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Old 01-30-2009, 11:25 AM   #1
Andres Castro
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Shoulder resurfacing copeland hemiarthoplasy and crossfit

I 37 and a U.S. Marine and have been for 17 years active. I have been doing crossfit for about 2 years now. I have had arthroscopic surgery on my right shoulder since I found out I have degenerative cartilage in the right shoulder. I had a torn labrum which they sewed back up and did did some removed debris from the shoulders. Had some bone spurs as well.

I rehabbed and was back at it but my range of motion was limited. 1 year later the shoulder started giving me pain when I kipped and anything overhead was painful. After awhile OHS were impossible even with a PVC pipe.

Last what did me in was a WOD that required HSP, next day I was in so much pain I couldn't go to the gym for a week. Made an appointment with my Doc, who referred me to a shoulder specialist. He is a Orthopedic surgeon & Sports Medicine Doctor, specializing in shoulder, Knee and elbow surgery.
Did and MRI and X-ray and the results were;

There is a small or trace effusion in the glenohumeral joint space.
The glenoid is flattened, especially posteriorly, where there are
multiple small cysts, most consistent with degenerative cysts. There
is a sever loss of articular cartilidge, mostly posteriorly. Large
osteophythe projects from the inferior humeral head.

The rotator cuff tendon is intact and there is no evidence of full
thickness tear. Tendon for the long head of the bicep is well
demonstrated. It attaches to the superior labrum satisfactorilly. The
anterior labrum is grossly intact. Posterior labrum is severily
frayed.

Acromioclavicular joint space is mildly prominent, measure 5 to 6 mm.
Impression:
1. No Evidence of rotator cuff tear.
2. Sever Glenohumeral joint degenerative changes.

The X ray shows that I have arthritis in the right shoulder and it hurts while I am typing this. It hurts all the time now, even when I sleep. The Doc recommended that I get a copeland procedure that is a hemiarthoplasy shoulder resurfacing. Placing a titanium cap on top of the shoulder. The procedure is evasive with them first cutting in front of the shoulder and working around the deltoid muscles and cutting a tendon that will be reattached later. Dislocating my shoulder and exposing the top of my arm. Smoothing out the head and drilling a whole on top to secure the cap. Then putting the bone back, reattach the tendon and and sew me back up. They said I will be in a sling for 4 to 6 weeks with rehab and 6 month to be at 100% healed.

Now with all that here is my question for anyone who have undergone this or has any expertise with this. Will I be ever to do;
1. Dead hang pull ups
2. Kipping pull-ups
3. Over head press
4. HSP
etc. after this surgery and I am healed with my strength back up. I have placed some links to what the shoulder will look like after they place the cap.

I love crossfit and I don't want to stop, but I have to know what is my limits. I don't want to mess myself up even more after I get this done. I am asking for any advice from anyone with any background in this. I am scheduled to have this surgery Feb 27th 2009. I am having second thoughts about this. I don't know if I should just suck it up! or would I be doing myself more harm?

X-Ray of what it would look like after the procedure;
http://www.zadeh.co.uk/shouldersurgery/copeland_1.jpg

Thank you in advance.

GySgt Andres Castro, USMC

Semper Fi.
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Old 01-30-2009, 12:05 PM   #2
Steven Low
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Re: Shoulder resurfacing copeland hemiarthoplasy and crossfit

Let me ask you this:

Does your orthopedic surgeon treat athletes?

If the answer is a no, you should talk to one about what types of physical activity you will be capable of after. Pullups, press, etc. are all kinds of things to bring up with your doc on what you can and cannot do with the surgery. Well, call the one that you have and ask... if you get an unsatisfactory answer get a second opinion from an ortho that treats athletes and see if there's any alternatives.


Anyway, I find it kinda interesting that they're not putting anything on the glenoid cavity/glenoid labrum area especially with the damage to the posterior labrum in your MRI. From what I've seen they tend to usually do total shoulder instead of hemi... but hemi may actually allow you to do more with it than insertion of both a cup and cap. I dunno.. might also be something else you want to bring up with the doc -- the difference in being able to use the shoulder after hemi and full arthroplasty.

Also, take your rehab seriously. Listen to your PT.
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Old 01-30-2009, 02:19 PM   #3
Andres Castro
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Steve,
I contacted him and he is the doctor for several College athletes and High Schools. Still when I mentioned Crossfit he had no clue what I was talking about. As for the PT oh you bet I will take it seriously, since I am still relatively young my bet is I will heal up fast. I am so concern with the stability of the shoulder since they are dislocating it and putting it back. I have heard of people who dislocating there shoulder and it becomes easily dislocated.

Andres
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Old 01-30-2009, 02:34 PM   #4
Steven Low
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Um well even though you asked him about CF I HOPE you asked him about individual exercises you were concerned about that you would be able to do again. If not, I would definitely call again and talk about that.

No, the dislocation won't be a problem. They do that so they have better access to the head of the humerus. In any of the ball joint arthroplasty that they do (hip and shoulder) they always dislocate the joint so that they can make the right cuts and such. They will reattach any of the cut tendons at the normal length they were before and your ligaments will *not* have been stretched. Often times recurring dislocations occur because of weak RC muscles + stretched out ligaments which won't happen in this case.

As long as you follow your PTs plan (should include rotator cuff exercises) you will be fine as long as you don't go too hard too fast to try to get back.. or put it in any super awkward positions (like falling backwards and put your hands back behind you).
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Old 01-30-2009, 06:56 PM   #5
Andres Castro
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Will do, I have a meeting with my Doctor on Monday. I will ask about what I can and cannot do. Thank you for your advice, I really do appreciate it.

Andres.
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Old 01-30-2009, 09:36 PM   #6
Andy Shirley
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Andres,
If you are still in Nashville, go see Jed Kuhn at Vanderbilt Sports Med, or Ed Glenn at Tennessee Orthopedic Alliance for a second opinion.

They both specialize in the shoulder. Kuhn did my shoulder, and is/was one of the orthos for USA Hockey. Ed Glenn is a great guy, played football at Clemson, and understands athletes. We used to train together(pre-CF). Not sure if he is familiar with CF, but he does like to squat.

http://www.shoulderworkahead.com/dr_glenn.html wfs
Tell Ed that "Loaf" sent you.
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Old 01-31-2009, 05:38 PM   #7
Andres Castro
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Andy,
Thanks, I will look him up since I work at Vanderbilt Naval ROTC program as an Instructor. I will be sure to mention you sent me. Also, what was done with your shoulder if you don't mind me asking?
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Old 02-01-2009, 06:51 AM   #8
Andy Shirley
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Andres,
I had multiple dislocations from playing rugby, and ended up getting a torn labrum. Got a repair of that(Bankart), as well as a Mumford(distal claviculectomy) for A/C joint arthritis. Nothing as complex or involved as what you are facing. I also did some training at Vandy Sports Med after getting my Masters in Nursing/NP(mostly with Dr Spindler, Kuhn wasn't there yet).

I had more than a few friends come through the NROTC at Vanderbilt while I was in undergrad there(all graduated around 1998-2000). How long have you been there?
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Old 02-01-2009, 07:21 AM   #9
Andres Castro
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

Andy,
I have been here since Feb 2006, I am coming to the end of my tour here. I will detach from here In May this year and have orders back to MCRD San Diego. I have enjoyed my tour here especially to finally see the Commodores win a bowl game. As for the shoulder, I wanted to try and get it done here prior to my departure. My goal will be to rehab it and be on the down side of my recovery when I report to San Diego. I am concerned that if I let this go and wait till I go to Naval Hospital at Balboa in San Diego, that I will be placed on a long waiting list. Worst of all possibilities be medically discharged from the Marine Corps if the Docs states in their opinion that I won't heal to the point where I cannot qualify with the rifle & Pistol, Do pull ups for my physical fitness test, Pass my swim qualification. Since my right shoulder is my dominant arm the stock of the rifle needs to be placed against the shoulder. Also, will I be able to hold a handgun while I qualify and dealing with the recoil as well. There is the question of stability. I am making every effort to see Glen this week. I have to get my primary care physician to send a referral and get me an approval through my military insurance to see if Glens practice takes Tri-Care. Glens resume is impressive compared to the MD that I have seen recently. If anything, I would like for Glen to do the surgery. First things first, I will set up the meet and ask him all the above concerns.
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Old 02-02-2009, 11:16 AM   #10
Andy Shirley
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Re: Shoulder resurfacing copeland hemiarthoplasy and CrossFit

The bowl win was quite nice after all this time. I was at Vandy 1995-2000 for undergrad, then til 2003 for grad school, then til 2005 as staff in the Neuro ICU. Worked out at the Rec Center all that time, started CFing there in 2005, until I moved away. http://board.crossfit.com/showthread.php?t=42249

I think the only NROTC guy that we might know in common is Nic Arnold, 06, now in Pcola. But he might have already been gone by the time you got started. I used to help out coaching the Vandy Rugby team off and on, and we always had ROTC guys out there.

Best of luck with the surgery and the recovery/rehab.
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