View Full Version : Hiking with shoulder issues
Was wondering if any hikers here have had shoulder replacement surgery, and if so, what limitations or issues it created with carrying a backpack after the normal post-op recovery and physical therapy? I've heard many different outcomes on this type surgery, and like anything, depends on the individual, the surgeon, etc. What I've learned so far is the recovery is several months, and the patient can recover almost all range of motion, but there are limitations on the amount of weight one can lift, etc. As far as backpacking, my guess is post-op, it is even smarter to reduce pack weight and get as much U/L as possible. But anyone who has had experience with this situation, give a shout out would be appreciated, either here or PM. My situation is osteoarthritis in one shoulder is gradually getting worse, with MRI showing severe deterioration of the gleno-humeral joint due to loss of cartilage, bone spurs, etc. Ortho says arthroscopic fix won't do it, and looking at shoulder replacement eventually. And I'm putting surgery off as long as possible. Have done the cortisone shots, and Naproxen Sodium is getting me by. Becoming a bionic hiker is the game plan, just keep replacing parts, hoo yah.
yellowsirocco
08-14-2013, 11:44
Just make sure you have a extremely well fitted pack. I had a shoulder injury a few years back and my OK fitted REI scratch and dent pack started killing me.
I have found lifting weights helps keep my pain down too. The muscles keep things where they are supposed to be.
Feral Bill
08-14-2013, 15:33
If you want to go crazy light, a large hip pack might work, at least for shorter trips in warm weather.
JustaTouron
08-14-2013, 15:56
The UL crowd will scream at this suggestion.
Go with an external frame pack.
Even a cheap external frame pack in my experience does a much better job at transferring weight from your shoulders to your hips than a good internal frame pack. (or maybe I never had an internal pack that fit properly) And the UL frameless packs will put 100% of your weight on your shoulders.
Or you might want to check out these.....http://www.aarnusa.com/default.htm although their design is more beneficial for spines than shoulders.
thanks for the tips on packs. I'm learning some tricks on the trail on adjustments to load-lifter straps, shoulder straps, and the waist belt .... to reduce the stress on the shoulder in question.... along with basic backpack 101 lessons like reducing pack weight, and also keeping load center of gravity close to the back and high, kind of between shoulder blades if possible. My biggest question in my mind now is how well I will be able to carry a backpack with 20-25 lbs after shoulder replacement surgery, and that will not be answered until after it happens. I met a sobo thru hiker in Vermont in 2010 with one arm, who was backpacking, he had one arm amputated at the elbow several years before, and he was hiking with a full pack, it was an inspiration to talk with him and his girlfriend.
I haven't had a shoulder replacement but I did have a shoulder reconstruction 6 yrs ago! All tendons had to be reattached and the surgeon also did an acromioplasty at the same time!
After 5 months of physical therapy I had regained 90% function and a full two years before I felt the surgery had been truly successful!
Im not saying this to be negative or to scare you, Im just pointing out that it can be a long process!
When I hike I have to have additional padding on my left shoulder strap! ( operative side) I've also done everything I can do to lighten my pack as well as making certain that my pack fits correctly, with the weight distributed on my hips not on my shoulders!
I can understand you wanting to delay your surgery as long as possible but consider this: the longer you wait the more damage you will incur. Plus you could lose even more range of motion. Regaining my range of motion was the most difficult part of my recovery! One of the main reasons for this was because I had put off having my surgery for so long that my range of motion was almost nil!
Good luck with whatever you decide!
scooterdogma
08-15-2013, 08:25
2344623447As you can see by the big smile on my hiking buddy there is life after shoulder surgery. We did 8 days through the GSMNP. She had shoulder and scapula reconstruction surgery due to a skiing accident. She was ecstatic to find the AARN pack kept the weight off her injured shoulder. She kept the shoulder strap a little loose on that side and reported all the weight from the pack was mostly on her hip belt, due to the construction of the "balance packs". Needless to say, she is very happy this pack was able to get her back out on the trails. Good luck with your pending surgery and Jen highly recommends the AARN Featherlight Freedom for your future endeavors, lol.
Based on your post, it seems that you have done your research on what to expect and have realistic expectations/good attitude.
You probably already have, but I would stress the need to do your research and find the best surgeon possible. As you noted, it is one of the variables that a good outcome is dependent on. After that, do the physical therapy exactly as directed, and when you are cleared to do so (if you are), do some “appropriate” weight lifting as “yellow” suggested – not only weight training that targets your shoulders but your other muscles as well, since they all work together.
After that, I’d lightened my load as you said. I found that keeping the weight at no more than 25 to 32 pounds (depending on length of the trip) has helped keep things pretty comfortable, and I made sure to get a really good fitting pack that allows a good portion of the weight to be put on your hips as has been suggested - the Osprey Atmos 65 and Exos 46 has worked for me but you may have a different build.
I had two surgeries on my shoulder (the second because I didn’t do research on the first surgeon and ended up with someone that didn’t know what they were doing - my stupidity) for a rotator cuff tear, SLAP tear, impingement, bone spurs, and bicep tendon tear/separation. Like n2h, my surgery was not as drastic as getting replacement surgery, but perhaps some of the same principles apply.
Although not specific to replacement surgery, here is another thread that might be helpful http://www.whiteblaze.net/forum/showthread.php?31981-After-Rotator-Cuff-Surgery (http://www.whiteblaze.net/forum/showthread.php?31981-After-Rotator-Cuff-Surgery)
Oh, and not to start a separate hammock vs. tent “discussion”, but I use a Warbonnet Blackbird 1.1 hammock now. Much easier on the shoulder than sleeping on the ground.
Good luck.
Double Wide
08-15-2013, 09:17
I've never had shoulder issues, but I have LOTS of first-hand knowledge of internal vs external frame packs. For a long time I wanted to go old-skool and do the external-frame thing. I bought a nice JanSport Carson x-frame pack and really liked it for short hikes, but for longer, multiple-day hikes, I found that after several hours it just sucked like crap on stick to carry it. Even the more experienced backpackers that I was with tried to help me get it fitted properly on the trail and make adjustments, but it just wasn't working. So I went to REI to get fitted and tried out about a half dozen packs. Turns out, my torso needed a medium sized frame, and all these years I thought I needed a large.
So I bought a Osprey Atmos 65. In the store it felt great, and walking the local greenway, I had no complaints. However, loading it up with 37 lbs of gear, food, and water, I was in a world of hurt coming down from Springer Mountain--I must've taken it off and tried to make adjustments a half dozen times before I got to Stover Creek.
Anyhow, a couple days later I did the shakedown at Mountain Crossings, and while Jason was able to shave about 2 lbs worth of gear out of my pack, he gave me some invaluable advice for making my pack more comfortable. Basically, every time I put my pack on, have all the straps full-loose. Then I work from the bottom up. The first thing I do is fasten the hip belt. With the pack riding low, it assures that most (almost all) of the weight is on my hips. Then I pulled the side load lifters, the ones at the base of the shoulder straps, tight. I finish at the top by tightening the north end of the pack against my shoulders as snug as I can get it.
It works wonderfully--there is hardly *any* weight on my shoulders doing this method, and my pack feels extremely light and very comfortable when I follow this advice. Basically the shoulder straps are there for stability, not load carrying. If the load is on your shoulders, you're doing it wrong. And I've since then, I learned to do the exact same thing every time I take off my pack for lunch stops or 'trail naps'. Usually, if it's a quick rest I keep it on, but I readjust every time I take it off. No shoulder pain at the end of the day now, so I'm totally sold on the idea of a properly fitted internal-frame pack, where for years I didn't want to believe it.
I guess the main problem with the external frame pack that I had was that the hip belt left much to be desired. That, and it caught every low hanging branch and sticker bush on the trail...
Thanks everybody who has responded with advice and info! I've recently switched packs to an Osprey Atmos 50, which is working good so far, with pack strap adjustments to lighten the load on shoulders, plus it kind of limits me on how much extra "what if" stuff I bring along. I'm using it on my LT e2e hike this September. My shoulder problem was precipitated by an incident while in the Army 35 years ago, while going thru training at a school in Ft Benning, GA, during hand to hand combat training, one of the instructors used me as the dummy for demonstrating judo throws, and I landed on this shoulder in a less than optimum way. It later led to arthritis, impingement syndrome, and I've been thru a couple rounds of physical therapy, and know the importance of exercises and stretching for the rotator cuff and other parts in that area. The good news for me at this point is no rotator cuff damage, no biceps tendon damage. I'm going ahead with fall hiking plans, but I'm going to the Andrews Orthopedic Institute in Gulf Breeze, FL in 10 days for a consult with one of their doctors on my options. It cannot be overemphasized the importance of getting a very experienced surgeon for joint replacement surgery, if and when I have it done. My local ortho is a good guy, but I'm getting a 2nd opinion from Andrew's clinic, its only a 2 hour drive from my place. Coincidently, Dr. Andrews has been in the news, he is the Washington Redskins team doctor, and recently did the knee ACL surgery for RG-III. That other WB thread discussed hiking after rotator cuff surgery, here's a link to a recent story from the Pensacola newspaper about some of the latest techniques being done at the Andrews Clinic for rotator cuff surgery. http://www.pnj.com/article/20130811/SPORTS/308110029/Hopeful-strength-shoulder thanks again and I'm always thankful for advice from WB vets who have already been down this road!
I own a ULA Circuit with the "S" shaped straps. For me, these ride further toward the neck and off the shoulders. Perhaps a design like this could help.
I had a shoulder replacement 13 years ago. Dr replaced the upper 5 inches of my humerus. I have no issue carrying a backpack. External or internal frame doesn't matter. The weight is not involved with the gleno-humeral joint.
I also no longer have any rotator cuff attachments - so the hiking issue I have is lack of strength to even consider trekking poles. And I need to lift the pack with my one good arm.