dimanche 9 juillet 2017

Life after shoulder surgery

Two whole months, that's all of May and June so far. The first time in my life that I've not climbed for anywhere near that length of time. There's still all of July, August and September as well. Climbing has been my life; it has kept me active and very happy more or less every weekend, every holiday and as often as possible during the week as well, for over 43 years. I don't want to sound negative but it is hard work, waiting patiently for my body to recover after surgery but I'll get there, I'm keeping positive.

What happened?
I heard a loud tearing noise in my shoulder whilst climbing a very steep route at Easter. I knew it was serious, despite much pain, but I was hoping it wouldn't need surgery to fix, alas I was wrong. I saw two excellent shoulder specialists who both recommended surgery. They both confirmed a partial tear in the supra-spinatus tendon (running along the top of the shoulder) and a slap tear in the long biceps tendon. The first injury was caused by a sudden shock load due to my feet cutting loose with my arms in a crucifix position (a very common situation when climbing steep routes), the second was caused by long term wear and tear. Both surgeons said full recovery was expected with a return to climbing again after six months or so. Both injuries are fairly common in climbers.

What did the operation involve?
Dr Nicolas Brassart carried out the operation, which consisted of four parts. Firstly, the tear in the supra-spinatus tendon was repaired, reinforced and reattached to the scapula with Kevlar sutures and two suture anchors. Secondly, the long biceps tendon was cut and reattached lower down the humerous with sutures and two suture anchors. Thirdly, the acromion (a bone at the end of the clavicle at the top of the shoulder joint) was shaved to remove any bone spurs and to prevent further pinching of the tendons in the joint (a process called acromioplasty). Finally, any damaged fibres were removed. The operation involved arthroscopic key-hole surgery, via four small incisions. It took one and a half hours under a general anaesthetic and I was in hospital for three days. I was signed off work for six weeks.

How's the recovery going?
My right arm and shoulder were totally immobilised for eight days and I was on strong pain killers and muscle relaxants for the first five days. After eight days I was able to remove the splint in the house and start doing some gentle pendulum exercises several times a day. However the arm and shoulder needed to be immobilised for sleeping and going outdoors. I started physiotherapy, with a really good sports physio here in our village, four weeks after the surgery, three times a week. Six weeks post op, I was able to stop wearing the splint completely and I can now use a 1 kg mass for the pendulums. I can now drive and do easy stuff around the house. Physio is going well and I'm making steady progress with gradually improving mobility, though it's quite painful at times. Sleeping continues to be uncomfortable.

How long will recovery take?
Physio will continue into September. I have been told not to force my arm for the first three months to allow the shoulder to heal properly. Then it will be a case of re-building the atrophied muscles with specific exercises starting with light resistance. I am hoping to be up for some easy climbing by the October half term holidays.

Footnote (April 2023):
I did actually start some easy training on the board at home in early October. Within a few days I was able to start climbing outdoors on 5s and 6as. By the end of the year I was doing 7a and by the following Easter I returned to doing 8a exactly a year after the accident. I have continued to stretch both shoulders every day and, amazingly in the 6 years since surgery, my shoulder has remained strong and injury free.

I would like to give special thanks to Dr Brassart for carrying out such a good job and for his continued advise and encouragement, and all the staff at Clinique St Jean in Cagnes sur Mer for their help and care. Also, thanks to Patrick Vialli for all his patience and care with my physio.

Finally, I would like to thank all the people who have taken the time to offer me help, advice and encouragement via Facbook. No doubt I will see most of you again at some crag soon.
Thumbs up one hour after the op when Elaine arrived.

A substantial arm splint and moobs (due to muscle relaxants!!!) one day post op. 

A very frayed long biceps tendon (looks like an old climbing rope!).

This shows the Kevlar sutures used to repair the torn tendons.

Not much to see on the outside.

Eight days post op, starting gentle pendulum swings.

Four weeks post op, using a 1 kg mass for the pendulums.