tear both of his rotator cuffs!
He ended up having to have surgery on both sides, months apart.  He described the tendons torn as being like rubber bands under tension therefore no way for them to heal short of surgery.
The physical therapy after surgery was very painful.
We were comparing notes and he had me move my arms in a certain way or stretch and said mine were damaged too.
Several years later I got a prescription for physical therapy from my doc and the therapists said something was very atrophied and I hunched my shoulders forward a lot, so I had to do a bunch of therapy and exercises to get things back to good.
I suppose that happened from favoring my shoulder due to pain.
But no one ever said it had been torn and healed.  I never had surgery.
So the bottom line is a specialist needs to examine it and determine how bad it is, as like I described with my experience and my director's, things vary with shoulder injuries.

[Mopsquad]

Great, you can just PM me with a pic of it or send it to my clinic fax.  I'll PM you the number.

[torredcuda]

I took a bad slip and fall a number of winters back, landed on my left shoulder on the concrete driveway and had trouble for a few weeks afterward even putting on a shirt or my coat.
I had a physical not long afterwards and my doc had me lean against the wall then slowly feel my way up the wall with my hand until my arm was fully raised.
He said that should mean nothing was torn. He offered to refer me to a specialist but I said I'd hold off for the time being.
I never saw a specialist but I had some pain persisting for a long time afterwards.
My director of engineering at work had a bad slip and fall around the same time, he was hosing salt residue off his garage floor or something, the floor was still freezing so the water turned to ice, he slipped and fell on his butt.  The jarring from that was enough to tear both of his rotator cuffs!
He ended up having to have surgery on both sides, months apart.  He described the tendons torn as being like rubber bands under tension therefore no way for them to heal short of surgery.
The physical therapy after surgery was very painful.
We were comparing notes and he had me move my arms in a certain way or stretch and said mine were damaged too.
Several years later I got a prescription for physical therapy from my doc and the therapists said something was very atrophied and I hunched my shoulders forward a lot, so I had to do a bunch of therapy and exercises to get things back to good.
I suppose that happened from favoring my shoulder due to pain.
But no one ever said it had been torn and healed.  I never had surgery.
So the bottom line is a specialist needs to examine it and determine how bad it is, as like I described with my experience and my director's, things vary with shoulder injuries.

I understand every injury is different and even depends on what outcome the person is satisfied with so I am just looking for others experrience and opinions to help me with the decision. The week or so after I injured it I could not get my arm above my shoulder at all and it was very painfull but with PT I can raise it almost up as far as my good right arm. I still can`t get it behind my back barely at all so I am continuing with PT for now to get full motion back regardless of whether I decide to go under the knife or not.

[7E-Bodies]

In 2014 I took a bad spill while downhill skiing. I hadn't fallen in years and got overconfident while moving at a rapid clip backwards. Something that always seemed easy. The resulting wipeout scattered great for 200' and resulted in a partial tear in my rotor cuff. My orthopedic surgeon saw the MRI and recommended the obvious. I followed through and must say it was no fun, but they managed the pain very well. Therapy was surprisingly gentle and I strictly followed my home exercises. I don't remember it being four months. More like two. Perhaps four months until I was released to weight lift again. The following year, I opted to have the other shoulder done which was worn, but not torn. It was much easier. I'm very glad I had them done.

[YYZ]

Sorry to hear about your spill

I've had both shoulders done.  The first about 6 years ago when I fully severed 2 of the rotator cuff tendons in a fall, and the other more recently after a complete tear of one of the tendons (wear and tear from work, sports, age and prior injuries)

The first operation was completely successful.  My range of motion is a bit restricted because of where the injuries occurred, but the arm is strong and generally pain free. 

The second I still consider myself in recovery for. Range of motion is 100% but there is still residual pain and 'lifting heavy' is not an option yet.  However, I'm confident that this will improve in time.

A few notes:

- if you have a full-thickness tear and surgery is recommended, don't delay it too long as there is a window in which surgery is most likely to be successful (and less likely for reinjury)

- do the Physio

- do not rush the recovery. It takes a long time (months) for the tendon to form a strong bond with the bone and it's very easy to rip out the repair in the early months

- get a Breg Polar Cube or similar for the recovery. https://www.breg.com/products/cold-therapy/devices/cube-cold-therapy/ It is way more effective than a traditional ice pack or bag of frozen peas and it's very helpful for pain relief

- be prepared for pain in the early stages.

If and when you decide to go for surgery, PM me and I'll send a list of tips and tricks you might find helpful for recovery

[7E-Bodies]

Amen on the icing machine that @yyz mentions. A couple hundred bucks (that most insurance companies refuse to pay), but you'd sell your soul for it after surgery.

[BIGSHCLUNK]

I've had 1 shoulder "rebuilt". 4 incisions about a half inch long and done quickly . I was in an out in a half day.  I would have lost serious range of motion without having it done.

And I can BLAME NIKKI on the injury. I was working on her and heard a 'pop" sound, That was it after that...

Bone spurs were my issue. Imagine a small hacksaw blade... and everytime you move a certain way it makes another cut. Eventually it goes all the way thru...

[js27]

I feel your pain. A few months ago my left arm in the deltoid area started hurting. I had limited ROM. I could raise it up in front of me shoulder height height with no issues unless I rotated my hand facing up. Then the pain was bad. My right hand I could put behind me and up the middle of my back to between my shoulder blades. My left arm I could not even put it behind me at all. My GP sent me to a specialist and he did Xrays which showed nothing as he expected. He said to try Physical Therapy for 6 weeks and if no improvement he would do a MRI. I went for 1 hr twice a week for six weeks as well as doing stretching exercises at home twice a day. I got about 75 % of my Range of Motion back with a lot less pain. The specialist said since I was improving he would skip the MRI and said he would give me 6 more weeks of PT. I told him that I would hold off since I could do most of the therapy on my own at home. PT charges $ 200.00 a hour. Lucky insurance picked up the bill. This all took place in Sept-Oct. I was good all of NOV and now the pain is coming back of course I have not done my therapy at home like I should have. I will start it up again now and hope it helps. If you can I would try physical therapy first. It really helped me out and saved me from surgery--so far ! Good Luck and hope you heal up.
JS27

[MKA]

I am a doctor and I'd be happy to view your MRI report to give you another professional opinion.

I want to use this line.       But I'm not a doctor, can you tell us about the nurses Doc 

[MKA]

I am not a doctor     But it sounds like your GPs are telling you to do PT.   Surgery always has risks.  If PT can work and you can be disciplined to do PT try that route first.    In the short term, my opinion, you can take that option risk free and do surgery if that doesn't work.  But.  Wait too long.  Don't do the PT and surgery only gets more risky but necessary.   Trade offs    Always

[torredcuda]

I`m hoping to avoid surgery and I am putting the effort to do the PT at home as well as the appointments. When I originally blew out my back I was determined to try everything to help it before giving in and having surgery but unfortunaely  none of the PT, back specialists, excersize helped so I had to go under the knife. I`ll keeep working hard at it and we`ll see in a few weeks if it`s working well enough or not.