18 replies to this topic

[Scooby Gimp]

Anybody ever heard of an artificial shoulder or shoulder repair or replacement surgery? I've worn out my right shoulder from 30 years of pushing a manual wheelchair.

[mellowgator]

hi scooby gimp,

i'm in the same boat as you since i've been pushing my chair 25 years. i am aware of rotator cuff surgery which is a fairly common out patient procedure. i know a few members here have undergone this procedure and are pleased with the results. although it's a tough recovery.

good luck to you. it's nice to see you posting again.


mellowgator

[A trophy guy]

I have had torn rotator cuffs since three months into my life in a chair. Since that time, they have progressively gotten worse, and it is only due to building and strengthening the surrounding musculature (as well as knowing what to do/what not to do) that has kept me from having to go under the knife. However, I do know that I am simply delaying the inevitable; and I will have to undergo surgical repair eventually.

But I dearly do not want to go through such an ordeal. There are SO many reasons why I don't want the surgery, I won't even get into it here. Have you explored physical therapy? What about weight-resistance exerices to strengthen the surrounding muscles? Also, have you any experience with those "propel-assist" wheels (I'm not sure what they are actually called) that assist when you push?

And what exactly do you mean when you say you've "worn out" your shoulder? Is there acute pain with certain movements? Does it hurt all the time? Is it weakened? Does sleeping in certain positions aggravate it?

Edited by A trophy guy, 05 November 2011 - 09:25 PM.

[Scooby Gimp]

I have joint pain in the right shoulder pushing the chair or lifting. It sometimes hurts with no movement. I hate surgery and will look into PT and am also going to an accupuncturist. But it keeps getting worse and I was wondering about surgical repairs.

[A trophy guy]

Scooby Gimp, on 05 November 2011 - 10:41 PM, said:

I have joint pain in the right shoulder pushing the chair or lifting. It sometimes hurts with no movement. I hate surgery and will look into PT and am also going to an accupuncturist. But it keeps getting worse and I was wondering about surgical repairs.

I would keep surgery as a last resort option. When/if you do decide to go the surgical route, there is no going back. Have you had an MRI? You could be suffering from tendonitis or bursitis or just slight tears in the rotator cuff tendons; or a combination of the three. This could be handled, most definitely with non-surgical means. Finding the right physical therapy program, as well as knowing some at-home and self-help things you could do, could go a long way towards improving the long-term health of your shoulders.

[tsh3406]

A trophy guy, on 05 November 2011 - 09:13 PM, said:

I have had torn rotator cuffs since three months into my life in a chair. Since that time, they have progressively gotten worse, and it is only due to building and strengthening the surrounding musculature (as well as knowing what to do/what not to do) that has kept me from having to go under the knife. However, I do know that I am simply delaying the inevitable; and I will have to undergo surgical repair eventually.

But I dearly do not want to go through such an ordeal. There are SO many reasons why I don't want the surgery, I won't even get into it here. Have you explored physical therapy? What about weight-resistance exerices to strengthen the surrounding muscles? Also, have you any experience with those "propel-assist" wheels (I'm not sure what they are actually called) that assist when you push?

And what exactly do you mean when you say you've "worn out" your shoulder? Is there acute pain with certain movements? Does it hurt all the time? Is it weakened? Does sleeping in certain positions aggravate it?

The way Dr's have explained it to me, and I right up there with these guys at 20 yrs, is that your shoulder joints, plain and simple, aren't designed for the kind of load and repetitive motion that a chair user puts them through. You prematurely wear out bursa, cartiladge, ligaments, tendons, sometimes get calcium deposits or arthritis. It's the same concept as an older adult needing to have a knee or hip replacement.

[greybeard]

I can attest that it is not a good idea to put off treatment for shoulder injuries. If you tend to get repeated sharp pain near the point of the shoulder, you might be fraying the long head tendon of the biceps muscle.

Ignore it at your peril or you can end up like me, where this tendon on the right side has been completely severed from its attachment point on the glenoid. Nobody will operate to re-attach the tendon and I am (of course) right handed.

This bit of the biceps muscle is now a useless bunched up lump sitting at the bottom of the humerus, and which goes into painful spasm whenever the right biceps comes under any stress. Early intervention might have prevented the tendon from tearing.

[A trophy guy]

tsh3406, on 05 November 2011 - 11:57 PM, said:

A trophy guy, on 05 November 2011 - 09:13 PM, said:

I have had torn rotator cuffs since three months into my life in a chair. Since that time, they have progressively gotten worse, and it is only due to building and strengthening the surrounding musculature (as well as knowing what to do/what not to do) that has kept me from having to go under the knife. However, I do know that I am simply delaying the inevitable; and I will have to undergo surgical repair eventually.

But I dearly do not want to go through such an ordeal. There are SO many reasons why I don't want the surgery, I won't even get into it here. Have you explored physical therapy? What about weight-resistance exerices to strengthen the surrounding muscles? Also, have you any experience with those "propel-assist" wheels (I'm not sure what they are actually called) that assist when you push?

And what exactly do you mean when you say you've "worn out" your shoulder? Is there acute pain with certain movements? Does it hurt all the time? Is it weakened? Does sleeping in certain positions aggravate it?

The way Dr's have explained it to me, and I right up there with these guys at 20 yrs, is that your shoulder joints, plain and simple, aren't designed for the kind of load and repetitive motion that a chair user puts them through. You prematurely wear out bursa, cartiladge, ligaments, tendons, sometimes get calcium deposits or arthritis. It's the same concept as an older adult needing to have a knee or hip replacement.

Oh yes, this is totally correct. Like I said, the surgery, for me(and many others), is inevitable. However, there are things that you can do to delay the need for such things. THings that I have already mentioned. Keeping your muscles and tendons strong, you keep the surrounding tissue healthy and compensatory for any wear and tear taking place in the shoulder joints. This is important. Regular use of a UBE (arm bike) also helps keep the joints healthy and flushed of lactic acid and buildups.

I think it's even worse than an older person needing an hip replacement, because the human body was never designed to be used in the manner we must use ours now; so the problems we face aren't like those that arise simply due to old age. More, they are due to chronic misuse due to necessity.

But for those who have been in chairs for decades (like yourself and the others in this thread), it may very well be too late for any of these other treatment options. I just think its worth a try looking into them because surgery is so final, and I think every last avenue should be exhausted before it is selected.

[A trophy guy]

Just adding my 2cents, that's all.

[tsh3406]

You had to say decades? Now I feel really old, but hell, I'll probably get put down by a failed parachute or jealous boyfriend/husband before they get THAT bad, lol....

[Tetracyclone]

I appreciate the excellent knowledge and experience offered by all on this thread. I have only been in a chair 3+ years, but I did abuse my shoulders a lot before that using hammers and electric drills 8 hours a day. I did not have the build to support that kind of work.

Since injury I lost a LOT of muscle, and in one's late 50s it is very difficult to get any of it back. Couple this with recurrent nutrition problems , that leaves me still unable to chink past 50 kilos, or 110 lbs for you yankees. Not very impressive given I used to weigh in at 57 kilos, or125lbs., 10 years ago. I have had to learn to ignore PTs who urged "Try as hard as you can!", as following that advice led to several early injuries that crippled my recovery process. I would be more able today if I had trusted the messages from my own body, but i thought paralysis had let me into a new ball game. I was wrong, and mostly the old rules of living in this body remained accurate.

We can struggle with many limitations as we age, and that is what each of us must do- learn our own bodies intimately- from the inside out. Most of us do have some internal perception of muscular function even when we lack superficial sensation.

This is a good thread!

[A trophy guy]

tsh3406, on 06 November 2011 - 01:54 AM, said:

You had to say decades? Now I feel really old, but hell, I'll probably get put down by a failed parachute or jealous boyfriend/husband before they get THAT bad, lol....

Oh man, my bad.

If it's any consolation, I'm a "decade"-er myself

[A trophy guy]

One factor that goes into chronic shoulder injuries for lifelong wheelchair users is the repeated stress and use of very specific muscles, joints and tendons. Over time, as has been pointed out here, those soft/connective tissues "wear out" and become more and more prone to injury.

By strengthening the opposing and assisting muscles, one can offset or even prevent such rampant tissue breakdown from occurring. The rotator cuff itself is made up of four tiny little muscles/tendons. There are specific exercises to strengthen those areas as well. I'm not talking about going out and becoming a powerlifter or bodybuilder, just strength training. And I'm sure this isn't news for most of you.

And at any age, results can be had. It's true that the older you get, the harder you must work for less return. However, it makes it all the more important to do it. I wish my father would begin a resistance training program; I have been on him for so long. It's important in so many ways.

[Scooby Gimp]

I've had the MRI and been told I have severe arthritis in my right shoulder joint. It hurts almost all the time and when I move the joint I can hear it crunching. The crunching sound occurs without pain sometimes but the soreness is impeding my mobility. I hate surgery and don't know how anyone dependent on the upper body could effectively rehab from shoulder surgery. Has anybody here actually undergone the surgery?

[edlee]

I've always been "afraid of the knife". And, I think< with good cause. There are NO operations to cure arthritis. If there were,, THAT is the one I might try.

Something not mentioned to this point,, is cortisone shots. Around here,, that is the first course of action for bursitis. I find that I get almost immediate relief after getting mine,, and I can usually go almost a year befre I'm forced to get another. In fact,, I'm a bit overdue, right now.

TG is also right about the exercising. The one thing to remember when thinking about exercise for the rotator cuff,,, is ,, be gentle. Low resistence and stop when you start to feel the strain. The real key is to do the exercises more often,, but with short duration.

As for the bursitis,,,, well,,, unfortunately,, exercise doesn't helpmuch, there,, as it does for arthritis.

For the most part,, just remember to keep all your joints moving so they don't rust up and sieze.
ed

[wheeliebear75]

I'm glad that Ed mentioned the shots. I've been in Gimp-Ville for 21&1/2 yrs (saying OVER 2 decades makes me sound even older than tsh3406 ) quite a few of those years being primarily on forearm crutches; I was told the same thing about our arms/shoulders "the human body wasn't designed to propel one's self around with the arms". I had an injury to my left shoulder.....although mine was a dislocation by an , abusive, son of a ! Who is now my EX-husband.....I had a lot of swelling & inflammation in the left shoulder thanks to him. The shot itself burned somethin' awful for a few hrs afterwards BUT by the next day it was noticeably easier to move.

I've been told that eventually I'll "HAVE TO have surgery" on my back & neck since the docs are taking bets on things going hell,west & crooked at some point. And they've also told me I'm at a high risk for repetitive injury/damage to the shoulders & wrists/hands from using my arms to get around with since age 14. But like Ed & others.....I'm dead set AGAINST surgery until I'm out of OTHER options & IF delaying surgery would cause it to be unsuccessful whereas going in earlier would have given much higher odds to a GOOD outcome.....then....then I MIGHT...I'd still have to think on it & even then I doubt I'd stop being scared out of my mind til it was all over with & so was the recovery phase.

[Vanessamaee]

AHHHH!!! I wish I didnt read this... Good information but WOW... not something im looking forward to dealing with!

[Lou05]

being a low level injury i keep getting warned about wearing out my shoulders, can anyone pushing as a c5c6 with experience help me out with some insight on whether i should switch to a power? i really love pushing my chair....

[darryl]

Lou05 push as long as you can, keep the muscles working, tendons stretched, and of course the cardio aspect. I've been a T6-7 para for 40 plus years, and 25 of those included competetive bball, which in the long run saved my shoulder integrity until 2006 when I finally gave into the pain, tingling etc of bilateral rotator tears. Along with the tears I also developed what the deemed 'calcium' tumours on both clavicles, this complicated things a bit more with the downward pressure on muscle & tendons, and of course the bursa's are effected. Surgeon sais he could not do laproscopy with so much involvement so it would be open surgery rotator repair + shaving the clavicle. Surgery, and one shoulder at a time would have required the arm immobilized for at least 6 weeks and no weight bearing for another 2>3 months. In Ontario you can only receive in-home care assistance for 2 hours per day, the rest you pay for at average $25/hour. The complication is that home care workers are not allowed to do single person transfers,and with one arm in a sling you need 2 people, that ain't covered....so, long of the short I was told I would have to go to chronic care for at least 3 months, never did get them done. Managing on good old opioids and by using manual chair plus basic detoid strengthenin.They did try cortisone shots, 3 in each shoulder done under flouroscopy, and each shoulder was pain free for a whole 2 weeks! My advice...since I am now a bit past 58 yrs, I will not have the rotators do, however if you are young in terms of injury, I would recommend repairing, they will only get worse and more debilitating. Which ever route you choose, all the best to you

dk