GetUpnGo

I had a total shoulder replacement 25 days ago. Surgeon say 3 months recovery before kayaking and 4 months to load the kayak on the car. I forgot to ask him when I can bike. I bike only on paved roads, nothing rambunctious. Swept-back handlebar (like an old 3-speed) keeps the hand in a neutral position.

Anyone have experience with this? Any concerns besides pressure on the shoulders and falling off?

philbob57

What kind of replacement? I had a full replacement that required cutting the subscapularis muscle. Surgeon wanted no external arm rotation for 6 weeks. He was OK with my riding on the road at 3 months.

cb400bill

Thread moved to 50+ Pills and Ills forum.

GetUpnGo

The lowest rotator cuff tendon and the biceps tendon were cut and reattached to access the joint. Surgeon said the rotator cuff was in good condition. I'm thinking that biking is less demanding than kayaking, for which he said 3 months. I've started light passive external rotation in physical therapy,

OldTryGuy

Monday-Oct. 10, 2016 exactly 3 months from my 66th birthday I had a total right shoulder replacement. Oct. 11, 2016 less than 24 hours from replacement my PT removed the sling, checked the stitches and movement. NO LIFTING but allowed to move gently. Doctor confirmed that I could ride my bike the following day, but do not fall!!!

DID NOT want to ride the bike on Wednesday so I waited until Thursday and went for a short ride. Tuesday-Oct. 18th back to see PT and received some easy arm exercises for movement but nothing that would strain stitching-main concern.

Clermont Horrible Hundred early November and Space Coast Half Marathon the end of November.

GetUpnGo

Umm . . . This defies the imagination. You had permission to bike 3 days after surgery? You wore a sling for one day? Where did you get your surgery?

GetUpnGo

Philbob, I'm guessing the main concern besides falling is the added pressure on the shoulder with mounting and dismounting? I use an upright handlebar so there's less stretching and pressure once seated.

canklecat

I can't imagine a surgeon approving any activity with as much risk of falling as bicycling on the road, in less than a month after total joint replacement surgery. Certainly not for someone over age 50. Spin bike in the gym, or home trainer, sure.

But it varies tremendously from one person to another.

One of my local cycling friends broke her clavicle in a bike crash and was back on the bike in three weeks. But she's only 40 years old and was in exceptionally good physical condition.

My mom's recovery from total shoulder replacement surgery was very slow, but she was in her mid-70s, with osteoporosis and generally poor physical fitness from years of being sedentary. It took her weeks just to recover mentally from the effects of anesthesia and morphine for pain. That was about 7 years ago.

In December my mom's femur snapped spontaneously while walking in her home. For the surgery to repair a fractured femur and old knee replacement, they used a nerve block rather than risking morphine for pain. She was still extremely disoriented for weeks afterward, just from the anesthesia. And her physical therapy didn't include any standing or walking for almost two months. They were so concerned about the osteoporosis they didn't want to risk it.

And that's something to consider. As we age we're more susceptible to the effects of alcohol, opiates for pain and general anesthesia. It can affect our balance, judgment, etc. -- for weeks with some people.

If you feel like your balance is good and you have no history of poor health involving bones, connective tissues and joints, three to four weeks post-op might be okay.

philbob57

The thing my surgeon was most afraid of was a failure of the subscapularis sutures. It sounded like the muscle was cut and then just sewed back together end-to-end. Rotating outward more than 90 degrees put the join at great risk. Sounds like your surgery was different.

Better ask your doc.

OldTryGuy

Actually 2 days after replacement but I waited for day 3. Dr. John Moor, Sarasota, Fl. 10 years Cincinnati Reds ortho and a few patients ....Dr. John T. Moor - Sarasota, FL - Patient Stories

I asked about immediate sling removal and bicycling OK and was told that with his implant approach, the shoulder was securely fastened immediately and as long as I was careful regarding the sutures there would be no issue,

GetUpnGo

Honestly there's something terribly wrong with this picture. What is this magical approach that allows an immediate return to biking?

Reasons why this is impossible to imagine: anesthetic still in system (up to a week), medications in system, bone and prosthesis need time to bond, vulnerable sutures, very restricted range of motion immediately after surgery. etc. What was special about your surgery that none of these were risks?

I hope others reading this aren't tempted to get on a bike 2 days after surgery. My God, I couldn't even blow my nose two days after surgery. When tissues are cut, the repaired tissue can't even hold the weight of your arm (hence the sling), let alone support your weight leaning on the handlebars. One reason for the sling is to hold the arm within 4 or 5 inches of the body, with no external rotation.

OldTryGuy

I am sorry that you can't believe my outcome but it is true and the group I bicycle with can attest to my NON-ISSUE in regards to movement and riding. Sling was removed following day and movement was allowed WITH NO PAIN MEDS NEEDED. NO anesthetic issue AT ALL for that surgery or any other surgery I've had even with the 4.5 hours I was under for my prostate cancer surgery and as mentioned I was informed that the union of bone and implant was as strong (secure) the day after as it would be a year later, plus the method of suturing was NOT a normal closure technique employed by many orthos thus allowing movement that otherwise would not be possible.

canklecat

Yup, the technique OldTryGuy described could indeed facilitate much faster healing with less pain -- same technique used on pro athletes to be minimally invasive and expedite healing.

And he probably had an unusually high baseline foundation of physical conditioning and tolerance for pain. You can't be a serious roadie riding up to 100 miles a day and be pain-intolerant.

Yeah, back on the bike in only two days sounds like it's pushing the luck envelope. But life is short and every day off the bike is one less day to ride.

Very different from my mom's shoulder replacement surgery. She has severe osteoporosis and it was necessary to expose more with an incision to ensure adequate support for the replacement joint. Same with her left knee replacement. Both took weeks of recovery. But mom was coming from a baseline of non-existent physical conditioning. She didn't exercise, ever. She doesn't tolerate pain well. She was uncooperative with physical therapy. And she reacted unusually strongly to the effects of anesthesia and opiates for pain. All of those factors caused her recoveries to drag out for months.

Ditto mom's femur/knee surgery in early December. To minimize the risks they did a nerve block rather than using opiates. It was effective. But she's still in rehab. Probably never will be able to live at home again. She's 79 with severe osteoporosis, almost zero physical conditioning, on an abdominal feeding tube because she still can't swallow without a risk of choking, and worsening dementia that makes it difficult for her to cooperate with more than the most basic level of physical and occupational rehab.

A longtime friend who's now 75 enjoyed rapid recoveries from her knee and hip replacement surgeries. She wasn't up playing tennis again in 2 days. But she was released from inpatient physical rehab in only 2 days because she was recovering so quickly and cooperated with the prescribed physical therapy. She had a good baseline fitness, and puttered a lot rather than just sitting around getting flaccid.

The human body is remarkably adaptable with the right genes and care. And disappointingly fragile in other people.

GetUpnGo

OR: Every day off the bike spent in sensible recovery is one more day to ride. I'm willing to give up a few weeks of biking to have a strong and safe recovery. I wrecked three major joints (so far) by pushing beyond reasonable limits in sports and things like splitting wood and shoveling snow. I sacrificed 15 pain-filled years of my life to those bad decisions fueled by thinking that I always needed to do more---more miles, more weights, more wins.

canklecat

Also true. I lost almost 15 years of full mobility after my neck and back were broken when my car was t-boned by a driver who ran a light. I wasn't able to resume cycling until 2105.

The C2 is still splintered. My neck still hurts after, and sometimes during, every ride. When I stretch my neck and feel and hear that bone-on-bone grinding, I wonder whether I'm being stupid for continuing to ride a conventional bike instead of a recumbent.

A bent is in my future, since I'm not a candidate for surgery -- I can't imagine surgery on a C2 vertebrae.

But then I'll check the weather report, see there's a 22 mph wind out of the west or south, and another opportunity to set a new personal best on a difficult segment. Like today, looking out the window at those wind socks, and thinking about that mile long climb and new PR...

The problem with being 60, after having missed so many years of mobility, is knowing there are only a few years left to reach a peak of performance. After that brief window of opportunity, the body will decline no matter what we do. So every day there's a temptation to ignore the pain and risks and tell myself "I'll deal with the neck thing next year."

Carbonfiberboy 

A doctor friend of mine rode a double a week after breaking his arm. Had the orthopod cast it in drop bar position. Must have stunk pretty badly. I was back on the bike 3 days after meniscus surgery. For some things, active is best. OTOH after a total Achilles rupture, it took me a month to walk normally again, 2 months to do a hard group ride, a year to fully heal.

GetUpnGo

I totally identify with this counting of years, in my case not for peak performance (I know that's over) but simply enjoyment. When you pass 65 you know you might only have 10 more good years, and you don't want to give up a single one of those. It makes you regret all the other "windows of opportunity" that you missed when you didn't realize how precious each one was.

umassgrad

New forum member. Just had my 3 month check-up today for total shoulder replacement. No restrictions moving forward, except try not to fall on right (tsa) side. We even went over how to fall if you can tell it is going to happen.

GetUpnGo

Can you describe your surgery procedure?

What did you learn about how to fall?

Do you also kayak by any chance? If so, what were you told about paddling and loading a kayak on a vehicle?

Thanks!

frogbiscuit

I believe it. Had rotator cuff surgery last summer from a level 2 AC separation and a massive L shaped tear. He said if I was 70 (I am 56) I would be a good candidate for a shoulder replacement, and will probably need both shoulders replaced when I reach that age. It's a relatively new procedure (2004 I think) that is called a reverse shoulder replacement where the socket is in the arm. He said once the pain goes away, there are very little restrictions. Your shoulder movement is somehow transferred to the deltoid muscle. He said he has had very good luck with these procedures, but it is too new to try on anyone as young as me.

Biker395 

OMG ... I'm presuming she had a surgical repair?

canklecat

I don't know. I don't recall seeing her mention any surgery.

I'm looking at shoulder physical therapy at a minimum and probably surgery now. I was hit by a car while riding my bike last week. Shoulder is dislocated and hanging 2-3" below normal. It's been a week and we're still waiting for the incident report and driver's insurance adjuster to respond.

My attorney said he'll find an ortho specialist to accept a referral on a contingency basis. I have no medical insurance so we're relying on a favorable settlement and promise to pay. Should be easy since the driver turned left against heavy traffic and clobbered me while I was already into the intersection heading straight. But the delay and lack of communication from the driver's insurance indicates they plan to slow-walk the process. Not good since delaying medical treatment will only make the process more expensive in the long run.

OldTryGuy

My understanding is the the bolded above is the reason for a reverse not age. Information provided in the following ..... https://orthoinfo.aaos.org/en/treatm...r-replacement/

I was 66 for my total standard replacement in 2016.

Biker395 

^ Holy crap. That must have been terrifying! You're shoulder is disclocated that much and you're not in terrific pain?

I have matching broken collarbones. One fractured in only one place and the other in two places. Both healed by themselves but took a good long time. I think the healing time without surgery is a function of displacement, and recovery with surgery is much more rapid. Shoulder disclocations and separations can be nastier and more difficult to heal.

I hope your attorney gets you the help you need ASAP.

canklecat

Oh, it's plenty painful. Tuesday was the worst, nearly a full week after the collision. In part that was due to regional storms -- sudden barometric pressure changes always give me joint pain and sinus headaches. Usually I'd rank the pain a 6-7 on a scale of 10. The worst pain I've ever experienced have been cluster headaches and trigeminal neuralgia -- those are a 10, far worse than my broken neck and back injuries from a 2001 car wreck, my finger being crushed in a machine several years ago, or the recent shoulder injury. I'd rank Tuesday's midday pain about an 8. I took a muscle relaxer and napped for a few hours. I felt better after the regional storms passed and the barometric pressure normalized.

I have prescription pain meds but take only about 1/3 of the prescribed amount, usually just at bedtime. I get by on ibuprofen the rest of the day. Whenever it's tolerable I'll do some easy stretching and partial range of motion exercises, stopping when something begins to feel crunchy. Fortunately I'd been doing some upper body strengthening for several months. That may have limited the damage somewhat and may help with recovery.

And I'm trying a fairly potent capsaicin roll-on dispenser that may be helping -- the theory is that capsaicin works better with a cumulative effect and that as the skin reacts less to repeated exposure, it works better on adjacent joints. No idea whether this is true, but I have noticed that with repeated applications I no longer have any skin reaction -- no redness, burning or even tingling. According to studies published on the PubMed/NCBI site, capsaicin "defunctionalizes" pain receptors. It certainly seems to be working better than the usual muscle rubs I've tried -- menthol, eucalyptus, salicylic acid, etc. The capsaicin is persistent too -- it's almost impossible to wash off. Even after bathing and scrubbing the skin with various soaps, isopropyl alcohol and peroxide, I could still taste the peppery sensation when I rubbed the shoulder with a wet fingertip and licked the finger.

I can easily reach the front and top of my shoulder where the worst impact occurred, and the pain is relatively less severe there after a week of using the capsaicin. I can just barely reach the bottom of my shoulder blade by twisting my left hand behind my back with the roll-on applicator, but I can't reach the rest of the shoulder blade -- and that's were the worst pain remains.

Just anecdotal stuff, but it sure seems more effective than other topical analgesics I've tried.