Achilles versus Rotator cuff

[Jay521]

Backstory...
About 25 years ago, I suffered a complete rupture of my Achilles tendon. It was a long road to recovery. A month ago, I suffered what the ortho called a "massive tear of my rotator cuff" where the tendons separated from the bone. I had surgery 3 weeks ago where the tendons were re-attached to the bone with some sort of synthetic screws. I start PT next week.

Going forward
Obviously, I am bummed - make that borderline depressed - that this has put a stop to any couloir climbs this spring and any sort of difficult (for me) hikes/climbs in the near future. And a very kind user on this site had just taught me how to rappel and had offered to take me to a climbing gym and then this happened. Damn! My reason for posting this is to ask comparison questions as I'm sure I'm not the only one on this site who has suffered both an Achilles rupture and a torn rotator cuff. Those of you that have had both issues - can you compare the recovery of the two? Length of time, ultimate success, any limitations? My Achilles took prob 4 months (although I'm sure rehab techniques have improved in 25 years) and I think I pretty much recovered 100% although my left calf is still a bit smaller than my right. Should I assume that the rotator cuff will take longer? (plus, I am almost 70 and my heal time prob isn't as fast as it used to be). Can I hope to get back to where I was after this?

Final thoughts
Before this, I spent a lot of time on 14ers.com. Now, I will be spending even more as I will be living vicariously through all of you - so please keep posting trip reports, OK?

PS - This was an accident at home and the moral of the story is that one should check all holds at home - not just in the mountains!

[12ersRule]

Hope you get well soon, Jay! Stay vigilant with the rehab!

[Mtnman200]

I don't have any experience with an Achilles tendon rupture. However, eight or nine years ago I had a bike wreck and ended up with torn biceps tendon, which I think is similar to your rotator cuff issue. I remember that simply putting a shirt on was difficult and painful. I asked the doctor about surgery and was told that because I didn't make my living as a baseball pitcher, he would refer me for physical therapy instead.

It took four months of PT before it felt 85-90% healed and another two months of PT until it felt fully healed. I was very dedicated about doing the PT exercises every day, as I had already planned a two-week climbing trip with my sons and didn't want the trip to be compromised by my inability to reach my arm over my head or behind my back.

I'd never done PT before my bike wreck and will admit that I was skeptical, but PT really did work and got me back to where I'd been before the wreck. Good luck, Jay!

[pfiore1]

Sorry to hear about your injury Jay. I've never torn my achilles before but I have torn my bicep tendon clean off the bone a little over a decade ago. It's not a rotator cuff but it was very similar procedure and location. The surgeon reattached the tendon to the bone with a screw similar to yours. My main advice...do not lift anything more than one pound with the injured shoulder before it is healed. About 3-4 days after my surgery I picked up a gallon of milk with my right arm, the same one where the bicep tendon was screwed into the shoulder bone, then snap. Just a few pounds stressed the tendon enough to pull the screw out of the bone and I had a nice ball of a bicep muscle down at my elbow. A secondary surgery drilled a hole through the bone and they passed the tendon through the hole and attached a button-like device to the tendon to prevent it from coming out.

After the second surgery it took at least a 4-6 weeks before I could lift anything heavier than five pounds but still lighter than 20 pounds. It took about another 6-8 weeks before I could lift 40-50 pounds. You'll probably have a little less range of motion with a rotator cuff tendon tear versus my bicep tendon tear, my shoulder still makes popping noises and I cannot sleep on that side. Even after you're healed it may be more difficult for you to raise your arm up high (like reaching for a handhold well above your head or plunging an axe in snow also above your head). Just keep up with the PT 110% and you may be healed well enough for a late couloir season, especially if it's not your dominant arm (but don't listen to me, just your physical therapist, I tend to push things too quickly). However, if this drought keeps up there may not be much of a spring couloir season at all, or at least for long.

You live in Salida, right? Did you get your surgery done there or somewhere else? You may be aware of this, but at HRRMC physical therapy, once you're "officially" done with PT and insurance is done paying for it, you can (or at least used to) pay for a membership, sort of like a gym membership but it's at the HRRMC PT facility. It was like $20 a month and you can continue using all their equipment well after insurance is done paying.

Best of luck, Pat

Edit...interesting timing, after I posted this I just saw MtnMan's post about his torn bicep tendon. Second his advice.

[painless4u2]

Interesting... I've had BOTH shoulders done (RC) with a bicep attachment loss, L4, 5 fusion with titanium, and have an old Achilles tear that has finally become unbearable and going to visit ortho next week for that one. Welcome to the Old Farts Club (I'm 63). So, while I can't compare recovery times for you (yet), I certainly commiserate with you. Rotator cuff repair isn't something you can rush, but 6 weeks after one I went downhill skiing without problems, and about 3 months after the other one I went on a 5 day backpack and summited Mt. Whitney. So, life goes on! Hang in there: pain just means you're still alive.

[TomPierce]

Jay,

I haven't had the exact injury you describe, but have had occasional Achilles issues and mild to moderate chronic RC issues (caused by overzealous weightlifting years ago). I have had, however, two complete simultaneous separations of the bicep tendons (severed tendons), one of which was reattached similar to what you describe, screws into bone. I too am older (over 50), fwiw. Thoughts:

-Every situation is different, consult your doctor, trust nothing you read on the internet, blah, blah...

-That said, the thinking appears to be different than in decades past: I was active far earlier than I thought would be the case. Not pulling a mono doight dyno to surmount a rock overhang , but I was moving the arm far sooner than I expected post-surgery, with medical encouragement. I assumed I'd be bandaged up for a couple of months, not the case. Recovery, then very light movement, etc etc. You might be somewhat active sooner than you think.

-Give the PT a chance, and stick with it. In my younger Immortal Phase of life, I pooh poohed PT: Once I had range of motion and wasn't seeing spots from pain, I was gone. But in hindsight I think I may have shortened the recovery/rebuilding process to the point where subsequent injuries may have been aggravated, e.g. slightly weaker ankles due to multiple sprains that healed so-so. Even if you're hoisting baby weights, my advice is to stick with it, fully recover, and work on range of motion and scar tissue elimination. Boring but necessary.

Sorry to hear of your injury, good luck with the recovery.

-Tom

[Jay521]

To alll - my sincere thanks for your input. To answer a couple questions/concerns - I made the decision even before the surgery to do exactly what my doctor and my PT tell me to do. No more, no less. Everyone seems on the same page that pushing the envelope only causes trouble. I've made a lot of mistakes in my life (understatement) and I am determined not to make that one. I've heard a couple horror stories similar to what you speak of Pat and I don't want to go down that path. Also, I live in Parker but I do love Salida! <smile> I am bracing myself for a longish recovery and hopefully a more or less complete one.

David/Eddie/Pat - thanks for your support and thoughts.

Tom - Geez... And here I thought I had been tough on my body! <smile>

Painless - Yeah - I've been a member of the old farts club for longer than I care to admit, but I guess that's better than the alternative.

[TomPierce]

Tom - Geez... And here I thought I had been tough on my body! <smile>

OMG, those were just a fraction of my injuries. Rock climbing falls, mishaps on ice, skiing accidents, life. I've kept the orthos gainfully employed...

Again, good luck with your recovery, Jay!

[DaveLanders]

I had a completely torn rotator cuff surgically repaired in the fall of 1996. That winter, I was allowed to snowshoe, but I was also told not to fall, so I only did a few very easy trips. By the following summer, I was good to go, and I consider the operation to be a 100% success.

Good luck with your recovery Jay.

[koeffling]

Hi Jay. Sorry to hear about the shoulder! I'm a physical therapist and I see a fair amount of Achilles ruptures, but an even larger amount of rotator cuff tears. They both are no walk in the park but lots of people go back to their previous levels of activity after both. I'm not exactly sure of the nature of your surgical repair (which tendons were repaired, the amount of damage, arthroscopic or open- these things affect recovery times), but for the most part you can expect to be in a sling for 6ish weeks- which means do nothing and let the tissue heal, fail at sleeping, make ice your best friend, and generally be miserable. The next 6 weeks will work on your range of motion and start muscle activation, some protocols will initiate some light strengthening depending on what was repaired. From there it's a gradual progression of strengthening to get you back to where you were, and I do mean gradual. You'll feel better but won't be cleared for throwing those fastballs for 6-8 months. I tell my patients that complete return to full strength can sometimes take a year, but you'll be functioning well much much sooner.

The good news is you can hike on your feet and not on your hands. Like a previous poster said, just don't fall down or lift stuff you shouldn't. Sometimes the impact of hiking can be bothersome for a surgical shoulder but it's good, and recommended, to keep up with your cardio fitness.

I'll look forward to reports of when you can wash your hair again or pick up that gallon of milk... and trip reports, of course. For now, squeeze the heck out of that little ball that comes with the sling. Good luck! You'll do great and be back out there before you know it.

[justiner]

Also PT is an awesome tool and all physical therapists should get christmas cards in the mail for the work they do. Carry on.

[12ersRule]

PTs are awesome. I owe pretty much every technical climb I've ever done to a PT.