# Subacromial Decompression - Shoulder



## fossyant (17 Feb 2011)

As I've just had this done I'd thought I would share for any others who may need this doing in future.

It's not uncommon for sports folk to get problems with shoulders, and the most common cause for cyclists is, of course, falling off onto your shoulder, or in my case, I was knocked off.

What effectively happens is that the space within your shoulder get's compressed, and due to injury bone spurs form, causing irritation to the soft tissues (muscles/ligaments and tendons) within the shoulder.

The operation generally involves key hole surgery with an arthroscope through two or three small incisions.

The surgeon will generally go in, look for abrasions, tears and bone spurs and 'fix it'.

I my case the surgeon removed a number of spurs and scuffed areas by 'burring' the bone and smoothing it. Whilst in there he also repositioned my coracoacromial ligament (I'll know more tomorrow - but I suspect the crash impact shifted it 'behind' something, rather than being 'infront').

I won't go into the detail about the two plus years it's taken to get it repaired, other than being a stubborn fairly fit 'cyclist' who won't put the bike down doesn't help the diagnosis.

The hospital was rather 'efficient' with the ops - walked down into a preparation ward, a number of us jumped into various beds and we were then wheeled off to various theatres (felt a bit like the 'Avatar' film). Into the anaesthetic room, quick chat, line in and out zzzzzzzzzzzzzzzzz

Woke up in recovery two hours later at about 4pm.

Had three incisions which had been left open as they inject a few litres of fluid into your shoulder during the op - had a messy pillow and a big bandage on. 4-5 hours after the op I was allowed to go home as I had recovered fine. Off came the bandage and on went some 'waterproof dressings'.

One thing you do get is a nerve block, which basically numbs your entire arm - i.e. it's effectively dead. This takes about 24 hours to clear, and you get movement back in your hand first. As the muscles aren't able to hold the joint, it feels like it will dislocate if you move it.

First night home was a bit rough as you aren't sure what to do with this dead arm. Felt OK 24 hours later, but was knackered and in a bit of pain so was in bed by 6.30pm. 

Day 2 (today) felt much better and movement started coming back to my shoulder - still feels a little loose (i.e. like it will dislocate). Pain is much reduced, and as the hours have gone on, the shoulder has loosened up.

Anyway, here is a photo of the wounds 48 hours after - pretty neat 'eh.


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## MacB (17 Feb 2011)

That does look like neat work, glad you're on the mend


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## Angelfishsolo (18 Feb 2011)

I second that!


MacB said:


> That does look like neat work, glad you're on the mend


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## magnatom (18 Feb 2011)

Aye, good to know it has gone well so far. Fingers crossed the op does the job!


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## dan_bo (18 Feb 2011)

Right Foz, how's about doing the whole Mary Townely loop this sunday then?

No? 

Oh.


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## Crackle (18 Feb 2011)

Very neat job that Fossy, hope it heals well.


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## fossyant (18 Feb 2011)

Balls - just seen the physio for post op check up. Can't ride on road for 6 weeks due to the vibration. 

Can go on the turbo so long as I don't hold the bars with my bad arm (Mrs F not happy).

Won't get another physio appointment for 6 weeks - that's how long my consultant leaves it.

Have 2 weeks sick note, and possible extension by having a chat with my GP 

6 weeks no riding. OMG


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## citybabe (19 Feb 2011)

I had an operation for carpal tunnel decompression in the middle of january and 6 weeks on I'm still struggling to go far on my bike. Pressure on my hand from leaning on the handlebars is still too painful

I have total sympathy for you not being able to get out for 6 weeks 'cos I hate not being able to ride


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## gb155 (19 Feb 2011)

6 weeks



?


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## spence (21 Feb 2011)

Had the same operation a few years back, only recall being off the bike for about 3 weeks, although only on the flat stuff. Have some rather interesting internal photos somewher. Was good to be able to raise my arm again.

Hope the recovery goes well.


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## fossyant (21 Feb 2011)

6 weeks was the physio's recommendation based upon my Consultant - the 'other' Consultant gets you up an running a bit earlier, both guys do things a bit different. Apparently my consultant is very particular about details. 

I'm sure I could physically get back on the bike on the road any time, but the physio said the 'vibration' won't help the bones heal.

I have to follow the rules as there is litigation involved though, so me doing stuff too early could cause issues with my PI claim.

I stopped my painkillers yesterday, arm is sore as you'd expect, but not bad enough for pain relief. Movement is coming back well, the only thing I'm not allowed to do is extend the arm out and up from the side - I can only go out forwards/backwards and up, not out to the side yet (it's also very painful if I do try that).

Glad to ditch the codeine as that doesn't half bung you up


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## SlowerThanASluggishSloth (21 Feb 2011)

Best wishes for a very speedy recovery.

In the meantime, what are you going to do with all of the time you'd rather be cycling? Opportunity to accumulate brownie points?


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## fossyant (2 Mar 2011)

Wounds healing up nicely. Just been for first physio session and my movement is fine. Got some exercises to do with a BIG elastic band, and also some with dumbells (no excessive weight though).

Most importantly I can ride, but not to push it. Allowed on the MTB at first, on road, as the big tyres will absorb the road shock. If that's OK, then try a bit further, then can get back on road bike. Expects me to be fit within 6 weeks. Doesn't want me falling off onto the shoulder, so no riding in rush hour - good job I'm off for another two and a half weeks then  - plenty of opportunity to build up miles again. Can then commute on the MTB on the Trans Pennine Trail until I'm 100%. No messing with traffic.


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## ColinJ (2 Mar 2011)

SlowerThanASluggishSloth said:


> Best wishes for a very speedy recovery.


I second that!



SlowerThanASluggishSloth said:


> In the meantime, what are you going to do with all of the time you'd rather be cycling?


If I had an upper body injury but my legs were okay, I'd go out and do some brisk hill walking.


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## fossyant (2 Mar 2011)

8.3 miles, MTB, 600ft climbing, 35 mins ride. Great views over Manchester from Werneth Low (in the dark).


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## magnatom (3 Mar 2011)

fossyant said:


> 8.3 miles, MTB, 600ft climbing, 35 mins ride. Great views over Manchester from Werneth Low (in the dark).



Excellent news. Any twinges, or is it feeling ok?


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## fossyant (3 Mar 2011)

Bit weak, but nothing to bad - risked 10 miles on the road bike today - 90 PSI up front. Was fine, but I can't get out of the saddle at all (arm isn't strong enough), so it's climbing sat down, and no honking it from the traffic lights. That said, did the 10 miles with 600ft of climbing at 18.5 mph.

Fairly pleased at progress.


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## Evan (4 Jul 2013)

Hi fossyant,

Do you mind me asking you how your shoulder is now? Having lived with shoulder pain for years following a fall, I am now due to go in for the same procedure at the end of this month. Although my MRI shows no signs of bony spurs on the acromion, my guy (who is apparently the top shoulder surgeon in the country) is convinced that this procedure is what's needed.

- How long was the initial recovery phase?
- Was there anything (day-to-day stuff) that you were prevented from doing during this phase?
- Are you fully pain-free now?
- Less revelant, but how much did the procedure cost? I am presuming my insurer will cover it, but would like to know its affordability should this not be the case.

Many thanks


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## fossyant (5 Jul 2013)

Just seen this.

Shoulder is 100% now.

I'm 2 years post op. I'd say a good 6 months before the pain is right down, and 12 months before it's gone. I had added complications that meant I needed trigger point injections on my left side, two in my back and two in my trapezius in Feb 2012. This was not as a result of surgery, but on-going issues from the original incident. Basically the muscles on my left were very tight and wouldn't relax. The injections did sort it, and by May 2012 I was back to 95%

I was back riding within 2 weeks of the operation, back commuting daily on the bike by 7 weeks but the shoulder wasn't strong, so no honking the bike. By 6 months it was OK, still a bit painful on the bike, but by early 2012 and certainly after the injections, it was brill.

I'd recommend having it done, but it does take 12-18 months before you are pain free. Mecahnically my shoulder was click and crunch free from the day after the surgery.

Initial recovery was about 6 weeks. Off work for 5. Could cycle every day by week 7. Even managed a hilly 40 miles in my 4th week !

Day to day after surgery - getting dressed was 'interesting' - didn't have much movement in the shoulder without quite alot of pain to start with, so had to re-learn getting dressed. You'll endup laughing in pain some times. Movement was a bit limited at first, but it's important you keep moving the shoulder and don't rest it. After the operation, your arm will be completely dead - they give you a nerve block. You must leave your sling on until you can move your arm - about 24 hours till it wears off. Your fingers are the first to start moving. It was very weird having this dead limb and trying to get dressed. 

*As for cost, our wonderful NHS did it*. Had an excellent surgeon at Stepping Hill, Mr Clive Warren-Smith. The surgery costs about £5k-6k I think.

My repaired shoulder is mechanically 'smoother' than my other one now. Oh and the three scars are not visible now, they take time to fade, but I can't find them.

Worth having done, long term shoulder pain, and lack of sleep isn't funny.


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## ColinJ (5 Jul 2013)

That's great news! 

I damaged something in one shoulder a few years back doing something really trivial - trying to reach behind me in the dark to turn my alarm clock off! 

It was so bloody painful that I couldn't get my arm over my guitar comfortably for more than a year, and I struggled to even put a shirt on. I didn't seek help though. It took ages for the pain to go away, and this thread has just reminded me that the shoulder feels almost 100% again. I think it would flare up if I did anything to strenuous with it like lifting heavy weights, but everyday activities are fine.

Funny things, shoulders! They are such complicated parts of the body that it is amazing that they normally work as well as they do, so it isn't surprising that now and then they can cause a lot of problems.


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## fossyant (7 Jul 2013)

Quite right there. Complex joints that can take time to heal. Thank goodness we don't play rugby, that's really bad for shoulders. 

Shoulder injuries are common in cyclists as well, but nowt like rugby.


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## vickster (7 Jul 2013)

Knees are a pain in the rear too!


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## ColinJ (26 Jul 2013)

ColinJ said:


> That's great news!
> 
> I damaged something in one shoulder a few years back doing something really trivial - trying to reach behind me in the dark to turn my alarm clock off!
> 
> ...


3 weeks. Just 3 damn weeks after I posted that, I've only gone and buggered a shoulder again! 

I thought I'd triggered the same shoulder, but then I realised that it must have been the right one last time because that is the arm I put over the guitar. This time it is the left one.

I know what has caused it - same kind of thing as last time - an unnatural sideways movement of the forearm. In this case, reaching behind me and pulling out the large cushion that I prop myself up on when using my Galaxy Tab in bed, then tossing the cushion to one side. I did it a few nights on the trot and ignored the twinges, then did it one more time and it hurt a lot!

I can still use the arm, but the shoulder ached a lot when I got back from a 19 mile ride this afternoon.

Funny things, shoulders ... *NOT*!


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## The Jogger (27 Jul 2013)

I still haven't went to the doctor about mine. I put both mine out in january doing push ups. I can't raise arms above my head, difficult putting on a jacket or ruck and can't sleep on my side, I don't think they can do much for it, time will probably sort mine out.


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## just jim (27 Jul 2013)

Evan- have you tried seeing an osteopath or physiotherapist before considering surgery? I have had a combination of treatments since last October (mtb crash) and I'm now feeling more mended, though some way to go.


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## DooDah (27 Jul 2013)

> Knees are a pain in the rear too!


 
Yes, I guess a knee in the rear would be painful


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