I apologize if this has been asked already but I couldn’t find a relevant post.
Last summer I injured my rotator cuff. It’s been 8 months and still it hurts. The orthopedic surgeon I visited said it’s a weak area of the body—it has poor blood flow and heals very slowly.
I’ve found myself wondering if my weekly pulsed dose of rapa might be exacerbating the problem by making the healing go extra slowly.
Do we have any advice on dosing after surgery, or after pulling a muscle or injuring oneself internally?
In general - 8 months is well beyond the time frame where there would be healing. You’ll be in a steady state - and if things aren’t going well, a discussion with the Orthopedist would be the next course of action. It’s possible you have some structural reason for the pain, and might need something done procedurally.
For most procedures - and it differs depending what is being done - but most healing occurs in the 7-14 days after most surgeries.
I would certainly hold Rapamycin doses in the week before and couple of weeks after a surgery as I’d not want to inhibit mTORC1 in the setting of needing healing.
Longer term - it would seem like ongoing pain and issues with chronic inflammation tend to do better with having rapamycin for most people.
That would be my general thoughts on this - and not medical advice to you - and it would seem like a visit with your Orthopedist would be a sensible next step.
I’d push for more imaging to see what could be going on — perhaps an MRI. There’s modalities like TECAR, shockwave therapy, red + IR light etc. that might increase blood flow to the area but before you see what’s going on and where it’s tough to say so I would be a squeaky wheel to my ortho too.
I got an ultrasound and X-ray. There’s a tear. The Orthopedist said they don’t do surgery any more for routine rotator cuff tears because the surgery can do more harm than good.
He said it’s standard for it to take 6-9 months before inflammation goes away.
He suggested a product called “Crossover Symmetry” to strengthen the muscles around the shoulder. Said he’s met people with tears who don’t feel them because the other muscles of the shoulder give so much support.
Finally, he said the rotator cuff slowly degrades in everyone as we age and that it’s generally something to learn to live with if possible and unless it’s extreme.
There is still a significant amount of inflammation.
I was worrying that in such a case Rapamycin might slow the already slow repair of the injured site. I took a dosing vacation last week and this week I’m taking 2mg. I guess it can’t hurt to lower the dose for a month to see if it helps at all.
If you search the forum for my user name and PEMF, you’ll find discussion of Pulsed Electro Magnetic Frequency therapy. I’ve and many others have had significant success with it.
Have you tried physical therapy? Rehabilitation is an important part of healing. Honestly I would go into full throttle research mode on YT — there’s good orthos out there who are also good at explaining what’s what. If nothing else it will make you better at talking to your own doctor and advocating for yourself. I personally would drop Rapa entirely for a while just in case. Anything that stimulates blood flow to the area will help it heal faster. Perhaps research each modality I mentioned above on PubMed in relation to a rotator cuff—if you find something promising you can buy the machine from China for typically what it will cost to get one or two treatments by a professional. These are just thoughts, as usual consult with the ortho.
I’m grateful for this advice and for the advice of others, above! I’m looking into the TECAR and PEMF. I got physical therapy for the other shoulder a few years back and it was helped by a machine with electrodes that went through the shoulder.
You mentioned getting such a machine from China. Could you recommend a process for doing that? Like what sites would I visit? How do you know if a machine is top notch (certifications, brands, etc)?
The machine with electrodes sounds like what they call “stim” and is basically EMS. So the cheapest and easiest way to try something would be Amazon — look at what I get when I search for “ems”, I’d look at the reviews and see if you want to start there.
PEMF is more powerful but the machines are much more expensive, orders of magnitude, even out of China. I wouldn’t go there yet.
I’d try a red + infrared full body panel and use it daily for 30 min or so. I bought mine from this vendor and was very pleased. It’s the best price I’ve found anywhere for a top notch panel. Shipping is extra but I chose ocean freight which took about a month but was super cheap. If you want it faster you can pay more for air transport.
One of its components, what they call a “fascia knife,” is actually the same treatment as the electrodes — basically EMS so it’s a very comprehensive machine. I highly recommend it if you can afford it. Got mine for a chronic tendon injury and it has helped a lot.
Try the exercise called “face pulls” it’s wonderful for your rear deltoids and the small rotator cuff muscles. Start with bands first and then work up to weights.
If using weights: do the exercise with two ropes, not one. (Or alternatively with one big rope)
Why? Because otherwise you won’t be able to properly externally rotate.
