Shoulder reconstruction recovery time

edited September 3 in General Discussion
As some of you may have known, I ruptured my labrum (again!) earlier this year. Since it was a second tear in the same place, the only option offered (other than live with it and stop swimming more than a mile at a crack) was an invasive procedure to rearrange a bunch of stuff (biceps tenodesis and reattaching to the humerus, thus eliminating any future potential for another SLAP tear.) After spending a few months reading medical studies on the procedure (failure rates, etc.), I finally agreed to have it done.

But while the surgeon was poking around and cutting things up (he's also a swimmer, so he wasn't going in for shits and giggles,) he discovered my rotator cuff was 80 percent torn. By torn, he meant it had receded back so far that only about 20 percent of the cuff muscles were in place. I had no idea because I never felt problems, but I also did a bucket load of dryland weekly to keep the muscles strong.)

I'm now about four weeks post-op and have just started PT. It's going well, my PTist is solid and I'm letting them push me as hard as possible, even if it hurts like a mother. However, while they know I am a swimmer, they are not. Does anyone know whether I should be doing anything else in addition to the traditional active/passive work?

I've also been told my butterfly days are over and to work with a coach one-on-one to fully revamp my stroke to work in the new configuration (I was always a straight-arm recovery type, and now I must learn to bend my elbows. This should be fun.) My long-term fears now have to do with wondering if I will ever be able to get back up to the distance I was doing (in shape for 6-10 miles with the goal for much more) and, if so, will I ever be able to go longer? Am I going to have to stick to shorter swims (much less than 10K) or is it possible to slowly rebuild and get into marathon distance fitness and form in the coming years?

Anyone with experience or thoughts?
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  • I had a rotator cuff impingement, torn labrum and because of the shoulder instability, while the doctor was doing the surgery he also did a thermal shrinkage. I was in a sling and immobile for 4 weeks and went through about 12 weeks of therapy. It was on my left shoulder and I'm left-handed, so that was fun.

    My doctor is also a swimmer so he was very cautious about when I could start swimming again. I was able to start swimming after the PT and started very slowly.

    This was about 13 years ago and at the time I was still competing in masters meets. Like you, my butterfly days are over (although I never really had butterfly days to begin with). My pool racing days are done and now that I'm focusing on open water swims. I can tell you that I haven't had any problems increasing the distances from competitive swimmer to long distance swimmer and my shoulder has not given me any problems.

    Listen to your doctor and PT's and take it slow when you do get back in the water. Also "listen" to your shoulder and before you know it you'll be back to doing Iong swims.

    Good luck with your recovery and PT.
  • Rosemary,
    There are so many great swimmers on the forum that I hesitate giving advice… so, please place this in the “this is what works for me” category, not the “me giving Rosemary advice” category.

    I was in two car accidents – one at 19 that broke a couple of vertebrae and one in my 30’s that ruined my elbow. (Just for the record, no, they weren’t my fault. I wasn’t even driving for the one at 19. Really.) I have one awful knee as a result of a story I am not willing to share with the forum! And I have shoulder problems – I often lose feeling in the middle two fingers of my left hand for days at a time.

    With all that, pretty much something hurts all the time.

    So, I have stopped even trying to swim properly. In fact, most of the time I intentionally swim improperly. I swim in ways that reduce stress on the pain points. I am not focused on distance per second or distance per stroke. My goal is to swim far. With that in mind, I developed four different freestyle strokes – using each depending on what hurts the most at the time. It took a lot of experimenting and time to create these four strokes.

    For example, when I typically start a long swim, my stroke rate is higher, mid-60’s per minute, for the first hour and a half or so. Then I settle in to a mid-50’s rate. It doesn’t change that dramatically because I get tried. It normally takes me about 6,000m to feel normal – to warm up the shoulders. I intentionally don’t work as hard underwater. For me it isn’t the recovery that hurts my shoulders – it is the digging underwater. I am intentionally letting my hands “slip” through the water and not do the proper catch or push until I am warmed-up. I have trained to swim about the same speed whether I am doing a mid-60’s or mid-50’s stroke rate. (I go fastest in the upper 50’s, when I am getting a decent catch and my rate is a little higher.)

    Again, this isn’t advice. But what works for me is giving up trying to swim properly. Accept swimming improperly. Develop strokes that you can do a long time that don’t hurt as much. It is hard because you really have to “let go” of getting there (wherever there is) quickly.

    Good luck! Swim on. Anthony

    P.S. You say that you are going to stop with your straight arm recovery, but I have learned that a straight arm recovery is less stress on my shoulders than a proper recovery. (It is also better for dealing with chop.) Short (1 min) video:
    I don’t think there is a coach in the world that would tell you to swim like that... but it got me there.
  • Thanks to all for the suggestions and stories. I'm daunted by the concept of having to relearn how to swim (or at least that's how it seems) but I'm also excited with the challenge. I'm also relieved to know that my days of swimming long are not over! I used to be a very strong butterflier and that was always my favorite stroke, so I'm somewhat mourning that loss, but I consider it the price I'm willing to pay to keep swimming long.

    I had spent some time working with a TI coach before surgery and this is the style that my surgeon wants me to follow because it's how he thinks my anatomy (or rather, new anatomy) will work. Another thing I was told will need to change is the level of hip rotation. I have always had a stroke with a substantial level of rotation (probably on the order of 45 degrees) and that is going to have to be reduced by at least half.

    I had another post-op appointment yesterday and things are moving well and my range of motion is far ahead of where most are at this stage. I've been cleared to get in the water today to do certain types of movements and in two weeks I can start doing a highly modified stroke. In fact, he ordered me to get in the pool!
  • Sorry for your situation, Rosemary. But it sounds like you are on a good path to recovery.

    Since you asked for stories and opinions... He's mine (hopefully it will give you some hope and insight):

    5 years ago, I had impingement surgery on my right shoulder. The end of the clavicle was shaved down and the rotator cuff was freed up. Unfortunately, the rotator cuff had been reduced by approx 25%. The surgery was arthroscopic. All went well and I was back in the water in 6 weeks. However, it took 6+ months for me to feel like I had regained my strength and conditioning. Regardless, I was swimming like a champ afterwards and spent the next few years attaining personal goals.

    Now the real story… Last October, I took a nasty fall and broke my right shoulder. Technically, I had a displaced fracture of the glenoid. Less technically, I broke the dickens out of it. In the process, I shredded the labrum and tore the capsule. Luckily, the rotator cuff dodged the bullet. Oh, and between the accident and surgery, the shoulder dislocated three times – not pleasant at all and made a bad situation worse. I also ended up with nerve damage affecting the biceps and forearm.

    Bottom line: I had open surgery to repair the break and tears. Received two screws in the shoulder. Wore one of those immobilizing slings for 9 weeks. Went through three months of regular PT. Got back in the water slowly as my range of motion improved.

    The take-away: I am a few weeks short of my one year accident anniversary. The shoulder is far from “right” and needs a great deal more strengthening. And the nerves are still not quite firing right. But, I am swimming regularly – albeit a bit slower – and am entered in a 5 mile ocean swim in November. It has been a long road, but I am pleased with the results. I trust this gives you a little hope for your swimming future.

    A couple of words of advice for all shoulders-gone-wrong: Just because your dr is/was a swimmer means very little. He/she needs to be an excellent surgeon. Swimmers may understand the unique nature of a swimmer’s shoulder, but that doesn’t mean they can cut, drill, screw or sew well enough to give you the results you need to get back in the water. And, of course, constant PT is important. Also, don’t accept what anyone tells you about your swimming future. I have found that virtually everyone in the dr offices I went to said I suffered a significant break and series of tears and my swimming days were over. F’em!
  • I had my shoulder re-built in late 1996. 5 months later I was one spot out of making a US team for Worlds and Pan Pacs. The key to my success was being very aggressive with my physical therapy. I swam with one arm and fins. The fins kept me from blowing out my other shoulder. I cross-trained by running stadium steps and UCLA Drills on a football field.

    I had intermittent problems with it for about five years until I moved for work and had to curtail my training and racing. A few years of dogging it in a masters workout finally let things heal.

    Good luck.

    Chris

    PS: no more backstroke or paddles. They are the devil when it comes to ripped-up shoulders.
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