Shoulder surgery
General Topic
Contributors to this thread:
N-idaho 06-Feb-20
grossklw 06-Feb-20
N-idaho 06-Feb-20
glidingindian 06-Feb-20
N-idaho 07-Feb-20
Shawn 07-Feb-20
PTArcher 07-Feb-20
Shuteye 07-Feb-20
JohnMC 07-Feb-20
N-idaho 07-Feb-20
c5ken 08-Feb-20
creed 08-Feb-20
crooked arrow 08-Feb-20
creed 08-Feb-20
Shawn 08-Feb-20
N-idaho 08-Feb-20
glidingindian 10-Feb-20
LKH 11-Feb-20
c5ken 11-Feb-20
EMB 11-Feb-20
PTArcher 11-Feb-20
LKH 11-Feb-20
c5ken 12-Feb-20
Scoot 12-Feb-20
PTArcher 12-Feb-20
Scoot 12-Feb-20
c5ken 12-Feb-20
glidingindian 17-Feb-20
Shawn 18-Feb-20
Shawn 18-Feb-20
c5ken 18-Feb-20
AZ~Rich 18-Feb-20
BIGERN 18-Feb-20
N-idaho 18-Feb-20
c5ken 18-Feb-20
PTArcher 18-Feb-20
Rupe 18-Feb-20
Shawn 19-Feb-20
PTArcher 19-Feb-20
c5ken 19-Feb-20
From: N-idaho
06-Feb-20
I have not been able to shoot my bows since last February when I injured my shoulder. It was a minor injury that led to adhesive capilitis ( frozen shoulder ). I am having manual manipulation to resolve mobility issues. Has anyone had this done and after could they shoot there bow again. This was the first archery season I have missed in 25 years it killed me.

From: grossklw
06-Feb-20
You’re going to wake up from that manipulation incredibly sore. The fact it began last February is positive as the disease process will generally mostly resolve within 12-18 months, the manipulation should help you regain some motion in the short term.

You should be able to shoot again this fall. I’ve rehabbed plenty of Adhesive Capsulitis, it’s not really a no pain no gain type rehab. If you’re stretching to the point of severe pain it can cause increased inflammation and actually cause that cuff to lock down even worse. I generally tell patients push to a 4/10 pain level and we will get there eventually. Get a solid PT that understands your goals post manip and the elk should be in trouble this fall!

From: N-idaho
06-Feb-20
That’s encouraging news thanks

06-Feb-20
Grossklw is correct in that with no treatment most cases of adhesive capsulitis will improve to 85-90% within 2 years with no treatment. If your restricted motion is severe and has been there for months you might ask your Orthopaedic surgeon about arthroscopic capsular release. The response to manipulation or capsular release is very variable from patient to patient. No matter the technique used a skilled physical therapist and your commitment to improve are even bigger factors. Also agree that if all goes well and no complications or additional pathology you should be able to hunt elk in Sept. if you tag out you should post your story and pics here as encouragement to others. I also missed two seasons in 30 years due to surgery on both shoulders , and I was a shoulder surgeon during this time. Makes you incredibly grateful when you get it back! Good luck and let us hear back from you

From: N-idaho
07-Feb-20
I will post this summer when I’m back to shooting and hopefully this fall with a elk. thanks

From: Shawn
07-Feb-20
Go get it freed up by an orthopedic surgeon. You will be up and shooting way quicker than it healing on its own!! Oh that's if it ever does heal on its own!! Shawn

From: PTArcher
07-Feb-20
x2 Grossklw!! Shawn, that's what he is doing. N-Idaho: PT is no fun, but should be tolerable. Consistency with your program is the key. Trust your PT and orthopod. You'll be back at it in no time.

From: Shuteye
07-Feb-20
You will make the right decision. I wish I had gone to a doctor when I wrecked my motorcycle when I was 25 years old. My left shoulder was hanging way down and I picked up my arm and manged to get it to pop back in the socket. When You are that young you think you are bullet proof. I didn't go to a doctor and it hurt like heck for a long time. That night I took my now wife on our first date. It has never popped out again but has caused pain during some things like drawing a bow. I haven't been able to draw my bow for several years and had to go to a crossbow. Good luck with your recovery and I bet you will be fine in the future.

From: JohnMC
07-Feb-20
After breaking my shoulder about 4 years ago I had frozen shoulder and after months of PT could not get back range of motion. I could only raise arm barely above parallel to the ground. I had a manipulation under anesthesia. When I woke up I had almost all of my range of motion back. They say you need to do the PT to not lose it the range. I believe I went to PT every day for a week after it. I then what ever they told me after that. 4 years later my shoulder is not perfect but have keep range of motion. I could still shoot my bow before and I think I was shooting a day or two after having it done. Shoot me a PM if you want any more info. Good luck and I was nervous about doing but very glad I did.

From: N-idaho
07-Feb-20
I’m am nervous about it but i can’t stand another year or for ever like this I will let you know how it goes..it is scheduled for the 18 of feb the day after my hound season is done ??

From: c5ken
08-Feb-20
Had my right shoulder replaced (total reverse replacement) 13 months ago. Still painfull & weak. I just started to pull a 50lb bow. Can pull bow about 10 times in a row max. However, I'm old... maybe younger guys will recover faster..

Good Luck

From: creed
08-Feb-20
c5ken, so you are drawing a bow with a reverse? I am looking at one somewhere down the road. I have been told that with a reverse drawing back a bow is something that I will never do again. So far I have been getting A2M/PRP injections and it has been holding off the replacement but I will eventually need one.

08-Feb-20
Creed I would suggest that you get a second opinion on having to get a reverse replacement, I had one surgeon tell me my shoulder was so messed up that he would only be able to do a reverse surgery. I got a second opinion from another surgeon and the one I chose to do the surgery who said he could do a regular replacement and that I would be able to start shooting my bow in 6 or 7 months at lower weight. So far I am 2 months in and therapy is going great and am ahead of normal recovery. Good luck

From: creed
08-Feb-20
Unfortunately I have had 3 different doctors tell me I would need a reverse. I have massive irreparable tears in both the supraspinatus and infraspinatus.

From: Shawn
08-Feb-20
I was nervous too as I had a total shoulder replacement April 2019. I heal unusually quick and after 12 weeks I was shooting 60#s again. Like most surgeries having the best surgeon perform the surgery makes all the difference. Shawn

From: N-idaho
08-Feb-20
Shoulder injuries are no fun. Very humbling experience

10-Feb-20
Grossklw is correct in that with no treatment most cases of adhesive capsulitis will improve to 85-90% within 2 years with no treatment. If your restricted motion is severe and has been there for months you might ask your Orthopaedic surgeon about arthroscopic capsular release. The response to manipulation or capsular release is very variable from patient to patient. No matter the technique used a skilled physical therapist and your commitment to improve are even bigger factors. Also agree that if all goes well and no complications or additional pathology you should be able to hunt elk in Sept. if you tag out you should post your story and pics here as encouragement to others. I also missed two seasons in 30 years due to surgery on both shoulders , and I was a shoulder surgeon during this time. Makes you incredibly grateful when you get it back! Good luck and let us hear back from you

From: LKH
11-Feb-20
This is for those who are in great shape. Do the shoulder therapy exercises now. I've had both shoulders (bone spur removal), and the left a failed slap tear repair which ended with them doing a bicep tedonisis (cut the bicep tendon off and screwed it into the head of my humerus). I now have a partial tear of my right rotator cuff and some other damage.

I go to the gym 3 days a week and start every session with the shoulder exercises. I have great range of motion and excellent strength for a 72 year old. I credit it to doing the exercises all these years in spite of a fair amount of discomfort.

From: c5ken
11-Feb-20
Yep, Had a total shoulder replacement (reverse) 13 months ago. Recovery has been terrible. Lots of pain & weakness. After extended PT sessions & numerous trips back to the surgeon, I'm told all looks good. However, pain & weakness continues. I sold my 70# Halon 32/6 and backed my 60# Mathews chill down to 50lbs. However, the DL got so long I was unable to shoot it. I recently purchased a 40-50 Traverse & I'm able to shoot the bow at 48lbs 10 to 12 times. Still very painful & at times I have to go through contortions to draw the bow. I see comments from younger guys that had the same surgery as me, experienced a very fast recovery & none of the problems I'm having. I really don't want to go to a xbow but maybe it's inevitable..

From: EMB
11-Feb-20
N-Idaho. Hang in there. Just a little encouragement from someone who's been there.

A little over 3 years ago I broke the proximal head of right humerus diagonally, in half, across the ball. They put it together with screws and a metal plate. 3 months non-weight bearing and only passive therapy. April 1, 2017 was my first day back in the gym.

Fast forward almost 3 years. It's taken me that long to get really really close to full range of motion in my shoulder. To get there I do/did my own self imposed daily rehabilitation program. I stretched and went to the gym daily. Most upper body exercises incidentally work the shoulders, but I only did one specific shoulder work out per week. Since I can now move my shoulder, I'm working on regaining strength.

For archery I use/used a bow exerciser from Saunders Archery. Lancaster sells them. Mine has about 5 lbs attached to it. I started trying to shoot about 6-7 months after the accident. I started with 2 arrows a session and went up from there. I turned the bow down as low as I could and went up as I could handle the weight.

I basically went OCD on my rehabilitation and refused to accept anything less than 100% recovery. Even though my first year (2017) hunting attempts were pretty poor (in hindsight), I was happy I was out there enjoying the hunt.

Don't ever give up on yourself. You'll get there.

From: PTArcher
11-Feb-20
c5ken, Sorry you have struggled in recovering from your reverse shoulder replacement. I have rehabbed literally hundreds of these in my career (Board Certified Orthopedic PT). For the most part, they are designed to give you the opportunity to be able to raise your arm up above your head after your rotator cuff has been injured beyond repair. It is my opinion that your are pushing the limits of the prosthetic device by trying to continue shooting a bow. I never say never to anyone, but if the reverse fails, the consequences are dire. As much as I would hate to do it, I would switch to a crossbow or rifle/muzzy hunting if it were me. Certainly, you will make the decision you feel best about, just sayin.....

From: LKH
11-Feb-20
c5ken. Agree with the above. Friend who works out at the same rehab as me had that done and was told 25# was the max he should lift using that arm. Forever!!

From: c5ken
12-Feb-20
To: PTArcher & LKH, Thank you guys for the info. Although I hate to admit it, my days of shooting a bow may be over. As stated above, I'm an old guy who has shot archery for over 50 years. I guess nothing lasts forever.... I purchased a xbow about a year ago & had to hunt with it this past season. Although it gave me the opportunity to continue to hunt the archery season, it's not something I want to continue to do. However, it may be a xbow on nothing. Prior to destroying my right shoulder, I typically was shooting a 70+ lb bow, this, I'm sure was the reason my shoulder had to be replaced. Thanks again for your comments...

From: Scoot
12-Feb-20
Question for PTArcher & LKH regarding c5ken, could he simply switch handedness (e.g., from right handed ti 3 left handed) of his bow? I would think that might be a reasonable option for him?

From: PTArcher
12-Feb-20
Scoot, Shooting left-handed would likely be less painful for him due to less muscular effort in the bow arm v. pulling, but the risk of damage to the shoulder is not eliminated. The primary function of the rotator cuff is to provide stability to the shoulder joint. Those without a functioning rotator cuff, i.e. all those with reverse shoulder replacements, lack the stability of a normal shoulder. Without adequate stability in the bow arm, not only will it be more difficult to stabilize the bow, but the compressive and shear forces across the prosthetic components can potentially lead to breakdown of their fixation. The biggest issue I have with this is that the reverse shoulder is essentially a salvage procedure designed to make the best out of a bad situation. If you mess it up, perhaps it could be re-done, but you are more likely to be left with deficits that will not only effect your archery, but also daily life activities. To me, the potential risks outweigh the benefit. Perhaps as an orthopedic surgeon, glidingindian may weigh in as well.

From: Scoot
12-Feb-20
Gotcha- that makes sense. Good response and info, PT. Thanks!

From: c5ken
12-Feb-20
PTArcher, I appreciate your professional comments regarding my shoulder situation. I brought this situation up to my surgeon telling him I'm into archery & I'm working out with deltoid strengthening exercises, including shooting my bow set between 48 & 50lbs. . Never did he tell me I could damage the prosthesis causing long term permanent damage. Although archery has been my only hobby over the past 50 years, its no longer worth the possibility of causing additional shoulder problems. Looks like xbows are for me in the future...

17-Feb-20
PTArcher gives an excellent summary above. Obviously he is very experienced and being an archer really makes a difference . Reverse shoulder replacement is indeed a salvage procedure often due to arthritis with deficient rotator cuff tendons . It is totally different from a total or partial shoulder replacement, internal fixation due to fracture, slap repairs , rotator cuff repairs , biceps tendon re attachment ( tenodesis) etc Also, each individual has different quality bone, stability and other issues making each case unique. . If I had a reverse shoulder replacement I would reluctantly go to an Xbow if my draw arm or drop way down on poundage and try to draw a compound if my surgeon would allow. I too am afraid I am getting near the end of my bow hunting career at age 64 and 4 shoulder surgeries total. It bothers me a lot to think about. Good luck and be sure to tell your surgeon and PT how much you love bow hunting, might change their approach to you!

From: Shawn
18-Feb-20
My surgeon is a bowhunter. He is also one of the best in the country at total shoulder replacements. He told me if I had a reverse replacement on my bow arm shoulder than the days of shooting right handed were over. My bow arm is my left. He said going to lefty would work but to only shoot 40#s or so and only shoot to sight in and hunt. In other words not a lot of reps. PTarcher gives very sound advice. I heard the horror stories but was assured with my solid bone structure and being in exc shape I would shoot 60#s by August after my stemless or

From: Shawn
18-Feb-20
Total shoulder replacement, I was shooting 40#s by the end of June and by July 15th 60#s. Only went to PT 3 times and learned what needed to be done and did it on my own. Shawn

From: c5ken
18-Feb-20
It's so hard giving up archery after participating in the sport for so long. PTArcher & others have given some excellent advice based on their professional experience. Because of my complaints regarding weak & painful shoulder some 13 months after the replacement, I had an X-ray & MRI on the replacement. Per my surgeon, all appeared normal.... Nonetheless, pain & weakness continues. My advice to you guys shooting heavyweight bows, unless you're going to hunt dangerous game back the weight off and maybe you will be able to continue to enjoy archery well into your seventies...

From: AZ~Rich
18-Feb-20
I just have to add to thiscconversation as my hunting buddy is now facing the likelihood of never using his bow again. He’s 68 now but had his left shoulder replaced in 2011. After months of rigorous rehab and PT he was able to shoot again but still struggled with the initial draw tension. He is a fitness fanatic also, swimming everyday at lunchtime with rigorous cross-fit trainings at the gym in the evenings. I was worried that he was going too hard on his new mechanical joint and brought it up with him more than a few times but he persisted. Last summer he had his other (right) shoulder totally replaced and the rehab is definitely slower, mostly due to regenerating peripheral nerves. Well, a couple months ago his first replacement joint in his left shoulder was creating a lot of pain. Turns out he’s worn down his prosthetic joint beyond any normal level essentially ruining his joint function. His Surgeon was really shocked at degree of wear on it. No more cross fit workouts, probably will not be swimming like he was and certainly not going to be pulling back his bow. It’s been a really hard reality for him as he now realizes his mistake in over using it. Any mechanical joint only has so many flexes inherent in it’s lifespan before it wears out. unfortunately he wore his out in just 8-9 yrs! Guess a crossbow is in his future now.

From: BIGERN
18-Feb-20
AZ-Rich, Thanks for the information on expected lifespan of those parts. I'm 62 and just saw the pa of the guy who will be doing mine in October or so. Be talking to the doc next week and am hoping for an end to my problem shoulders. One is shot and the other not too far off. I just need to get started shooting and make it thru September ......

From: N-idaho
18-Feb-20
Just got out of doctor office had the manipulation done. Sounds like it went well now onto pt this after noon and every day for two weeks. Sounds like my shoulder is in good shape compared to some of you guys.

From: c5ken
18-Feb-20
Question for PTArcher: In your opinion, what is the normal lifespan of the prosthesis in a reverse shoulder replacement?

From: PTArcher
18-Feb-20
c5ken, That's a tough question. Standard answer is around 10 years, but that is very dependent upon a lot of factors, including the patient's bone stock, general health, physical activity, etc. Also, I think they are coming out with better materials and techniques all the time. The belief is that they will last longer, but no one knows for sure until we get down the road and actually see.

The great thing about our "living" tissues is that they can constantly adapt to the stresses we place on them. We get into trouble when the amount of stress exceeds that adaptability. Prosthetic components have no adaptability, thus they will wear out eventually, if we live long enough. Fortunately, (or unfortunately) unless we really stress the region, most of us don't live long enough to wear them out. If that does happen, surgeons at times can go back in and replace the replacement, but outcomes typically are not as good.

I have been treating reverse shoulders since around 2001-2. Unfortunately, I don't get follow up on most of these folks. I have however kept in touch with a couple that are now greater than 15 years post-op. I have also seen a few repeats, but to the best of my recollection, they all failed secondary to trauma, e.g. falls and motor vehicle accidents. So, the 10 year lifespan certainly is not written in stone. However, my opinion is that shooting a bow is more likely to put you on the low end of the lifecycle.

From: Rupe
18-Feb-20
In April of 2019 I had a torn Labrum and torn Rotator Cuff repaired. I was back shooting my 70 pound compound by September. Only issue is I lost a small range of motion, even that has improved greatly.

From: Shawn
19-Feb-20
My orthopedic surgeon said my replacement parts should last at least 20 years and mine was done in such a way that it can be replaced again if need be. Stemless is the way to go if your bone structure and density are good. Shawn

From: PTArcher
19-Feb-20
Shawn, you are right in that stemless reverse shoulders are being done. One huge advantage is that there will be less bone loss ( since there is no stem) if they need to be re-done. This will make the second procedure easier to perform. They do look promising, however, how long they will last is simply a best guess, as there are no long term studies as of yet. I certainly hope yours lasts 20 years or longer. Best of luck!!

From: c5ken
19-Feb-20
Mr. PTArcher, Thanks again for the info...

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