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Shoulder arthritis:

Old 05-16-20, 04:18 PM
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Shoulder arthritis:

Is anyone in the Bike Forum community suffer from shoulder pain? I've been to a doctor, and he can't tell me if it is tendontis, bursitis or arthritis. I've been reading up on arthritis, and the author said using handlebars that are not too low (too low) if found to be key. I am think about getting Nitto Albatross handlebars as a remedy. Nice bars, nice price. Maybe Wald bars?
I paid to have a bike fit several years ago, and the benefits have not been long lasting. I paid: $75 for the bike fit. I've read that the going rate is around $250 to $300. As a retired newspaper reporter my retirement income cant afford an upper income amount for a bike fit (Retul, or whatever is the fashion these days.)
I'd appreciated some input, and insight to my predicament that other have experienced.
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Old 05-16-20, 05:37 PM
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Iíve never been fit, but if I can recall some of the stuff I read; one thing to check is your saddle angle. You may still need to raise your bars and possibly shorten your stem, but if the saddle is tilted down and pushing your weight forward it may still be an issue.

John
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Old 05-16-20, 07:20 PM
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Yup, very familiar. I had no shoulder problems until I was hit by a car two years ago. Grade 4 separation and broken bone that supports the shoulder. Even at age 60 I figured it would take only a few weeks and I'd be good as new. Nope. Two years later it still aches every damn day.

And it worsened an old neck injury from being hit by a car in 2001. That incident broke my neck and back in six places and still causes pain. The C1 and C2 are deteriorating and off-kilter, along with minor scoliosis, so it's a daily thing. Worse with barometric pressure shifts that accompany many t-storms and drastic weather changes.

Physical therapy and massage are an every day thing now. I do most of it at home, especially with the pandemic. I also have an auto-immune disorder and chronic upper respiratory inflammation so I can't take chances with unnecessary visits to physical therapy or massage clinics. Fortunately I had a really good PT so I continue doing what they showed me, along with using some good tutorials from YouTube (be careful, because there are also some really bad YouTube "tutorials").

It helps. In late March I slipped on an unexpected patch of icy puddle and landed smack on the same shoulder. Fortunately it was slow speed, around 8 mph. And I was wearing a winter jersey, that wicking fabric that's not really padded, more like a spongy towel-thickness. Mostly I have much better muscle tone now. Not even a bruise or sore spot on the shoulder itself. But a week later my ribs started aching and took a month to fully heal. Full body scans show I've broken ribs many times before, between boxing and crashes on bikes and motorcycles -- lots of healed breaks I was mostly unaware of. So while it's uncomfortable it's usually harmless unless it's a compound fracture that punctures a lung or internal organs -- luckily none of mine have every been that bad. Just takes a few weeks of discomfort to heal.

I don't have any gym equipment at home, but I improvise with water jugs. I have three cats so I save those medium and large plastic jugs from cat food and litter to fill with water. I use 'em like dumbbells or kettlebells. And large cans of soup or chili for range of motion exercises with weight. Shadow boxing is a really good exercise for strengthening shoulders and upper body flexibility, with no impact and minimal stress on the joints. Add a little weight at a time, holding a can or small dumbbell, or weighted gloves. Don't snap punches the way we would in actual sparring or fighting -- that isn't necessary for physical therapy and can be harmful to aging joints. It should be a smooth motion, akin to tai chi. A couple of former pro boxing champions in my area teach no-impact workouts following similar methods. They've both been through the psychologically damaging grind of repeated head trauma and won't do traditional sparring sessions, but will do glove work with some advanced students. One of them, former bantamweight champ Paulie Ayala, developed a training session specifically for folks with Parkinson's to encourage better flexibility, mobility and balance.

Regarding self-massage, I strongly recommend a good long handled vibrating/"impact" massager with dual heads. These are about the size of golf balls and straddle the spine so we can easily reach those aching muscles on either side of the spine along the neck and back. Mine also straddles my shoulder blades, so I can reach those muscles along the scapula without touching the bone itself.

I use some topical analgesics, mostly for lubrication to reduce skin irritation from the vibrating massager. The only topical analgesics I've tried that really do anything useful for reducing pain are those that contain an ingredient that's a transdermal carrier -- something to penetrate the skin layer and deliver some relief to the nerves just under the skin. I doubt there's any non-prescription topical analgesic that can actually reach muscles or joints. But DMSO and MSM help reach the surface level nerves. DMSO is mostly used by labs for cellular studies, and as a horse liniment, but can irritate human skin -- I have some and it feels a bit prickly for 15 minutes or so. MSM is less irritating and is common to several readily available topical analgesics -- Stopain (I've tried only the roll-on, works well for 15-30 minutes), Osteo Bi-Flex, and Ted's Pain Cream.

However the transdermal carrier theory only seems to apply if the active ingredient is small enough to pass the skin barrier. Most stuff probably just sits on the skin and creates a mild distraction from the subcutaneous pain, a warming or cooling sensation. Probably the same effect some folks report from acupuncture, acupressure and some forms of touch therapy that don't really do much other than provide a temporary distraction and some placebo effect. Reminds me of a trick I learned as a Navy Hospital Corpsman for injecting patients who were terrified of needles -- I'd pinch up the skin just slightly, not enough to be painful, just a bit of pressure, near the injection site. Every patient said the injections were painless. The mild pinch trick just distracted the nerves. Hey, whatever works is valid, as long as it does no harm. That's why I don't disparage placebo -- it's a real thing and helps some folks.

Ted's is unique because it contains resveratrol, which seems to "reset" nerves locked into pain mode longer after an injury has healed. Sure works for me, but only a year after my injury. I tried it shortly after the 2018 injury and it did nothing more than the Stopain roll-on -- just temporary relief for 15-30 minutes, which helped while doing PT exercises. But a year later I tried Ted's again. Last year I still had dime-sized spots of pain around the shoulder and scapula that felt like jolts of electricity to the touch. It hurt just to have a chiropractor touch those spots, let along do any actual therapy (and I'm not a fan of chiropractors anyway -- massage therapy is better for deep muscle pain). So I tried Ted's again as directed -- three times a day for two weeks. This time it worked on those small painful spots. I still use it occasionally, but not daily.

I also have some CBD balm from a company that makes great orally administered CBD. Honestly I can't tell whether CBD has any effect as a topical. Even with DMSO or MSM. But it smells nice. Mostly I stick with oral CBD, which does help. It's not as effective as prescription opiate pain meds, but better than aspirin or ibuprofen.
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Old 05-16-20, 07:23 PM
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Originally Posted by italcyclist View Post
.................... I've been to a doctor, and he can't tell me if it is tendontis, bursitis or arthritis.....................I'd appreciated some input, and insight to my predicament that other have experienced.

Time to go to a Shoulder ORTHOPEDIC Surgeon. My shoulder issues began decades ago with arthritis and progressed to bone on bone resulting in total shoulder replacement in 2016. X-ray, CT Scan, MRI Scan are used to locate the cause of pain and determine treatment. Could be joint (bone) related or tissue issue.
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Old 05-16-20, 07:36 PM
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Oh, regarding bike fit stuff....

Ditto, albatross bars. A friend gave me a Nitto Albatross bar for my hybrid when I was recovering from the car impact injuries. He prefers swept bars and has several sets, but found the Nitto bar was too wide and long for him. But it was perfect for my bike. I rode that bike for almost a year before I could comfortably handle my drop bar road bikes again. I tried flopping the albatross bar, North Roads style, for better aerodynamics, but it was uncomfortable at the time. I might try it again. But two years later I still like that bike just the way it is. I set up the bar to be level with saddle height, which required switching stems from upward angle to a road bike stem that was parallel with the ground when mounted. Works for me.

Swept bars like the albatross are remarkably versatile, almost as many hand positions as a drop bar but more comfortable. Give 'em a try.

No idea about a pro bike fit, I've always done my own. I tinker with bike fit a lot to suit how I feel on any given ride, day or week. At age 62 with lots of aches and pains from injuries, subject to change at the whim of weather, there's no single bike adjustment that's perfect for every day.

I also check my position on the bike using video. When I feel like something is "off," I'll record myself either on the trainer, or outdoors. I'll set up a camera or two along a quiet road and pass several times to check my position and ergonomics. That has helped me identify problems such as incorrect saddle height and rocking in the saddle, stem length, bar height, etc.

I do watch and read some tutorials by qualified pros. The Bike Fit Advisor on YouTube is the best I've found. His videos do run a bit long so there's no 3-minute summary. But every time I encounter a specific fit problem, he already has a video to address it with tips that work for me. Strongly recommended.

Most shorter bike fit videos are too generic, and too many ramble on endlessly without any sense of the host having prepared his thoughts, no notes or outlines, no editing, just a mess of word salad.

I've put out a few feelers on Facebook among the local bike community and didn't get a good feeling about any of the people recommended. The highest recommended bike fitters only seemed interested in working with pros or serious amateurs who are in their primes. Their responses to some of my specific questions were dismissive, so I scratched them off my list. I wanted to know whether they could test for specific pressure points, identify and correct cadence problems, etc., and their responses indicated they either didn't think it was important or, more likely, they don't have the equipment to measure those factors. So I'm not inclined to waste $100-$300 on a bike fit that isn't geared toward my needs.
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Old 05-16-20, 08:12 PM
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I have have had very painful bursitis - my left shoulder is a mess (had an old rotator cuff injury there too). I found reducing road vibration at the bars (specialized future shock) helped some. I have had a professional fit too and I have a riser drop bars. I think proper saddle positioning so that you do not have too much weight forward makes the most difference as far as fit.

But what I found to help most and and keeps my bursitis at bay is wet heat. Whenever I take a shower I dedicate some time running hot water over my shoulder.
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Old 05-16-20, 08:53 PM
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I had a shoulder replacement, too, also in 2016. Should have done it earlier. I strongly recommend a shoulder specialist orthopedic surgeon. If you know any physical therapists, you might ask him/her for a recommendation. I asked a PT I had worked with whose patients had the easiest time recovering.

But first, get a good diagnosis, which means, I believe, an MRI - but I'm not a doc. Do what your orthopedic surgeon recommends. If it's bursitis or tendonitis, you avoid the knife.
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Old 05-16-20, 11:06 PM
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The ancient SCHWINN 7881 handlebars are superb if you don't mind that they are steel. They fit the 25.4mm clamp and are 7/8 dia (22mm)brake lever mount size.
The chrome quality is superb and millions were made, such that unless severely rusted or hit by a Mack Truck, most of them will have a near perfect appearance.
The largest year range for these is 1967 through 1978. These will be stamped SCHWINN 7881-67 (for 1967 production), SCHWINN 7881-75 (for 1975 production)...you get the picture, as the last two numbers tell you the year. Expect to pay between $18 total including shipping and $23 maximum total including shipping FROM SELLERS ON EBAY..................obviously you might find them for less than $18 total cost but since postage is close to ten bucks to ship these....you should expect that folks are gonna figure these are worth at least nine bucks and nine bucks to ship, thus about eighteen bucks total. These were original equipment on so many different SCHWINN bikes between 1967 model year and the late seventies.............Breeze, Speedster, Collegiate, Suburban and others.
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Old 05-17-20, 05:51 AM
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When I registered as a member here 5 years ago a great member here by the handle of qcpmsame helped me out big time by asking my address and sending me a book called...

"Zinn & The Art of Road Bike Maintenance" (asking only that I "pay it forward" and do the same for someone else someday which I did...very cool)

and I followed the bike set-up of that book to a "T" and speaking of that book and "T"s?...here's my take-away from it all...

Speaking of T's: I'm 5' 7"s, weigh 200lbs, have a 28" inseam. the shoulder width of an NFL linebacker and?...T-Rex length arms and be it Zinn's or anyone else's Bike Fit adjustment instructions for drop bar RB's?...for me they are at best just a suggested starting point and from there?...

By the time I got to where my RB was tolerable for any ride over 10 miles?...my drop bars were rolled upwards like they were launching into space and the only time I'd fall into the drops was when encountering serious headwinds...other than that?...my grasp was high up on the brake grips with a riding position much like that of my flat bar Hybrid Crosstrail Disc and I even have extension options on those bars.

Whether it's physic, age, physical condition. lower back problems, shoulder issues or just a lack of upper torso limberness?...(where in my case it was just too much upper torso weight on my T=Rex armed wide shoulders)...as much as some might like to think so?...I don't think drop bars are for everyone at least not in the 50+ forum and if drop bars on non suspended forks were my only option?...I'm not sure I'd be riding much anymore because my other life long love of a activity has been traditional archery and my 61 year old shoulders are shot out...literally.

Hope that helps.
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Old 05-17-20, 03:36 PM
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I've had grade III AC separations in both my shoulders, and yes, they do ache when I ride. Raising the handlebars helps, as does pre-ride medication with NSAIDs (e.g. ibuprofen or naproxen).
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Old 05-17-20, 05:03 PM
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Originally Posted by JohnDThompson View Post
I've had grade III AC separations in both my shoulders, and yes, they do ache when I ride. Raising the handlebars helps, as does pre-ride medication with NSAIDs (e.g. ibuprofen or naproxen).
I'm no doctor but I've abused myself in many ways long enough to know that "Pre Anything NSAIDs" is not a good idea and will only mask the pain enough for you to cause further damage to your joints.

"CHRONIC PAIN" is your bodies way of telling you to stop doing what's damaging it...silencing that chronic pain with NSAIDs is a horrible idea because that one extra ride it allows you?...could be your last for quite some time....the far better option?...

Answer your bodies cry out for help (i.e. "inflammatory joint pain") by modifying the ergonomics to provide less stress and strain by increasing comfort.
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Old 05-17-20, 06:59 PM
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I had shoulder pain after I first started riding. My fit was way off. The bike was too large and my reach was too far. Plus the bike frame and ride was just way to harsh. I was riding with my arms straight and my shoulder was absorbing all the bumps from the road. I got a shot of cortisone from my orthopedic doctor and shortened my reach. My ortho took xrays of my shoulder and there weren’t any arthritis issues. I made a point to ride with my elbows bent so they absorbed more of the road buzz.

I’m now riding a bike 2 sizes smaller. If you were fitted properly hopefully that’s not the same issue for you.
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Old 05-18-20, 10:49 AM
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When and where does it hurt?
Does it hurt to lie on your side in bed?
Are they stiffer first thing in the morning?
Does it hurt to raise your arms over your head?
Do you have old shoulder injuries like from skiing falls?
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Old 05-18-20, 10:51 AM
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Two words

Recumbent bike
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Old 05-19-20, 03:32 AM
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Originally Posted by Jinkster View Post
I'm no doctor but I've abused myself in many ways long enough to know that "Pre Anything NSAIDs" is not a good idea and will only mask the pain enough for you to cause further damage to your joints.

"CHRONIC PAIN" is your bodies way of telling you to stop doing what's damaging it...silencing that chronic pain with NSAIDs is a horrible idea because that one extra ride it allows you?...could be your last for quite some time....the far better option?...

Answer your bodies cry out for help (i.e. "inflammatory joint pain") by modifying the ergonomics to provide less stress and strain by increasing comfort.
Depends on individual conditions. I have chronic inflammation and pain related to an auto-immune disorder, on top of serious injuries from being hit by cars twice, and others that were my own fault (bicycle and motorcycle crashes, falls when climbing, boxing, and just being a reckless young man). I generally go along with recommendations from my primary doctor and specialists. I see my endocrinologist, immunologist and ortho docs more often than I see some friends -- especially during the pandemic. I haven't seen my usual cycling buddies in two months. I've seen my docs a few times a month despite the pandemic because some treatments can't be postponed.

My docs all know my preference for being active. My weight is darned near optimal (150 lbs at the moment, just a few pounds over my amateur boxing weight in my teens and 20s), I'm careful about my diet, take the recommended supplements ... and other supplements that my docs aren't convinced about but say, basically, "It's your money, waste it however you want."

And I dislike taking opiates and prescription muscle relaxers, although I have prescriptions for those. My docs know I've never abused prescription drugs and usually a "one month" supply lasts me 6-12 months. But they make me drowsy and lazy, so I take them only when the pain is unbearable and doesn't respond to anything else. (Same with cannabis from well meaning friends who say it helps their chronic pain. All it does for me is make me a chronic napper. I have no idea whether it helps with pain. I slept through it.)

The docs prescribed diclofenac, an NSAID. Frankly it doesn't do much for me. They said I can use aspirin if I prefer. I've been taking one 325mg aspirin twice a day for two months and it's been significantly better than diclofenac for me. It helps reduce chronic sinus inflammation and related headaches, and helps a little with chronic mild pain from the neck and shoulder injuries.

For anything worse than mild pain I'll use CBD. It's good for moderate pain (but not for severe pain, at least for me -- it's not a substitute for hydrocodone, tramadol or cyclobenzaprine). And good for anxiety, which also helps with pain management. Some hype for CBD claims it's also an anti-inflammatory but I haven't seen any independent research that confirms this. It certainly didn't help with my chronic sinus inflammation, while aspirin did within a couple of days.

My daily morning pain that feels, subjectively, like muscle and joint pain isn't consistently related to injuries. Others are definitely related to injuries (I've been hit by cars twice in less than 20 years, with permanent damage to my spine and shoulder). The muscles in my neck and shoulder are often knotted up -- feels like barbed wire under the skin. Pain relievers don't really fix that problem. Even muscle relaxers ... don't. They just block pain. So I do a lot of stretching and calisthenics, and massage using a dual headed percussion massager (best toy I've bought for myself, next to a bicycle). But those muscles have been knotted up for so many years it doesn't seem like they'll ever respond to anything.

There's hardly been a day in 20 years that I woke without pain. If I let that dictate my actions I'd never do anything more strenuous than walking to the kitchen or bathroom -- which was pretty much all I did do for about 10 years after the first serious injury.

Exercise itself is a great pain reliever for folks whose bodies respond positively to exertion and reward us with dopamine, endorphins, serotonin, etc. It doesn't work for everyone, which some researchers suspect may be the key to why some folks thrive on exercise while others hate it.

And I tweak my bike fit and related stuff often to suit my comfort. Occasionally I'll video myself on the indoor trainer or even outdoors to check my posture and ergonomics. Helps spot and fix problems with saddle height and position, crank length, stem height and length, etc. But with my favorite bikes that have quill stems, I'm likely to raise or lower the handlebar during a rest break during a long ride to suit how my neck feels. Can't do that with my threadless stem bikes. Usually just a 1/4" or 1/2" tweak is all it takes to finish a ride with less discomfort.

While I agree that we shouldn't ignore pain, especially new pain that may warn of injury or illness, some of us are forced to try to ignore chronic pain if we want to stay active. It's just part of life for some folks. I'm fortunate to be one of those people whose body pumps out brain chemicals that reduce pain while I'm exercising. The pain comes back later, but at least during a bike ride, walk or exercise I feel pretty good.
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Old 05-19-20, 08:36 AM
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Yeah, I've had shoulder pain and fixed it. If you'd respond to my post 13, maybe I could help you. My guess is that it has nothing to do with arthritis or bike fit. Your doctor didn't help you because most doctors don't know anything about people our age who exercise.
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Old 05-20-20, 01:55 PM
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If your doc can't tell you what the issue is, PT is the first step.You might just have a relatively minor rotator cuff issue. Recumbent won't fix a shoulder issue, but may make living with it easier.
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Old 05-21-20, 02:48 PM
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I went (and am going through) the shoulder thing. My research informs me that most everybody goes through it and usually it starts in the 50s.
Something will aggravate one or both and then you are in for a long strengthening, stretching, learning to sleep on your back, ordeal. After getting over one shoulder thing that could have been caused by a minor bike crash or surfing, I had a sudden onset of Calcific Tendonitis of the shoulder. OUCH. Needed the Opiates for that one. Luckily, I got to the doc before they were afraid to prescribe the good stuff.
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Old 05-21-20, 10:35 PM
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The most common shoulder ailment as we get older is impingement. Fortunately, it's easy to fix. Most doctors don't know what it is or what to do about it. All you have to do is hang by your hands for 2 X 1' about every other day. Fixes it in a couple weeks to a couple months.

When we were kids, we used to play on the monkey bars. When's the last time you did that? There's reason we did that, and it's because of our arboreal roots, which are still with us, not only in our heads but also in our shoulders. We need to hang by our hands, simple. That remodels the acromion, which becomes misshapen with age, narrowing the gap through which some nerves and tendons pass. Worked for me. No more shoulder pain. And it's free and good for you.
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Old 05-22-20, 10:57 AM
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For years, I couldn't figure out why my neck always hurt after every ride. Then I became conscious of how often I was turning my head to check traffic coming up from behind me. I installed a rear-view mirror on my bars and the neck pain went away overnight. Just my personal experience.
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Old 05-22-20, 01:46 PM
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Lessening road vibration was huge for me. I run 80 psi in the back and 77 in the front. Made a huge difference. A while back I read where Tom Boonen runs 60 in the back and 59 in the front for Paris roubaix. That's when I started trying different air pressures. It really helped me. Good luck.
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Old 05-26-20, 06:03 PM
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Originally Posted by italcyclist View Post
I've been to a doctor, and he can't tell me if it is tendontis, bursitis or arthritis. I've been reading up on arthritis, and the author said using handlebars,,,,
whatever is the fashion these days.) I'd appreciated some input, and insight to my predicament that other have experienced.
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Old 05-29-20, 08:58 PM
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Originally Posted by philbob57 View Post
I had a shoulder replacement, too, also in 2016. Should have done it earlier. I strongly recommend a shoulder specialist orthopedic surgeon. If you know any physical therapists, you might ask him/her for a recommendation. I asked a PT I had worked with whose patients had the easiest time recovering.
How long was your recovery period? My right shoulder is messed up but, unless something traumatic happens, I'm going to wait until November to get it fixed.
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Old 05-29-20, 09:15 PM
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I followed my surgeon's advice to stay off the road for 3 months. IIRC, I got back on the trainer after 6-8 weeks, but he was none too happy about that. OldTryGuy had similar surgery, IIRC, and got on the bike very soon (a few days?) after surgery. I didn't have the replacement done until I was using opioids every day, and I don't like opioids.

The problem, according to my surgeon, is that one popular method is to cut through a big shoulder muscle, and it takes 6 weeks for the muscle to knit well. If you rotate your arm/shoulder more than 90 degrees too soon after surgery, the muscle separates, and it's very difficult to reattach the 2 parts of the muscle, because they retract quickly and require a lot of force to put them back together.

There's another form of the operation in which the surgeon goes through the back of the shoulder, which is trickier, because it's hard to get to the right place, according tomy surgeon. Also, a lot of people say recovery is very painful. It takes a lot of PT, and I did my exercises at home.
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Old 05-30-20, 12:31 PM
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Originally Posted by Retro Grouch View Post
How long was your recovery period? My right shoulder is messed up but, unless something traumatic happens, I'm going to wait until November to get it fixed.
Originally Posted by philbob57 View Post
I followed my surgeon's advice to stay off the road for 3 months. IIRC, I got back on the trainer after 6-8 weeks, but he was none too happy about that. OldTryGuy had similar surgery, IIRC, and got on the bike very soon (a few days?) after surgery. I didn't have the replacement done until I was using opioids every day, and I don't like opioids.

The problem, according to my surgeon, is that one popular method is to cut through a big shoulder muscle, and it takes 6 weeks for the muscle to knit well. If you rotate your arm/shoulder more than 90 degrees too soon after surgery, the muscle separates, and it's very difficult to reattach the 2 parts of the muscle, because they retract quickly and require a lot of force to put them back together.

There's another form of the operation in which the surgeon goes through the back of the shoulder, which is trickier, because it's hard to get to the right place, according tomy surgeon. Also, a lot of people say recovery is very painful. It takes a lot of PT, and I did my exercises at home.
Replacement was via FRONT with sling off next day and riding 2 days later. Concern was for stitching NOT JOINT INTEGRITY and pain was almost non-existent. Acetaminophen did the job very nicely. Age was 66 and wish I had found Dr. Moor much sooner.
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