Yet another supraspinatus tear thread

[tbennett]

Hey, Rip. Was hoping you or the coaches might be able to weigh in on this.

I have been having some left shoulder pain for the last 10 months from no discernible specific incident. Not terribly bad, and in fact I'd previously had tendinitis in one shoulder and bursitis in the other previously over the last 6-7 years, which I had always addressed by brief PT and then moving on to the program, with great results. Pain went away after a few weeks if not months. However, this time the pain hadn't gone away (typically waking me up at night when I rolled on to my left side), even after a decent re-running of basic linear progress because I took a long time off for silly reasons. BTW, 47 years old, 6'0, 205. Most recent numbers were press 150 (5,5,4, failed on that last rep), squat 305 3x5, dead 335 1x5, bench 217.5 3x5, and weighted chins 37.5 3x5. No pain in any of that other than 1/10 mild discomfort when hanging from the chin-up bar.

Since the pain never went away (in spite of getting my press to the highest it's ever been, and without any pain during the pressing motion, imagine that), I had an MRI done, with the following results noted:

"There is a small-to-moderate full-thickness tear of the anterior aspect of the supraspinatus tendon. The tear extends 8 mm anteriorly/posteriorly and 6 mm right to left. There is no retraction of the musculotendinous junction. There is no muscular atrophy. The acromioclavicular joint is normal. There is minimal thinning of the articular cartilage of the glenohumeral joint." There's a bit more about the biceps, all fine. Also, the doc mentioned he saw a bone spur that the radiologist did not mention, and he'd like to file that down to help make sure I didn't have to come see him again down the line.

Doing a search on this, you mentioned to a poster in 11/2012 that if someone has a full-thickness tear, they're going to need the surgery sooner or later, and sooner was better if at all possible. This was backed up by Walter Palmer (SSC). Similarly, the doc told me he felt it was not the sort of thing that would get better with any level of PT, training, passage of time, etc.

So, all that said, it seems I should get the surgery. The doc told me I'd be out of commission for ~4-6 weeks, and after that I should be able to return to whatever I felt like as long as I progressed slowly and carefully and didn't get too ambitious too quickly.

So, the questions - is this still your recommendation to get the surgery done with an issue like this? And is the doc's statement reasonable about returning to lifting? And have you seen folks do well after this procedure and recovery?

Random observation - all my lifts are still progressing linearly, if this damned thing wasn't waking me up at night or else feeling like I get stabbed when I reach at certain angles, I'd be tempted to ignore it. Amazing that the program works around it with nary a kink, though it scares me to think that at some point a heavy weight will wobble just the wrong way at the wrong time and make things worse.

[Mark Rippetoe]

Get the surgery done. Then: Shoulder Rehab | Mark Rippetoe

[David Mitchell]

I had both shoulders done, two years apart, and the protocol linked in Mark's reply worked very well for me. Comparatively speaking, it worked much better than the PT protocol used after my first surgery. The second repair was much smaller than the first (which was a 5cm full tear) so that may have skewed my experience somewhat.

As to 4-6 weeks... that seems very optimistic. Are you sure it wasn't "after 4-6 weeks of PT"? I think it was 4-6 weeks before PT began, both times, for me and 12 weeks before weight was introduced.

FYI, when the doc clears you for PT, go for a while. The assisted ROM stuff they do is quite helpful... I think this is mentioned in the protocol video.

[Mark Rippetoe]

Outpatient PT for this surgery is a complete waste of time, and may well leave you with compromised function. But it's your shoulder.

[David Mitchell]

Outpatient PT for this surgery is a complete waste of time, and may well leave you with compromised function. But it's your shoulder.

If my gym had rings I would have skipped PT altogether. However, I was unable to lift my arm much past shoulder level after coming out of the sling. So I did the assisted ROM for 2 weeks and then went to the gym.

[tbennett]

Much obliged, Coach.

[Mark Rippetoe]

If my gym had rings I would have skipped PT altogether. However, I was unable to lift my arm much past shoulder level after coming out of the sling. So I did the assisted ROM for 2 weeks and then went to the gym.

If the gym has a power rack, or even a chin-up bar, you rig some straps and handles from the bar. If not, go to another gym.