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Anyone had a shoulder arthroscopic capsulorrhaphy?

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Kat H · · San Diego · Joined Jan 2017 · Points: 0


Healyje · · PDX · Joined Jan 2006 · Points: 295

Don't worry about the timeline to return to climbing - you'll want to focus 110% on the physical therapy and let climbing happen in its own time under the guidance of your doctor and PT. Be wary of a condition called 'frozen shoulder' post-op and the way to stave it off (and to get back to climbing) is doing your PT super religiously. Getting back to climbing pre-maturely or without the proper run-up to it would likely be a big mistake.

Also, consider asking your doc about a grapefruit-size dispenser of nerve block that lasts about 7-10 days vs just getting a shot of it during the procedure.

P.S. This advice is from caregiving my wife through a multi-year bout of severe frozen shoulder in both shoulders along with (eventually) back-to-back surgeries. It wasn't pretty.

Trevor Wende · · Unknown Hometown · Joined Mar 2016 · Points: 0

I have had this capsulorrhaphy. I would definitely recommend at least a second opinion.

I am NOT A DOCTOR, but here was my experience:

My understanding is that "capsulorrhaphy" is synonymous with laser thermal capsular shrinkage (again, NOT A DOCTOR so double check this). This procedure (thermal shrinkage) was relatively new when I had it done in 1997. I had a hypermobile right shoulder with significant labrum damage - lots of subluxations and probably a dozen or so full dislocations. My surgeon for this procedure was Dr. Arthur Ting in the bay area (who later became well known as Barry Bond's doctor)

It helped, but only for a few years. Within 4 years my shoulder was just as bad, if not worse, than before the procedure. At that point I saw another surgeon in SoCal who specialized in shoulders, and he said that the thermal shrinkage procedure was known to not last - he indicated that it was usually only effective for about 5 years. Keep in mind this was now about 2002, so a lot could have changed in 15 years, but according to him (Dr. Russell Petrie) the thermal shrinkage procedure was trending out, as not being a good long-term solution.

Dr. Petrie, who I highly recommend (see below), did a second shoulder surgery on my right shoulder which involved tightening the joint through new bone anchors for the ligaments. I don't remember the name of the procedure or more details, other than it was not a direct capsul repair or shrinkage, but the bottom line is this second surgery really worked. I eventually regained about 90% range of motion and probably a similar level of strength, and more to the point I can frequently rock climb without pain or fear of dislocation. Admittedly I am still, 15 years later, very cautious with long reaches with my right arm and some "shouldery" moves, especially gastons - so I still have a credible excuse when my girlfriend sends a route I got stuck on - but to go from a shoulder that twice dislocated while simply swimming to one that allows a 200 lb guy to occasionally knock out a 5.12 - let's just say I'm very, very happy with the results of the second procedure.

Some realism though on timeline - I'm sure the surgery and rehab techniques have improved dramatically in the last 15 years but be prepared for a LONG hiatus from rock climbing and needing (and probably wanting) to lap a lot of <5.9s for a while when you do come back. Aside from baseball pitchers, rock climbing is the most extreme test for shoulders in sport. I was out for 2 years and didn't really climb aggressively for another year after that. This was longer than my doctor's ban, but it took that long for me to feel comfortable putting my shoulder in those positions and bearing unpredictable loads. In either surgery I never felt like I got my old shoulder back, I felt like I had a new, weird shoulder that needed to be developed from ground zero. Also the rehab was painful at first and tedious later on, eventually turning from rehab to "maintenance" - you should plan on doing shoulder stability exercises for the rest of your life (or as long as you want to rock climb, at least). External rotation, internal rotation, and scapula stability exercises at least. All in all it was definitely worth the trouble, without any correction I would have stopped climbing, swimming, and would not even be able to throw a ball.

Going back to Dr. Petrie, I'm pretty sure he's still in OC, so might be worth the drive if he's in your insurance's network. I originally got sent to another Orthopaedist when I was going in for round II of shoulder surgery, but he said "listen, I could do this, but your shoulder is a bit more complex and we are lucky enough to have the Mozart of shoulder surgeons right here in this hospital", so he sent me over to Dr. Petrie. Petrie was thorough, detail oriented, and really followed through to make sure the rehab was on track - I was happy with every aspect of the process with him.

Good luck and speedy recovery, whichever way you go.

amockalypsenow · · San Diego · Joined Nov 2014 · Points: 720

I love seeing these generous responses on MP. Being able to hear about others experiences has helped me greatly, especially given the fact that the specific mechanisms of injury and body types are generally uniform among the population of climbers. Keep the responses coming!

Trevor Wende · · Unknown Hometown · Joined Mar 2016 · Points: 0

I love that you're looking for size 49 ice climbing boots in the WTB section. Do Sasquatches even need boots and crampons to ice climb?

sDawg · · Unknown Hometown · Joined Mar 2011 · Points: 0

I don't know anything about thermal shrinkage. I had labral tear repairs on both sides along with significant stitching in the capsule to improve stability and prevent future injuries. The labral tears happened in normal climbing and falling so pre-injury laxity was a contributing factor. Both arthroscopic. I was in my late 20s and was leading in the gym at around my previous onsight level within 7-8 months. Projecting harder climbs and bouldering took longer, and there were certain types of moves I would not attempt near my skill level for 2-3 years after the surgery. Now I'm 5 years out from my second surgery and climbing stronger than ever.

I always recommend a second opinion before surgery. I got one before my first even though my surgeon was great and highly recommended. You just need more than one perspective in order to get yourself to a place in your knowledge where you can feel like you're owning the decision, not having it made for you by an expert.

Also, I hated the nerve block. It numbed the muscles I use to breathe voluntarily so I could barely talk. I opted out of it for the second surgery.

Most important, though, is that you actually do the PT exercises 3-5 times a day, every day, for 6 months. Then I kept doing them a few times a week for the balance of a year, and then once a week or more as needed for ~4 years after surgery. I still do rubber band exercises occasionally if I'm having stiffness or pain in my shoulders. It's a big commitment. I kept PT gear at my desk at work, I found the ice machine in my building. and I got up early to do a round of exercises and ice before work. But those 6 months after the surgery are your only chance to really recover properly and if you don't do the work every day, the surgery will be a missed opportunity.

Healyje · · PDX · Joined Jan 2006 · Points: 295

Way more beat shoulders over on supertopo, might try over there...

amockalypsenow · · San Diego · Joined Nov 2014 · Points: 720
Healyje wrote:Way more beat shoulders over on supertopo, might try over there...
Dang, you're right. good call.
Jon Nelson · · Bellingham, WA · Joined Sep 2011 · Points: 4,675
Kat wrote:

Woah -- I am incredibly grateful for these responses and the time you guys took to give me detailed information. I am sorry for taking so long to respond, but as my story took a sad turn, I tried to forget everything surgery-related. 

I was set to have the surgery March 7th. I originally got myself some bomb diggity PPO health insurance back in June for the specific purpose of having my shoulders looked at. After MRIs and X-rays and all kinds of appointments, I was told the surgery would come to $780 per shoulder. Fair dinkum, I thought, and plugged the date into my calendar. I continued to pay my insurance (premium went from $260 to $360 on Jan 1st THANKS OBAMA. Just kidding.), expecting to get my moolah's worth in March. 

But FOUR days before my surgery, I get a phone call from the Doc's office... turns out I have to "fill my deductible" before the insurance company will even start chipping in! So that makes shoulder number one a $6800 + $780 shoulder! If it's gonna cost that much it better have a built-in bottle opener and come with a free pass to Knott's Berry Farm! And number two would come out at another $780. Well, I wasn't exactly raised on truffle mush by a French nanny in a countryside mansion, so I had to cancel my surgery... bummer! 

My only option is to have the surgery done in my homeland -- so I'm moving me, myself and husband home to flipping Arctic Norway this summer if all goes well. There I can have not only a free shoulder eval and surgery, but also a free continued education, and I'm applying to Norwegian medical school next fall. Yay socialism. Quite the turn of events! Good thing hubby likes ice climbing...

Thus -- I continue to do physical therapy to minimize the chronic pain, and I try to tell myself that at 26 I still have plenty of time to rehab and get back to the mountains for many decades of climbing, kayaking, making beds and other physical activity involving arms... But my climbing dreams are on hold for now. I sure am glad I still have the strength to lift a cold brew to my lips!

Thanks again for your kind and educated advice. Come catch me in Lofoten in two years time!

That's a terrible story. Being told one price, then later a price about 10x higher... it's too bad so many workers here in the US readily give out answers without knowing what they are talking about (sadly, I have the same darn habit.... but back when I lived in Japan, I could be sure that if I was told something by a worker, I could trust 100% that it would be true.)  

Arctic Norway could be a fun adventure. Good luck! 

Guideline #1: Don't be a jerk.

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