Rotator Cuff Tear

February 25, 2006 at 05:51 AM · I just putting this out there to see if anyone else is experiencing something similar.

About 3 years ago, I took a fall down a hill, and in the process tore my right rotator cuff. It took a long time for it to "heal" to the point where I could use the arm somewhat normally.

I started playing about a year and a half ago (when the shoulder was behaving) and things were progressing.

Last month, while doing some light exercise, I got careless and reinjured it.

I am still practicing, but my technique (such as it is at this juncture) is being adversely affected.

I am considering arthroscopic surgery to repair the damage. Is there anyone else out there who has had experience with this? I want to get an idea of how effective the procedure is in general. I know that i would obviously have to consult my orthopedist, but any opinions I cold glean from here would be of help.

Replies (17)

February 25, 2006 at 04:21 PM · Hi, Robert:

I had surgery on my left elbow about 3 years ago due to severe tendonitis. It got to a point where I actually couldn't lift my arm. They told me they thought it was from all those years of playing the violin. That was speculative. But in any case, the arm has been just fine ever since. I also had a hip replacement last year after suffering with hip osteoarthritis for 25 years. The recovery is slow but excellent, and has involved lots of physical therapy.

My wife, Christine, this year celebrates her 21st year as a Paramedic with the Chicago Fire Department. They do lots and lots and lots of lifting. Several year ago she tore her rotator cuff on the job, and had surgery, which was an unqualified success.

From the vantage point of our experience, I would say that in any given situation there is an optimal time to consider surgery. You don't want to do it before you have exhausted other reasonable courses of action. On the other hand, if you wait too long, you could do all kinds of ancillary damage and could screw up your posture and the surrounding muscles and who knows what else.

I would definitely discuss it with a doctor, and maybe get more than one opinion. If surgery is right, it can really be the best thing to do.

Good luck in wrestling with this. It ain't easy to decide.

Cordially, Sandy

February 25, 2006 at 10:35 PM · Greeetings,

no no and no. The shoudler is the one palce you do not want to go. The resulats are fairly consistently crap, its dangerous and the only people selling it have a vested interest.

Start with a book called 'The Athletic Musician" by Barabara Paull.

Cheers,

Buri

February 26, 2006 at 02:34 PM · Yes, I said IF surgery is right. Weigh it very, very carefully, indeed.

Sandy

February 26, 2006 at 11:28 PM · Greetings,

just to clarify, I wasn`t suggesting Sander had a vested in terest or was pushing anything in a less than compeltely rational manner.

Cheers,

Buri

February 27, 2006 at 12:54 AM · Thanks, Buri. I appreciate the comment. You're the first person who's called me "rational" all month.

Cordially, Sandy

February 27, 2006 at 01:23 AM · Greetings,

of course, we don`t know if it is just a Buri misspelt obscenity,

Cheers,

Burp

February 27, 2006 at 01:29 AM · That reminds me - I've always wondered what were the nicknames of famous violinists:

Heifetz - Yash?

Ysaye - Gene?

Paganini - Nick?

Sarasate - Pabs?

Elman - Mischi? (when he was a child, Mischella?)

Locatelli - Pia?

Corelli - Archy?

Ricci - Ruggi?

Cordially, Sandy

February 27, 2006 at 03:45 PM · While I agree with Buri that the shoulder is no place to play around surgically, I also have to consider the future. For example, I was painting this weekend, and my should was screaming at me after I finished one wall. This was despite taking one Alleve in the morning before starting. It's limiting my ability to do even necessary things.

I will weigh all the options however. I have tried cortisone shots and, get this, I'm actually allergic to them! I've had 3 so far, and 24 hours after each one I've broken out in a rash about my face and neck which took 2 weeks to subside.

I value your opinions, and will take everything that's beign offered here into careful consideration.

Thanks ,

Rob

February 27, 2006 at 04:25 PM · Rob: I wouldn't rule out surgery completely at all, but you indeed should consider it very, very carefully. Also, where are you located? You want to make sure that you find the best doctors. If they're not in your area, go where they are. I know that here in Chicago there are some fabulous professionals who have enormous experience with this kind of problem. I assume that where you are you can find similar pros.

Anyway, good luck. Yes, I know that when I had my tendonitis, I literally could not lift a pencil until I had the surgery, and that was after a year or two of physical therapy and everything else I could think of. It's been great ever since. My wife's rotator cuff surgery, also, was a great success, and she has had virtually no problems since. She still can't lift exactly the same weights, but she's getting there. Of course, she doesn't play the violin, but as a Paramedic she has to lift people on stretchers.

Cordially, Sandy

February 27, 2006 at 05:43 PM · Give it a real good rest if you can.Operations don't always help but rest does. We are all too impatient

February 27, 2006 at 06:56 PM · I live in New York, so I have access to probably some of the best specialist around, so that's not a problem. As for rest, I've been resting it for the better part of a year and a half. It was feeling fine, until one day not long ago I reached out suddenly to grab something that was falling and wham! Back to "square one".

Believe me, it's not something I'm anxious to rush into, but if the odds are good that it will help, I need to look at it as an option.

I'm not looking to throw 90-mph fastballs, but I would love to be able to pick up the bow and not have to worry about painful string changes.

Rob

February 27, 2006 at 10:58 PM · Greetings,

aside from being painful cortisone shots also mask what we are doing , making the problem harder to address. They also through the bodies chemsirtry out of whack making healing more difficult in the long run.

Violnist in generla are at serious risk from these kind of injuries for one simple reason: however good your posture an dtehcnique etc is, the nature of what we do unbalances the body by overdeveloping the front pulling the rotator cuff area badly out of sync. To compensate there are some very basic and easy exercises for building upo the tiny muscies in the shoulder blade region that are the key to this kind of problem. The book I mention explains this in detail.

I know about half a dozen violnists who had the surgery. They all regretted not trying other options.

Its somethign you learn to live with . Doing jobs that require raisng the arm high are one of the things one learns to avoid like the plague. Anyway, I hope you find some relive from this misreable problem.

Cheers,

Buri

February 28, 2006 at 05:01 PM · I wonder though if i'm doing more harm than good )as far as technique is concerned) by bowing with my right elbow closer to my side than it should be? I've tried that, and it's certainly less bothersome, but my tone suffers, so it's not looking like a viable option.

March 1, 2006 at 12:59 AM · Greetings,

saw Perlman doing that a couple of weeks back. he really had to rotate the fiddle downwards to play on the g string. On that particular ocassion I would say his sound had gone.He almost appeared mortal.Heifetz had an operation that forced him to lower things somewhat. Szeryng was very verbose on how unnecessary he thought it was.It can be done.

Got a couple of questions for you

1) Are you including dietary changes of any kind in your healing regime?

2) Are you doing exercises that help you get back into a better position and then some isometric kinds of exercise for those small muscles that are probably completely stuffed?

supriwhatsits face? There is some really good and safe stuff in the `Violinist as Athlete book . lots of tensing and relaxing using rubber tubing. Incidentally , alot of weight trainign exercises are a complete no-no. I assume you are not working out to get though the problem?;).`

3) Cryotherapy may be an option for pain control.

Cheers,

Buri

March 1, 2006 at 01:16 PM · Thanks Buri :)

I was doing moderate weight training for the shoulders, very light, no more than 15 lbs each arm for overhead presses. Almost impossible to do chest presses with any kind of weight, that's where I really feel it. Since I reinjured the shoulder I stopped working out, which is a bad thing too. Before I practice however, I do some stretching, slowly going through the range of motion as much as possible to loosen things up a bit (I think they're called supraspinatus?, I could be wrong).

Practiced last night, started out ok, then about 30 minutes into it the shoulder got my attention again. I stopped, did some more loosening, and that helped a bit.

As for diet, I take vitamins, and cut down on the junk in my diet, which I needed to do anyway.

All of this may or may not help, but I'm at least fortunate in that I have wealth of resources and opinions here to tap into.

thanks again

Rob

March 3, 2006 at 07:03 PM · Dear Buri,

Thank you very kindly for taking the time to provide me with a wealth of=

information that will keep me busy for some time. At the same time I a=

m distressed to learn of all that you have been going through, and hope =

that the paths you choose to help you fight these battles will continue =

to meet with success and improved health.

I have read the article from the ACSM, and it's detailed explanation of =

the complex mechanism of the shoulder has given me a better understandin=

g of my problems. As a guitarist, this would hardly have been an issue f=

or me. But, as noted, the violin makes some unnatural demands on human p=

hysiology and kinesiology, and there appears to be no such thing as a "m=

inor" injury where playing is concerned.

As for diet, what you say is very true: eating properly is the key.

I plan to further investigate a good many of the ideas you've put forth =

here. Chances are I may just hit on something that will help. =

In the meantime, I keep playing :)

Most gratefully yours,

Rob

(PS.. I tried to reply to your email, but it was returned)

March 3, 2006 at 09:01 PM · sorry,

brivati@gw7.u-netsurf.ne.jp

PS If you sendme your address i will post you some pages from the book I keep harping on about

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