# Acromion Surgery... Anyone had it?



## Artemis (Feb 15, 2005)

I'm adding this post to the FITA site as I've not had any response from the "General Discussion" Forum. Hopefully somebody here might share their experience  

It's my turn for rotator cuff surgery... My doctor has advised me that I have a Type 2 acromion (the bone that comes over the shoulder... mine is hooked, but not as bad as Type 3) and he would like to "shave" the piece of the hook that has caused the tear, along with repairing the tear. This should prevent future damage. 

Has anybody had this type of surgery, and if so, would you share your stories? I've searched through a number of threads discussing spurs and RC tears, but haven't found any discussing this procedure.

One more question: I'm a recurver... should I think of switching to compound after the surgery or is there any difference?

Thanks a bunch for any words of wisdom!


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## restrung (Jun 24, 2006)

I had the whole enchilada a few years ago, on the draw shoulder - recovery took a long time and I hadn't been shooting for years already (but not just because of that). 

A couple of years after surgery I decided to try it again and started with a low weight bow (24 lb) and am now up to 38 lb. I was never national team level anyway, and am very happy with where I am now. Stability, strenght, consistency of draw are all better.

But it was very important to find a rehab program that worked for me, the first one was thinking more in terms of just keeping the shoulder from freezing and all I ended up with was mobility. I went to a rehab place that works with major league pitchers and showed them what archers do and that did the trick. I work out with weights once a week with a trainer still.

I don't know how bad your stability/pain issues are, but this was a positive all around for me. Except for the length of the recovery period, and I needed some time off work anyway!


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## bownut-tl. (Sep 21, 2003)

*Acromium Surgery*

I had it done to both shoulders. The first was my bow shoulder. About two years later I had it done to my draw shoulder (had to do it because the pain in my bow side caused me to alter the way I drew the bow which ended up damaging my draw side). I didn't have any rotator cuff issues.

For both surgeries it took about 5 months before I could start shooting a bow (low poundage) on my bow side and about 6 months on my draw side. The main thing you have to do is be patient. I tried to come back too quickly from the first one and caused severe swelling in the shoulder joint. At first it didn't hurt and I thought the swelling was just my muscles getting bigger from the weight training during rehab. I was wrong and the pain got to be almost as bad as before the surgery. I learned my lesson on the second one and took it real slow. Used a stretch band once my range of motion came back and slowly started increasing the resistance until I could shoot a bow at around 15 pounds. At this point I just gradually increased the poundage, number of shots, and shortened the time between shots until I got to where I was before. A different problem caused the second surgery to take longer to recover (i'll explain in below).

I have changed my overall archery approach by a couple of things. 1) I try to make sure I stretch the shoulders before I shoot and 2) I don't shoot the heavier poundages anymore. I shoot a 46 pound recurve and limit my compound shooting to about 55 pounds. I don't shoot the heavier compounds anymore because the initial draw weight and trying to get a more radical cam to roll over stresses my draw shoulder too much. 

I will warn you about two things. The first is to make absolutely sure that your doctor knows what your desired goal is and make sure the doc tells you what the different options and risks are with the surgery (I'm not talking about complications and surgery risks. I'm talking about how much shaving the bone is done). Make sure he/she knows you are an archer and walk him through how you actually shoot a bow. The doc needs to know how you position our arms and your hands when you draw because the bone and muscle movement can be different depending upon what how you do it. The second is to make sure you go to a good rehab office. They need to also know what your goal is. They can then develop a specific rehab program that is better suited for an archer. I'm telling you this because of what happened to me. 

When the doctor did both surgeries, he new I was an archer and wanted to shoot again. He fixed the first one and I haven't had any issues since. The second one is another story. In the second one he decided he wanted to minimize the amount of strength I would lose to he decided to only remove a little bit of bone and to not shave it back as far as he did the first time. Well, 4 years later and I am still limited in what I can do. I can shoot a recurve with no problem. I can shoot a caliper release with no problem. However, if I try to shoot a thumb trigger release or back tention release I can't do it as well because the hand position (thumb down) causes the same pain in the shoulder that I had before the surgery, just in a different location. When I told him this, he said he could have removed more bone and cut further back along the bone like the first surgery but I could lose some strength. Had I known this was a possible option that he might decide to use and what the risk was my response would have been easy. Shoot 60 lbs instead of 70 with no pain or shoot 70 with pain. I'll take the no pain approach. That is why I went under the knife anyway. I didn't want to pay for another surgery so I live with the limitations now.

As for the rehab center. The first one didn't set up a program specific for my needs and it took longer to get back into archery. The second one did and I was able to shoot at my normal draw weight (recurve) after 2 months (the 2 months is from the time the doc says you can start back into archery and not after surgery). Starting back into compound bows is where the longer time took.

I'll stop here.

Terry


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## Artemis (Feb 15, 2005)

*Thank You!*

Thank you both for your responses. 

You have really reset my expectations. I wasn't expecting/hoping to hear about such a long recovery/rehab timeframe, but it makes sense, given the extent of the surgery. Some of the other posts about surgery boast of being back at the range in weeks, so I was expecting to Superwoman. 

Terry, you bring up a really good point about working with the surgeon up front. I'm in rehab right now and the thumbs down exercises cause me a world of hurt. Eventually I can see myself moving to compound and need to plan accordingly. 

Net-net, it looks like I need to spend some quality time with the surgeon and his PT team before surgery. And plan for some quality downtime afterwards. 

Thank you so much for your coaching!


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## Hoytemgood (Aug 19, 2006)

*5 surgeries*

I have had 5 shoulder surgeries on the same shoulder. The last one was in 1994 and it did the trick. I did not have a RC tear but I have had my acromiom shaved. 

The main thing is make sure you have a SPORTS Ortho surgeon and not just an ordinary surgeon. Then make sure that the PT is also on the same track as mentioned above. I went to a completely different PT then thru my surgeon. I was in a "Gun Slinger" brace for 6 weeks, then not allowed to do any PT for 4 months then started PT. I had the surgery on April 1st and I returned to my first triathlon (post surgery) Nov 1st. Depending on how bad your injury is will dictate how long your recovery is. The better physical shape you are in prior to the surgery the quicker your recovery. And I don't just mean your shoulder/arm muscles, I mean total physical shape. 

Just as a side note, most people check out their surgeon (meaning their background, complaints, etc.) but very few people check out their anesthesiologist. Yet more people die because of med mal from that end then they do from the surgeon. I


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## werdegar (Aug 22, 2006)

Before you agreee to shoulder surgery you absolutely need a second opinion. Most of the injuries of this type to the shoulder have nothing to do with rotator cuff damage. They result from improper loading of the bicep during the hook and set phase of the draw, causing strain on the bicep tendons going through the acromial notch in the shoulder. If you are cursed with a curved bone at this opening, and if you add to the problem by starting your draw with a semi-closed instead of an open stance, and the old straight arm pull up to expansion, you cause great impediment of the bicep tendon, leading to inflammation and scarring. This is called bicep tendinitis, and it's possible to be corrected WITHOUT surgery. You need to find an orthopod who really understands the mechanics of what's going on in the rotator cuff, and who can recommend you to a physical therapist or chiropractor who knows how to loosen the scar tissue, reduce the inflammation (along with prednisone injections), and prescribe a series of graduated exercises to build the strength of the rotator cuff muscles enough to depress the bicep tendon so it clears through the acromial notch. This will be a slow process of 2-3 times a week visits over a period of 4-5 months without ANY archery at all. I've done it, and it works. I'm back in competition using a 45lb Win&Win with no pain whatsoever. Good luck


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## zydeco (Jan 14, 2005)

Can't add much to the exceptonal advice others have offered. Tore the rotator cuff bicep tendon completely off the bone and had the surgery done in 1998. Pretty brutal surgery with lots of bone trama. My surgeon was a Sports Ortho guy who had done thousands. He insured that an MRI was done to precisely define the problem. He also warned me going in that the surgery was "the most painful" orhto surgery there is and to expect a long and slow recovery.

Your surgery should not be as bad as mine, but I totally agree with the points posted above. Sports Ortho experience for sure, full understanding with the doc, MRI or whatever is appropriate, and a second opinion never hurts. Don't rush the rehab, you sure don't want to repeat the surgery. I know that surgical techniques and technology has improved a great deal since I had mine done. A friend had the same damage as I did and had his surgery last fall. He is a little younger than I and that helps, but his recovery was much faster and he had far less pain.

In my case I had lost a great deal of my right shoulder range of motion, lost a lot of strength and had chronic pain. The surgery was well worth and a complete success. Lastly, my surgeon stressed the importance of a few simple stretching exercises as the best way to prevent further problems. That has provento be great advice.


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## Engelsmung (Jan 12, 2005)

*surgery*

I had sub-acromial decompression and cuff repair in 2004, brought on by old softball and flag football injuries, and a type II acromion. My ortho did the repair on Wednesday, Sept. 15th, 2004, and told me later that my acromion was so hard the deburring tool would not work, and he had to chisel it flat. I got the impression of a ******* craftsman at work, getting the job done by whatever means necessary. Anyway, he sent me to therapy the next Friday, and the therapist, a personal friend, began torturing me immediately. After 2.5 months of therapy, i was released, still not back totally with strength, but no pain. I was able to hunt over the new years eve holiday, 3.5 months post surgery, and blew a shot on a doe, due to poor distance judgment, not weakness.

Now, two years later I have few problems, though I get an occaisional twinge in the shoulder if if move it to an extreme position. I was 37 when I had the surgery, though the shoulder had bother me for 5 years before. It had reached the point where I had severe pain upon reaching over my head, and would get a shcoking sensation, followed by hand numbness. Now it's knee trouble. It's always something.


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## Artemis (Feb 15, 2005)

Thanks everyone! Pretty incredible responses, I really appreciate the care and detail. Also makes me feel incredibly lucky to just have a small tear (Zydeco... my shoulder hurts in sympathy for you).

I have lined up a pretty solid doctor (he was my second opinion guy) -- he's in Cuba right now with the USA Baseball Olympic Qualifying Team. He took away my bow, put me on PT and gave me a shot of cortisone back in May, wanting to see how I could progress without jumping into surgery. 

Werdegar, you were spot on about the bicep tendonitis, which was definitely a problem. It's calmed down quite a bit, but I still hurt the very top of my shoulder when I raise my arm. Since I can't go through life without raising my hand, I'm going to bite the bullet.

You guys are amazing for going through all this. Thanks so much for your advice.


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## bownut-tl. (Sep 21, 2003)

*Surgery*

I re-read my earlier post and my use of the Engilish language was pretty bad but hopefully understandable.

I had originally injured my shoulders from using poor weight lifting form. I didn't start shooting a bow until about 5 years later. The combination of the weight lifting injury, the bent acromium, and using poor drawing techniques eventually made me select the surgery. I started with the cortisone shots (about one every 3 or 4 months) and they worked great until the pain returned. I decided I didn't want to keep taking the drugs and an MRI convinced me to take the knife.

The one major improvement that I received is the ability to actually throw something overhand. For years I couldn't throw a penny with an overhand motion without severe pain in the shoulder. During rehab I was able to throw a 9 lb weighted softball into a small angled trampoline and actually catch it with the same hand with no pain. That was enough of a change to make me happy. Now I can throw my bow overhand if I wanted to! Haven't had the need or urge to but its nice to have the option.

Terry


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## DIV (Apr 12, 2012)

For those of you that have gone through the surgeries, may I ask whether the injuries were due solely to archery, or was archery " the straw that broke the camels back"?


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