crtreedude 

My wife has a request. One reason we are reaching out like this is that we live in the frontier of Costa Rica, near Nicaragua, the air clean, the water is pure, and the doctors are just about non-existent. So, all advice, experience is much appreciated that you can give. Besides, I find getting advice about sports injuries from people who tend to be very active just makes more sense. Of course, I am more than willing to give advice about visiting Costa Rica - we have lived here more than 12 years.

My wife saw an orthopedic surgeon, and an MRI showed a partially torn supraspinatus tendon. He said she may or may not need surgery and to try rehab exercises first. Extreme pain began 7.5 months ago from pulling heavy objects, after repeated injuries over a period of years. There is no sign of frozen shoulder; she's not using a sling and is moving the arm as much as she can without causing a lot of pain (doctor's orders).

We live in a remote part of Costa Rica so it takes a full day and costs a lot of money to get to a good doctor, so dropping in for repeated evaluations is not an option, although this is what the doctor considers ideal. Question: If she goes to see him again 6 months from now and it turns out surgery is needed, is it risky to have postponed surgery for another 6 months? That will mean having the surgery after about a year of trying to rehabilitate the injury.

Thanks all

FBinNY 

I'd love to help you, but the question is unanswerable. Like so many medical issues, the devil is in the details.

If she babies the shoulder a bit, and doesn't do anything catastrophic, odds are that no harm will come from waiting. However there is the risk of further damage and creating an emergency.

FWIW - I'm the master at putting off medical treatment, and find that all my injuries tend to heal themselves if I give them time. The first question I ask, is about the consequences of delaying or passing on treatment entirely.

So, keeping my bias in mind, I suggest you ask the doctor the same question (by telephone)and ask about ways you can monitor and evaluate the progress yourself. Also be sure to ask what negative signs to look for. Then, armed with information, wait and observe. There's a decent chance that time will work for you, and the likely downside of delaying surgery is living with pain longer than she had to.

crtreedude 

Thanks, one thing I think she missed in saying, the Doctor said she may not need surgery. She is very careful not to do anything worse to it - unlike some of us.

BlazingPedals

My wife fell and completely tore a ligament in her shoulder. Then she went for a year and a half, farting around with prescribed PT. When she finally got a good diagnosis, she was still in time to do the surgery. A partial tear usually heals itself, although tendons heal slowly due to limited blood supply.

berner

I once had a very sore shoulder and elbow due to too much tennis. A chiropractor I saw at that time for a separate complaint gave me some exercises and stretches to do. Having suffered with the elbow and shoulder for months, within a matter of days I felt considerable relief. So my inclination would be to try the rehab route before more drastic action. That rehab though need be done just as prescribed or it may not work as well.

JohnDThompson 

Several years ago, I had a grade III acromioclavicular separation; that is, three of the tendons connecting my shoulder to my collarbone were completely torn. The orthopedic surgeon I saw said he could do surgery, but the long-term outcomes don't tend to be any better than just doing physical therapy to strengthen the muscles supporting the shoulder. I opted for the physical therapy, and within a couple months I had full range of motion and no pain. That shoulder is still a little weaker than the other, and there is a prominent lump where the unsupported end of the collarbone sticks up, but it doesn't interfere with doing what I need to do, including riding my bike.

seedsbelize 

Have you done any riding in Nicaragua? When I went through there 12 years ago, it seemed it would be ideal. Great roads and very little traffic. I can't offer any advice on your wife's injury.

crtreedude 

Nope, but yeah, I bet it would be great. Then again, we have great off road here, a huge amount of dirt roads (well, they have river rock thrown on most of them).

One time I was heading up a mountain and looked to the right, and a monkey was keeping up with me - going along the wire of a fence... probably tells you how slow I was going. The look on the monkey's face was priceless, like "and they think I am funny..."

crtreedude 

Thanks everyone, I have passed all your comments on to my wife, she said they were very helpful. Just what she was looking for.