As those of you who have been attending my yoga classes know that I have been battling shoulder pain for quite some time now. Actually, the pain in my right shoulder started almost two and a half years ago (more about it later on in this post). However, a recent MRI of my right shoulder shows a maximum length tear in my rotator cuff. I got the MRI done about two months ago. I believe the tear happened about seven months ago when while coming down the stairs in my house, I slipped and fell down, landing hard on my right shoulder. The resulting pain was excruciating and my wife, Manju, and I rushed to the ER. The XRAY showed no broken bones, giving me some psychological relief. That was one of the rare occasions when I had to take a pain-killer pill so I could asleep. Even though no broken bones were found, the pain continued to grow over time. That is when I decided to ask my doctor for an MRI of my right shoulder.
I should add here that I have had previous surgeries on both my shoulders to repair torn rotator cuffs. These were done about eight and ten years ago respectively.
When I met the doctor to go over the results of MRI, he brought out the following aspects of the tear:
- It is a maximum length tear. He showed me the MRI and I could see the tear from the front all the way to the back.
- The muscle has retracted 2.9 cm away from the bone. This could be due to the lapsed time between the fall and the MRI or just weakness of the muscles.
- Because of this large distance between the muscle and the bone, the only way to fix it through surgery is to put a patch (graft) using artificial skin and then reconnect the patch to the muscle and the bone. Subsequently he told me that the patch is usually made out of pig skin.
During my first meeting with the doctor, he suggested that the best course of action for me would be to try a steroid injection and see how it does. He wasn’t in favor of immediate surgery as it would be too invasive and there was no guarantee of full recovery.
So he gave me a steroid shot and asked me to come back after 3-4 weeks for reevaluation. In the meantime, I decided to get a second opinion from another orthopedic doctor. Through a friend who lives in Rochester, MN, I was able to connect with an orthopedic surgeon at the Mayo Clinic, one of the most reputed medical institutions in the country. The doctor there told me that I had three options:
- Steroid injection. (I had already tried it without much apparent success)
- Surgery to repair the torn cuff. The chance of success, he said, would be about 50% for two reasons:
- This would be the second surgery on the same shoulder so the muscles would already be weak.
- The surgery involves introducing a foreign body into the shoulder which may not be fully accepted by the body.
- The third option would be a shoulder replacement. This would be a very drastic step and should be used only when the shoulder becomes totally unusable despite the previous two options.
So his recommendation was to go for the surgery option which, he said, could be done by the doctor that I was seeing at the UNC Hospital in Chapel Hill.
With the second opinion more or less confirming what my doctor here had told me, I decided to settle for surgery. In the last meeting with my doctor, about ten days ago, I set August 30 as the date for surgery.
In the meantime, one of my friends sent me a link to a talk with Dr Loren Fishman on the Peoples Pharmacy program on NPR radio. In this talk Dr Fishman claimed that simply with the yogic practice of Shirshasana (headstand) he had been able to "cure" over 700 patients in the past ten years. All these patients had torn rotator cuffs and they were able to reduce pain and avoid surgery.
I found it truly intriguing that he had used headstand, a pose that I have been practicing for close to fifty years on a fairly regular basis, as a cure for torn rotator cuff. Ironically, though, after the fall from the stairs when my shoulder started hurting a lot, I decide to discontinue the practice of headstand for fear that it might aggravate the pain further!
After this new revelation, I restarted my practice of headstand which I have now done for about two weeks.
I have also decided to cancel the scheduled surgery so I can see the impact of the headstand practice for another 3-4 months before once again going back to my doctor for a reevaluation. I did not want to tell the doctor that the reason for the change of my mind was this new knowledge about the headstand being a possible cure for the torn cuff. I just told him that it was too invasive a procedure and given that the chance of success were limited, I have decided against surgery for the time being.
In my mind it is a big mystery how the practice of headstand can have such a dramatic impact on the torn rotator cuff. After practicing it regularly for the last two weeks, I do see almost 5-10% improvement in my pain and mobility. So I am encouraged and willing to stay with the experiment for a few more months.
Mystery shoulder pain
Now let me get back to the pain in the right shoulder which started almost two and a half years ago. In the beginning it seemed like a minor discomfort in some of the arm movements. I didn’t pay much attention as I thought the body will find its own way to heal itself. However, when the pain began to grow gradually, I decided to see a doctor. At the recommendation of a friend I went and saw a doctor in Durham. He got an XRAY as well as an MRI done but couldn’t find anything to indicate the cause of pain. He attributed it to the fact that I had already had surgery on the shoulder and with aging the muscles have gone week. So with no other option in sight, I decided to just wait and see!
When the pain continued to grow, slowly but surely, I decided to get a second opinion from an orthopedic in Cary. He also looked at the MRI and came to pretty much the same conclusion as the first doctor. However, he recommended physical therapy for a few sessions. I went for PT for eight sessions but found no improvement in the situation.
At that point I decided to try some alternative medicine techniques. One of my yoga colleagues and friends suggested I tried an acupuncturist in Raleigh that she had herself used for some back issues. Now, I had never thought that I would look to Chinese medicine for my ailment, but decided to give it a try anyway. I was always a little curious as to how the needles in my skin would feel! I went for about five or six sessions of acupuncture therapy. There were moments when I felt that there was some improvement. However, after I stopped the therapy the pain got back to its original intensity.
Not knowing what I should try next, I just let it be for a few months. Then one of my yoga students recommended a chiropractor in the area. Interestingly, this chiropractor had already taken a few yoga lessons from me so I was aware of her.
Essentially the story goes on along the same lines for some more time. Since this chiropractor treatment provided no relief, I went back to a different acupuncturist at the Duke Integrative medicine center where I went through about six sessions. Still no improvement!
At this point I decided to go back to the orthopedic doctor in Cary to see if he could suggest a different course of action. This led to my going though a painful session of EMG (electromyogram) testing by a nerve specialist. She found a slight pinching of two nerves in my neck and suggested another MRI of the neck. The MRI unfortunately did not show any clear indication of the pinching of the nerves. So they gave me a steroid injection in my upper back which too did not help.
By that time I was getting quite tired of running around all the doctors and just decided to live through the pain for the rest of my life!
It is around this time that I had the accident of my fall coming down the staircase about which I have already written above.
Can Shirshasana (Headstand) heal torn rotator cuff?
Whether or not the headstand will bring much improvement in my shoulder still remains to be seen. As I mentioned above, I have already cancelled my scheduled surgery. Now I am committed to the practice of shirshasana on a daily basis, along with my regular yoga practice, for at least another four to six months.
What I find truly intriguing and mysterious is the pain that was there before I tore the rotator cuff. Currently, the pain due to the tear in the cuff seems to have overtaken whatever pain there was earlier. The question in my mind is – assuming that the issue of the rotator cuff pain is resolved, either through the practice of headstand or with surgery, will the mystery pain come back to haunt me further?
I would love to hear your views, especially if you have any experience with a tear in the rotator cuff, either now or in the past.What kind of treatment did you go through.