Shoulder Surgery

November 19, 2016 at 11:03 PM · I am curious. I've played forever and a year ago injured my left shoulder. This makes playing all kinds of annoying. But, have been getting steroid injections every 5-6 months and no big worries. I've had an MRI done and found I've got a torn ligament which was probably made worse by the PT I was assigned to. The doctor keeps suggesting surgery but since it's the left shoulder, I have not heard of many who have been able to recover fully enough to continue playing the Violin afterwards.. This is my livelihood. And I keep being told things have advanced a bit in the surgical field and how it's not as big deal as a decade ago. I'm skeptical.

Granted, the majority of folks I've known who have had surgery on their shoulders was maybe 15-20 years ago and always spelled the death of their own livelihood.

Can Violinist/Violists share their experiences? What am I looking at in terms of being able to return to playing full time, or would that be futile?

Replies (36)

November 19, 2016 at 11:36 PM · Hey John, I actually really started playing my violin since my second shoulder surgery called bankart repair.

It's repair to the front of the humerus, and first repair was not completely successful, and the second has been better(2011 and 2013).

Few things to note:

1.permanent alterations to range of motion. For me, I can never hold the violin "properly", I hold it crooked it, and with the neck pointing about 45 degrees from the front of my body, instead of the "proper" 90 degrees.

2. I can never go rock-climbing again. Swimming also makes my shoulder unstable.

3. It never feels safe to reach up.

4. I can never scratch my back with the left arm.

I am not a violinist/violist by profession, but I do love playing the instruments, and also I could not play 16" viola.

Where is the tear on your shoulder?

November 19, 2016 at 11:39 PM · John,

I recommend to contact Barbara Pauls and ask for her expert opinion:

http://www.stouffvillemusiciansinjuriesclinic.ca/

Christine Harrison, the co-author of "The Athletic Musician" described her own story about shoulder injury and long recovery after botched shoulder surgery.

I share your frustration with PT.... and please do not give up! Surgery should really be the last resort.

Good luck.

R

November 19, 2016 at 11:48 PM · Get a number of "second" opinions from recommended doctors - and not just orthopedic surgeons.

After my wife was told she had a torn ligament in a hip 15 years ago subsequent visits to two surgeons resulted in recommendations for hip replacement. Actually mild chiropractic care did her a lot of good. But one year ago with pain recurring she tried another 2 docs who recommended hip surgery again. She finally went into San Francisco to see the head man in the practice who looked at the X-ray and told her she did not need hip surgery.

I'm not a fan of chiropractic - my Dad was and MD very skeptical of that business/profession, but there is no doubt my wife's chiropractor knows a lot and has been doing her a lot of good for a number of years.

This business seems a lot like so many violin dealers (not all). After-all these surgeries are their "bread and butter" and reimbursements are way down with medicare and various insurance carriers.

Buyer beware and shop around!

(Sorry if my posts sometimes have strange word choices, but since I had my computer repaired, word choices at some sites (like this one) have been removed from my control unless I examine carefully what has been entered on the screen.)

November 20, 2016 at 12:01 AM · After reading Andrew's advice, I should probably mention that I suffered my initial injuries while working in the military. I refused surgery for over 2 years fearing that it'll keep me from doing a lot of "fun" things.

After having seen physiotherapist for 1 year, and have had my shoulder dislocate several times. I've decided to go on with the surgery after one incident. I was walking down stairs, and I slipped, I didn't fall, and I didn't need my arms to not fall, except my shoulder came out of its socket and I was in quite a bit of pain. I also spoke to 4 orthopedix surgeons in Ontario before finally going on with the surgery. Through the military, it didn't cost me anything, but I did recently get medically discharged.

November 20, 2016 at 12:55 AM · Perhaps I should elaborate about the PT. From my experience there are rare PT who know about full recovery process . What I mean by this is that there should be a customized recovery program designed for each and every injury; proper timing and sequence of massage (active release), stretching, re-balancing and strengthening is of utmost importance. Once injured, the main goal is to avoid getting re-injured and allow our body to heal and recover with proper nurturing and help.

Many PTs fall short of the above and focus on one aspect of physical therapy only. In fact, here in Ontario, it is quite difficult to get proper help (unless you are a player in Blue Jays)

Also, a holistic approach to healing works better than symptom-based short therm release. Proper nutrition, meditation, body posture (re-visiting one's accessories, such as SR and CR) are all part of the healing process.

This all is even more important after surgery.

November 20, 2016 at 03:12 AM · I think that the effect of the surgery on your long-term ability to play might depend on which ligament is torn. I ruptured the scapulothoracic and subacromial bursae in my right shoulder about 2 months before I started playing, and ended up being treated by a former violinist after 4 months of PT failed (seems to be a trend here); his general prognosis was that getting a subacromial bursectomy would be fine, but that regular cortisone injections in the other bursa would be safer than surgery. I'd suggest making it clear that violin is your priority though, could completely change the recommendation. Good luck with the injury

November 20, 2016 at 06:30 AM ·

November 20, 2016 at 12:27 PM · Well Steven, OP is skeptical about surgery. If your livelihood depended on it wouldn't you try less invasive options first? I guess you didn't so... what?

November 20, 2016 at 03:03 PM ·

November 20, 2016 at 05:59 PM · So, injury ended your career. Surgery did not enable you to return. Did you notice OP wants to avoid ending his career? Seems to me your case supports having surgery as a last resort.

November 20, 2016 at 07:51 PM · Thanks, Rocky. I will be emailing her in the next couple of days to see what advice she has since I do not trust the surgeon who has been pushing operating on my shoulder since our second visit.

Far as the debate over laser therapy, not being in the field or a doctor, I cannot comment. However, there isn't much to debate when it comes to a profession I've been in for many decades.

Like I said earlier, I'm all ears if anybody has heard of Violinists/Violists returning to their field after surgery on their left shoulder. If it were the right shoulder, I could be a little more willing but not by much. May also look into acupuncture to see how that is.

Will let you know what Ms. Pauls says and go from there, with at least a better idea.

Thank you for the responses.

November 20, 2016 at 08:28 PM · Hi John, in case you're interested in trying some less invasive alternatives, here are some threads where I've posted on the topic:

http://www.violinist.com/blog/Xixi/20128/13884/

http://www.violinist.com/discussion/response.cfm?ID=23059

http://www.violinist.com/discussion/response.cfm?ID=25868

I injured my left shoulder about 10 years ago after a run of a particularly intense show. I never got it checked but I started losing strength, it was permanently numb and often tingling, and it started to droop forward. It took several years to figure out that the only permanent solution for me was to change my violin hold (which then affected bowing angles and led to a revamp of my whole left hand/arm technique.) Self-massage and mobilizing help keep me going when I'm playing too much. Good luck with it!

Checkout Seven Things You Should Know About Pain Science from https://www.bettermovement.org/:

3. Physical Harm Does Not Equal Pain. And Vice Versa.

If you are in pain, you are not necessarily hurt. And if you are hurt, you will not necessarily feel pain. A very dramatic example of tissue damage without pain occurs when a solider is wounded in battle, or a surfer gets an arm bitten off by a shark. In these situations, there is a good chance the victim will not feel any pain at all until the emergency is over. Pain is a survival mechanism, and in cases where pain makes survival even harder, we shouldn’t be surprised that there is no pain. Although most of us have never had our arms bitten off by sharks, we have likely experienced bumps or falls during a sports match or some other minor emergency that we didn’t feel until the game was over. Further, many studies have shown that large percentages of people with pain free backs, shoulders and knees have significant tissue damage in these areas that can be seen on MRI, such as herniated discs and torn rotator cuffs.

On the other hand, many people suffer from pain when there is no tissue damage at all. Allodynia is a condition where even normal stimuli such as a light touch the skin can cause excruciating pain. This is an extreme example of something that might occur quite commonly on a much smaller scale – the nervous system is sensitive to potential threats, and sounds the alarm even when no real threat is present.

As for cold laser therapy, for those not inclined to click on above links, the founder of BioFlex Laser Therapy and Meditech is no alt-medicine hippy guru. From wikipedia:

Dr. Fred Kahn was born (August 4, 1929) and raised on a farm near the town of Uxbridge, Ontario. He attended and graduated from the University of Toronto School of Medicine in 1961. Dr. Kahn was a surgical resident at both Hamilton General Hospital and Montreal Children's Hospital. He is a Fellow of the Royal College of Surgeons of Canada (FRCSC).[1] and a Diplomate of the American Board of Surgery (DABS). Starting in 1966, he spent over 15 years practicing medicine as a vascular surgeon in Santa Ana, California.[2] He has performed over 15,000 major surgical procedures. He developed a 12,000 sq. ft surgical practice in Santa Ana and was the driving force behind the development of a 250 bed General Hospital in the area.[3] As a result, he was named Chief of Staff and subsequently, Chairman of the Department of Surgery.[2]

From "A 25 Year History" on http://bioflexlaser.com/about-us/

1986: Fred Kahn, a physician, sustained a severe rotator cuff injury in a skiing accident. Aware of the shortcomings of surgical repair for this condition, he utilized a primitive European Laser Therapy device in order to resolve this problem. Almost instantly, he obtained relief from the pain and with continuing treatment was able to restore a normal range of motion of the shoulder. This stimulated Dr. Kahn to explore the possibility of developing more sophisticated devices to treat a more extensive range of clinical conditions.

Edit: In case you never get to read about the magnitude of his career change, Dr. Kahn left his highly successful career as a vascular surgeon to explore and innovate in this new (to the West, but old to former USSR/East Europe) field of laser therapy. Yeah, I guess he could've conked his head during that ski injury and gone a little bonkers, or... maybe there's something to it (?)

November 21, 2016 at 05:59 PM ·

November 22, 2016 at 01:11 AM · Plants, animals, fungi, algae, bacteria, we all share common ancestry if you go back far enough, and hence biochemistry, in particular ATP hydrolysis (more detail,) which is just a part of the larger phosphorus cycle.

From The Brain's Way of Healing

How Lasers Heal Tissue

By 1965 it was known that low-intensity lasers could heal. Shirley A. Carney, working in Birmingham, England, showed that low-intensity lasers could promote the growth of collagen fibers in skin tissues. [S. A. Carney et al., “Effect of the Radiation on Skin Biochemistry,” British Journal of Industrial Medicine 25, no. 3 (1968): 229–34.]

... In 1968 Dr. Endre Mester, in Budapest, showed that lasers could stimulate skin growth in rats, and a year later that lasers could radically improve the healing of wounds. By the mid-1970s, the USSR had opened four large-scale research and clinical facilities to use lasers to stimulate living tissues, a technique that, by the 1980s, was common in the Communist bloc, though rare in the West.

Not until the end of the Cold War did medical lasers become more common in the West, and not until 2002 did the FDA approve the first low-intensity laser therapy device in the United States.

When photons are absorbed by living tissue, they trigger chemical reactions in the light-sensitive molecules within. Different molecules absorb different wavelengths of light. For instance, red blood cells absorb all the nonred wavelengths, leaving the red ones visible. In plants, green chlorophyll absorbs all the wavelengths except green.

Human beings tend to think that light-sensitive molecules exist only in the eyes, but they come in four major types: rhodopsin (in the retina, which absorbs light for vision), hemoglobin (in red blood cells), myoglobin (in muscle), and most important of all, cytochrome (in all the cells). Cytochrome is the marvel that explains how lasers can heal so many different conditions, because it converts light energy from the sun into energy for the cells. Most of the photons are absorbed by the energy powerhouses within the cells, the mitochondria.

Amazingly, our mitochondria capture energy originating 93 million miles away—the energy of the sun—and liberate it for our cells to use. Surrounded by a thin membrane, the mitochondria are stuffed with light-sensitive cytochrome. As the sun’s photons pass through the membrane and come in contact with the cytochrome, they are absorbed and stimulate the creation of a molecule that stores energy in our cells. That molecule, called ATP (adenosine triphosphate), is like an all-purpose battery, providing energy for the cell’s work. ATP can also provide energy that can be used by the immune system and for cell repair.

Laser light triggers ATP production, which is why it can initiate and accelerate the repair and growth of healthy new cells, including those that make up cartilage (chondrocytes), bone (osteocytes), and connective tissue (fibroblasts).

Lasers of slightly different wavelengths can also increase the use of oxygen, improve blood circulation, and stimulate the growth of new blood vessels, bringing more oxygen and nutrients to the tissues—especially important for healing.

Kahn uses four different methods to get light into the cytochrome molecules. The first is red light, generated by 180 light-emitting diodes (LEDs), laid out in rows, mounted on a soft plastic band the size of an envelope. Typically, the therapist will cover a body surface with red light for about twenty-five minutes. This red light penetrates one to two centimeters into the body and is always used first, to prepare the tissue for deeper healing, and to help improve circulation.

Next Kahn uses an infrared band of LEDs for about twenty-five minutes. Its light penetrates about five centimeters into the body, spreading the healing light deeper still.

LED lights have laserlike properties, but they are not lasers, and thus you can look directly at them with no ill effects.

Then Kahn uses the pure beam of lasers, beginning with a red laser probe, followed by an infrared laser probe.* A laser probe can deliver much more power than LEDs, in a focused beam that goes very deep. By the time the laser probe is applied, the superficial tissues have already been saturated with so many photons from the red and infrared LEDs that the laser creates a cascade of photons in the tissues, reaching as deep as twenty-two centimeters into the body. The laser probe is applied for a short time, in various spots. A total treatment with the probe darting over many points may last about seven minutes. As is not the case with LEDs, looking directly at the laser light from a probe can be dangerous, and patients and clinicians wear special glasses when using them. The energy of a “dose”of light depends on two things—the number of photons the light source gives off, and the wavelength or color of those photons. As Einstein showed, the color of a light is a measure of how much energy it contains.

In the immune system, laser light can trigger helpful forms of inflammation—but only where required. Where inflammatory processes have become stuck and “chronic,”as happens with many diseases, laser light can unblock the stalled process and quickly move it to a normal resolution, leading to decreased inflammation, swelling, and pain.

From http://www.burtonreport.com/infspine/lowintensitylaserkahneditorial.htm

Over the past two decades I believe that Low Intensity Laser Therapy has advanced to the point where it can now be termed “the New Dimension in Medical Practice”. Most importantly, it has proven to be highly effective in the treatment of musculoskeletal conditions, arthritis, soft tissue and sport injuries, wound healing and the treatment of numerous dermatological conditions and in most of these conditions it can actually be termed to be the treatment of choice. This technology has also demonstrated significant and not infrequently dramatic effects in the treatment of challenging medical conditions resistant to other conventional and traditional therapies. These include Crohn’s disease, Endometriosis, Dementias, Systemic and Neurological disorders.

By the way, don't discount the importance of mindset and placebo (outside Canada: Brain Magic-The Power of Placebo) in triggering the body's own powers of healing.

Edit: perhaps a more objective review

November 22, 2016 at 03:31 AM ·

November 22, 2016 at 03:39 AM · The Nobel Prize in Chemistry 1997

"I'm not sure what you're trying to accomplish by making such a great effort in defending this therapy, but I'm sorry, I think this "treatment" requires scientific review."

I'm not sure what you're trying to accomplish by making such a great effort in expressing your skepticism of this therapy, but scientists are researching and reviewing the effects of low level laser therapy.

4184 papers on pubmed tagged "lllt laser."

36 papers tagged "lllt laser shoulder."

November 22, 2016 at 03:41 AM ·

November 22, 2016 at 03:57 AM ·

November 22, 2016 at 04:02 AM ·

November 22, 2016 at 04:10 AM · Speaking of scams, which is the greater scam, new, albeit controversial, therapies or the ineffective status quo?

"Based on the up-to-date evidence, we must question the current line of treatment according to which patients with shoulder pain attributed to subacromial impingement or a degenerative rotator cuff tear are commonly treated with arthroscopic acromioplasty or repair of the rotator cuff or as the first-line treatment. It seems that instead of surgery, the treatment of such patients should first be based on exercise and rehabilitation, which are equally effective, less risky as regards potential complications, and less costly." http://www.dbc.fi/new-evidence-questioning-the-effectiveness-of-shoulder-arthroscopy-for-degenerative-shoulder-disorders/

http://www.nytimes.com/2016/08/04/upshot/the-right-to-know-that-an-operation-is-next-to-useless.html?_r=0

I'm not really defending laser therapy, but I do find it interesting. I just don't understand your blanket faith in procedures which are being questioned by medical science itself. I respect your skepticism, but it does seem to be a bit selective.

Edit: I get it. You are a card carrying skeptic, but there's no need to throw quack watch around and get all defensive on me. I don't really see how Dr. Kahn and his therapy fits your list, except for the lights (I don't know if they blink, but they are the actual source of the therapy, and the proponents claim to know how they effect therapy, just not in a way that makes sense to you.)

November 22, 2016 at 04:17 AM ·

November 22, 2016 at 04:24 AM · Wow, this could go on forever... you know there are quack watches on the quack watchers too, right? http://www.quackpotwatch.org/quackpots/quackpots/barrett.htm

I prefer Dr. Kahn's credentials.

November 22, 2016 at 04:26 AM ·

November 22, 2016 at 04:28 AM ·

November 22, 2016 at 04:30 AM · Maybe take your debating elsewhere? it's not too helpful.

November 22, 2016 at 04:32 AM · My Apologies John.

November 22, 2016 at 04:41 AM · I know I can't convince you, but there are actual scientists involved in cold laser therapy. Not all laser therapies are the same. Stephen Barrett is not an actual scientist, nor an MD. I hope you can agree Dr. Kahn is an actual surgeon. Dr. Doidge is an actual MD and psychiatrist. BioFlexLaser equipment was developed in conjunction with actual engineers from an actual university.

Dr. Kahn's brand of laser therapy is offered only through his two clinics in Toronto. You can't mail order it like hair removal lasers, or skin tightening lasers. Not the same thing. Also, the LEDs and laser are simply tools, like a scalpel is a tool. According to Kahn the effectiveness of the therapy lies in the hands of the therapist.

Already answered re. lights.

I guess you just don't believe Dr. Kahn is an actual surgeon. He's not world famous. But seems to be known in his former and new fields.

Cold laser therapy. Doesn't sound convoluted to me. Doesn't sound more scientific than shoulder arthroscopy.

Proponents claim it is an effective treatment for more than one thing, not 'just about anything,' but from what I can tell the mechanism is neither completely unknown, nor diverse.

I'm pretty sure this laser therapy is not the same as those listed on quackwatch. And I question the veracity of some of those lists, in particular those written by quackpot Stephen Barrett.

Edit: sorry John. I will stop.

Edit 2: but I will add that I have been motivated to speak out against surgery for soft tissue pain and dysfunction based on a few people I know who have undergone career ending surgeries, on top of the damning evidence, and my success at reversing my own injuries (sprained my left wrist once also, which I had to work through, and which turned into chronic pain) and those of a few former students.

November 22, 2016 at 05:21 PM · Jeewon, I have never heard of laser light therapy and appreciate the information which you have taken a lot of time to put out there for us.

November 22, 2016 at 06:26 PM · Jeewon has the wealth of information and knowledge both as violinist and an alternative healthcare advocator. I have benefited from his advice a great deal over the years. Thank you again Jeewon!

That said, I also a skeptic. My skepticism came from the fact that I was born and brought up by a doctor mother and I'm married to an anatomic & clinical pathologist. I was trained and practiced as a registered nurse in China, where TCM was mandatory during school years and then I worked in an TCM university hospital for three years on one of the top 10 national projects to treat late stage cancer patients with combined TCM and western medicine. I worked with country's best TCM doctors for those years. While I have a lot to say about it, I'll spare you the details by just saying this, among all the Chinese TCM doctors I know, when they or their family member got sick, they usually opt for western medicine. They do use some TCM as supplement, much like we take vitamins and supplements on the side.

I understand there is a lot legitimate concerns regarding western medicine -- the problems with pharmaceutical companies, doctor's greed and over-treatment we've seen too often. This is healthy skepticism. But then the wealth of expertise, web of knowledge, regulations and protocols, not to speak the researches and peer reviewed medical publications, all pretty solidly points to the fact that none of the alternative medicine can match the rigor of modern western medicine.

I'm also a strong believer in self-care, but I will never mistake this with self-diagnose or self-treatment. People can write all sorts of things and put them online. What kind of critical eyes do we need? That's a good question.

November 22, 2016 at 06:31 PM · Well said Yixi. The challenge with modern medicine is that many people hide behind white coat and their diplomas, with little practical knowledge and lukewarm interest - zero passion in patient's problems. Some of them do sell snake oil, too.

It is not either-or, but unfortunately who do you know. In Canada we have a 2-tier healthcare system and one would hope that money could bring quality of service. Wrong. The only way to reach a true expert (traditional or modern) is through personal recommendation from friends and fellow musicians.

November 22, 2016 at 06:46 PM · Rocky, you are so right that money doesn't guarantee quality of healthcare. I worked in the Ministry of Health here in BC for a number of years both as a program manager and senor policy advisor. I can tell you that in our two-tier system, those who have money and pay for extra treatment only get more treatment they want but not medically necessary. What does it mean? It means they are overtreating themselves. And that's more harm than good money does to us. In my house, we are particularly careful not to overtreat ourselves because we know it'd be easy and tempting for us to do, but the risks are just too high.

As for finding the right doctors, I don't know about where you are, here in BC, we do have shortage of family doctors. But even having a very good family doctor in my case, I'd still get second or third opinion when I'm not entirely convinced. We can always go to the walk-in clinic, ask for referral, etc. to achieve this. Usually you should get a pattern of opinions that give you some idea what's really going on. In some cases everyone contradicts each other, that means no one has a clue. Stoicism may be the best medicine.

Edit: One more thing, John, you should discuss with doctors about the risks of surgery while keeping in mind that, all treatments have risks and no treatment also has risks. So the question is a matter of balance of risks only you and your medical experts can decide together. What's more, traditional western doctors are trained as well as professionally required to disclose risks of treatment, but this is not the case in most alternative medicine practice I know. They may not know risks or are unwilling to tell you the risks. Over-claiming the benefits of their treatment is one of the telltale sign of snake oil business.

November 23, 2016 at 02:58 PM · Glad to be of service Jeff.

It's great the info was of some use, Yixi. So were you able to resolve your rotator cuff issues? Was there a single therapeutic modality that stood out, or was it a combination of things, time, rest?

~~~~

I wouldn't call myself an alt-healthcare advocate, per se. I guess I might read up on certain topics out of curiosity, possibly more than the average person, but I do look for evidence based info. I can't look up, or even understand, all the research out there, so like most people, I have to take certain assertions on faith in the person doing the citing. What I've discovered about the general state of medical knowledge and practice I find pretty unsettling. But I'm not out to try and dismantle the 'medical establishment' or anything like that, not that that's even possible. And I'm not trying to defend any viewpoint or convince anyone of anything. Just presenting what I've discovered. I guess I've always had a healthy dose of distrust of authority for authority's sake, and I can't bring myself to assume the expert always knows best. So I go on looking for evidence.

I'm a skeptic of sorts, but not the kind who goes around dismissing everything out of hand, just because it doesn't fit my world view. To doubt by default is not really true skepticism, because to do so implies the doubter already knows what truly is and isn't. That's really just a form of dogmatism. To the Greeks, the essence of skepticism is continual inquiry, not doubt, which should also be the mindset of the true scientist.

My current opinion of Western medicine started in the late 90's after reading a book, the title of which I've forgotten. But it suggested that whereas Western medicine was great for acute injuries, it didn't really understand chronic injury. And while I'd be ready to admit some bias for that conclusion, the evidence I've collected seems to bear this out.

I linked to some ideas about the importance of mindset above, but you can see the logical outcomes of certain mindsets. If you believe there is a 1 to 1 correlation between pain and physical injury, a naive realism, then you will look for signs of physical trauma and fix it, in this case, look for evidence of torn ligaments, cut open the shoulder and sew tears back together, shave away bones that might be impinging said ligaments, close up the surgical wounds, wait and see. If you believe that pain is more complex than that, that you can actually have pain without physical injury, or you can have physical injury without pain (https://www.ncbi.nlm.nih.gov/pubmed/12975193, https://www.ncbi.nlm.nih.gov/pubmed/10471998, cited in this article: http://www.mikereinold.com/can-you-have-a-rotator-cuff-tear-and-no-symptoms/) you'll do everything you can to recover function by other means, without going under the knife.

But even with exercise, massage, mobilization, I found I never recovered full function or completely eliminated pain in my left shoulder while playing violin (everything resolved itself when I didn't play for long periods.) Only changing my playing setup has allowed recovery (even now, with too much playing, some symptoms return, hence the self-maintenance.)

November 23, 2016 at 04:26 PM · It is not just a question of whether you should have the surgery but who should do it. There are surgeons and there are surgeons ! Ask a few GP's : 'Who is the best at this type of surgery ?' You will probably find that one or two names keep cropping up ; then you can make an appointment to discuss this operation with the surgeon himself. This person should be able to give you an honest assessment and the probable chances of successful surgery.

The other thing you have to ask yourself is : what will happen if you do not have the surgery ? Will the problem get worse ?

November 25, 2016 at 07:04 AM · I've had surgery on both shoulders as I had bad rotator cuff tears - too big to not have surgery. I have no idea how that compares to your injury, but i was able to return to playing viola professionally after both surgeries. They both required lengthy recovery periods and lots of physical therapy. In both cases, I took my instrument in and showed the therapist what I needed to be able to do so they could tailor the therapy for my situation. It is good to get more than one opinion. I'm lucky to have a close friend who's a PT. She recommended a surgeon on the basis of having rehabbed his patients and she liked what she saw. Asking around is a great idea. Good luck!

November 27, 2016 at 04:38 PM · Great responses from many members. A comment about my experience with a right arm shoulder surgery.

I have played the violin/viola for 58 years (well enough to play as a union back-stand orchestral professional paying the rent while in college, but never as a soloist or serious chamber musician).

I had an accident weight-lifting where I tore the end of my superspinatus muscle where it attached to the humerus (7mm wide, 7mm deep, in the center section of the attachment point). The muscle was hanging on only by the two much smaller outer strands). Xrays didn’t discover a thing and both my doctor and chiropractor attributed it to arthritis (which DID show up on the Xrays) caused by (then) 57 years of bowing my viola and sprained muscles from the weight-lifting accident. Only an MRI months later at my insistence confirmed that it was a torn muscle.

After the accident, I found it difficult to raise my right arm over my head, and painful to place my right hand behind my back, or even to touch my bottom, making bathroom breaks a much more awkward left-handed cleanup. Playing the violin was reduced to 20-minute periods at most, followed by 30 minutes of rest. As a conductor, not being able to raise my right hand above shoulder level created problems, and I was exhausted after even the shortest rehearsal. Fortunately, there were two other conductors who played in my orchestra, and I was able to turn over 2/3 of the podium duties to them for the next year until my surgery and recovery.

I sought out and found an orthopedic surgeon who also specialized in sports medicine (treating professional athletes with multi-million-dollar careers). He went in, scraped out a small hollow for a corkscrew-auger-looking ceramic anchor, sewed the three ends of the muscle together with three threads, and wrapped the six thread ends around the corkscrew anchor and tied them off. He also scraped off some accumulated arthritic calcium deposits that had been impinging upon some nerves as a bonus while he was in there (the ones that had shown upon the Xrays)

The surgery was amazingly fast (about an hour and a half). There was initial pain (more soreness), eased by pain meds, that dropped to an acceptable level of soreness needing only intermittent medication in about six-to-eight weeks. Several weeks of pre-therapy exercises were followed by several months of intense physical therapy. Because I had been working with a personal trainer prior to my accident, I had the discipline to do the exercises well and to push myself to the limits my therapist would allow. (I always wanted to do more, but my therapist warned that I could do more damage than good by doing too much too soon.) Because of this, my recovery happened in about half the time my doctor thought it would.

One important comment, now, a year and a half after the surgery, there is no pain, no soreness, no reminder that I had the surgery except for the small scar on my shoulder. I can now play as well (or should I say as badly) as I did pre-injury. HOWEVER, the only way to maintain the range of motion and the strength in my right shoulder is to continue doing my shoulder exercises for the rest of my life.

This discussion has been archived and is no longer accepting responses.

Facebook Twitter YouTube Instagram Email

Violinist.com is made possible by...

Shar Music
Shar Music

Yamaha Silent Violin
Yamaha Silent Violin

Pirastro Strings
Pirastro Strings

Dimitri Musafia, Master Maker of Violin and Viola Cases
Dimitri Musafia, Master Maker of Violin and Viola Cases

ArmSymphony AI Violin Competition
ArmSymphony AI Violin Competition

Find a Summer Music Program
Find a Summer Music Program

Violinist.com Business Directory
Violinist.com Business Directory

AVIVA Young Artist Program

Antonio Strad Violin

Bay Fine Strings Violin Shop

Bobelock Cases

Fiddlerman.com

Fiddlershop

Los Angeles Violin Shop

Nazareth Gevorkian Violins

Violin-Strings.com

Metzler Violin Shop

Leatherwood Bespoke Rosin

Warchal

Barenreiter

Johnson String Instrument and Carriage House Violins

Potter Violins

String Masters

Bein & Company

Annapolis Bows & Violins

Laurie's Books

Discover the best of Violinist.com in these collections of editor Laurie Niles' exclusive interviews.

Violinist.com Interviews Volume 1
Violinist.com Interviews Volume 1, with introduction by Hilary Hahn

Violinist.com Interviews Volume 2
Violinist.com Interviews Volume 2, with introduction by Rachel Barton Pine

Subscribe