RRC Archives

You shouldn't start so many sentences with the word so.

dustonian wrote:I have always managed to heal on my own, but that said I have very poor ROM in both shoulders..

I think this says everything you need to know. Someone who goes to school 14 years and then has X amount of years actually performing this relatively easy surgery tells you that you're a good canidate to come out of this with a good result? Or you can follow Dustonian here. Your choice. I'm always a fan conservative therapy first, but there comes a time when you just need to get things fixed. Either way, I'll be climbing and having a great time.

Brentucky wrote:You shouldn't start so many sentences with the word so.

Thank you for the grammar lesson! I will be sure to type with more elegance from now on. =)

Rotarypwr345704 wrote:

dustonian wrote:I have always managed to heal on my own, but that said I have very poor ROM in both shoulders..

I think this says everything you need to know. Someone who goes to school 14 years and then has X amount of years actually performing this relatively easy surgery tells you that you're a good canidate to come out of this with a good result? Or you can follow Dustonian here. Your choice. I'm always a fan conservative therapy first, but there comes a time when you just need to get things fixed. Either way, I'll be climbing and having a great time.

Anyone ever tell you you're kind of obnoxious? You also have a habit of jumping to unfounded conclusions. I have naturally poor ROM exacerbated by the fact I climbed and rigged for a living for over 10 years & was too lazy, busy, uninsured and/or poor to do PT, not because I didn't have surgery. Most orthos I've met and/or shadowed agree surgery is overprescribed in current practice...but they sure aren't complaining about the profit it brings them! Yes, surgery is sometimes indicated, but it all depends on the severity of injury and the quality & attitude of the individual orthopedist. The length of schooling is pretty immaterial relative to the practical experience level, aggressiveness, ethics, and mindset towards treating athletes...in all honesty the four years of medical school do absolutely zip to prepare physicians to make a decision such as this. So that cuts your idealized "14 years of schooling" down to a 3-5 year residency of actual relevant information.

Partial-Thickness Rotator Cuff Tears

Matava, Matthew J.1 e-mail; Purcell, Derek B.1; Rudzki, Jonas R.1

1. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri

Partial-thickness tears of the rotator cuff have been diagnosed with increased frequency because of a heightened awareness of the condition by clinicians and improved diagnostic methods. Research into the causes, natural history, and optimal treatment of this condition lags behind that of full-thickness tears. However, despite the limitations in the existing literature, there has emerged a consensus among shoulder experts that partial-thickness rotator cuff tears should be aggressively treated in the active athlete because of the unfavorable natural history of these lesions and success of accepted surgical algorithms. This review will provide an overview of the theories regarding the origins of partial-thickness rotator cuff tears, discuss the relative accuracy of accepted diagnostic techniques, and summarize the indications and methods of operative repair with an emphasis on the results of various treatment approaches.

So, I would put you in the "active athlete" category. Research seems to support better outcomes for surgical management.

PM me if you want me to send you the full article in a PDF file...

Well, there's one paper. Not exactly a consensus. You kind of worship pubmed huh?

climb2core wrote:Partial-Thickness Rotator Cuff Tears
Matava, Matthew J.1 e-mail; Purcell, Derek B.1; Rudzki, Jonas R.1
1. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
...despite the limitations in the existing literature...
...because of the unfavorable natural history of these lesions....
...a consensus...

we need more money to figure this out. call the rrgcc and have them apply for a grant study. all the climbers here can participate.
then we can at least agree on something.

dustonian wrote:Well, there's one paper. Not exactly a consensus. You kind of worship pubmed huh?

No, actually I get it off electronic journal center. I like to get the full article. I don't worship pubmed, but I do believe in evidenced based medicine over anecdotal opinions. Ultimately, I would trust the opinion of a good orthopedic surgeon, it is their business to ANYALYZE almost all the articles, determine the validity, and then apply it to each individual case...

"Anyalyze" it...don't criticize it!

I'm for EBM as much as the next physician-in-training (actually more so as I'm onto PhD work now), but an important point to be realized is that a huge percentage of the published "literature" out there is complete horseshit science rushed out of the academic pipeline with poor statistical and/or data collection methods, and another huge fraction of "scientific" publications are in fact thinly veiled advertisements for products and procedures and fully bankrolled by industry forces profiting from their approval & accelerated use...sad but true, science is run as a business like any other & very far from objective these days.

dustonian wrote:"Anyalyze" it...don't criticize it!

I'm for EBM as much as the next physician-in-training (actually more so as I'm onto PhD work now), but the important to be realized is that upwards of one quarter of the published "literature" out there is complete horseshit science rushed out of the academic pipeline with poor statistical and/or data collection methods, and another huge fraction of "scientific" publications are in fact thinly veiled advertisements for products and procedures and fully bankrolled by industry forces profiting from their approval & accelerated use...sad but true, science is run as business like any other & very far from objective these days.

Understood, that is why the research must be reviewed and analyzed. Also should look for trends and not one offs... Hopefully the being from a University Medical school would limit the bias and secondary gain issues. As a physical therapist, I am all for conservative management... when it is the best apparent choice.

But like I said... you need to find a good orthopedic surgeon and the TRUST her opinion...