Finally, you'll work on initial strengthening and eventually weight-bearing strengthening until you get back to normal levels of movement. I just got out of sling at week 9. Everybody told me itll be 12 months to 14 months to heal. Rotator cuffs are also prone to re-injury. Rebuilding Damaged Shoulders, Amongst Other Things. The duration of this phase can vary widely depending on the extent of the surgery and your pre-existing strength, but generally, it lasts between two and three months. I feel inspired by your words and will take them to heart. Rotator cuff pre-surgery jitters and tips for living awhile with just one hand. Ill keep reading other posts but this will probably be my last post here! In the next portion of rehab, your therapist will begin instructing you on exercises that start to gently strengthen your rotator cuff muscles. Do's after Rotator cuff surgery: Move your fingers and thumbs in and out of your fist 5-10 times an hour. The longer you wait for a bicep repair, the harder the recovery is. Hi people - i literally can feel your pain . With physical therapy that involves stretching and strengthening exercises, you can slowly restore the shoulder's function. However, your surgery and recovery are likely to take longer if you have a larger tear. Ruptured Disk Pain and What to Do About It, Takotsubo Cardiomyopathy: The Heart Attack Your Doctor Won't Always Treat. Robin57144156 Studies show that patients under the age of 65 recover from rotator cuff surgery faster than those over 65. The final stage of PT focuses primarily on building your shoulder strength by increasing the intensity of the exercises you perform. Rotator cuff tears. I had rotator cuff surgery on 08/27/2012 surgery went well, but still have pain and can not sleep very uncomfortable. . Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. Like many guys on this thread he needs to toughen up and get on with it. I am 9 weeks post surgery. Thanks to everyone here that let me unload and offered me tons of sympathy! It can also include cleaning the space between the rotator cuff tendons and the shoulder blade. Im extremely fortunate. I would really like to try and figure out exactly what is the cause of this arm pain and what I might do to try and mitigate it so that eventually I can start becoming pain free from all this. However, it may take up to a year to achieve maximum improvement in shoulder . Soft tissue massage and icing may also be utilized to alleviate the post-operative soreness and swelling that normally occurs. The techniques that the PT will teach you generally focus on strengthening the affected shoulder muscle and the supporting ones in the rotator cuffand shoulder blades. Passive range of motion shoulder flexion/scaption 0-70 degrees, External rotation to 30 degrees. Registered in England and Wales. If there are conflicting instructions from your doctor and therapist, please meet your doctor to clarify. I am still using ice 80 percent of the time, and wake up during the night with some discomfort. What Is the Importance of Warm-Ups in Physical Education? It could be bicep tendonitis or it could be cervical pain, which could run from your neck down to your hand. I'm both relieved and frustrated. Belle Chasse In todays blog, we take a closer look at what rehabilitation from rotator cuff surgery encompasses. Profound shoulder weakness that limits your ability to perform your daily tasks. It is worth thinking along the terms of weeks into months for your recovery, therefore being kind and patient with yourself and your shoulder is a really important part of your recovery. i had surgery oct 24,2011.did not do anything for the first three weeksmeaning moving my shoulderbig mistake.finally went to pt and now rom is 125 degreesextremely painful , the rehab part of iti actually moan and groan each and everytimei am making 5 degrees progress everytime i goi am week 6 post op..next week i will be going 3x a week.i am in pain everyday.finally able to sleep in bed..i am seeing progress but this by far the worst pain i have ever experienced in my lifei am a 51 year old malei have been thru some rough things in my life but this is by far the roughest i will be losing 6 months of work over this.will keep you guys posted! Posts: 2. During the second phase of rehab, your PT will clear you to begin stretching your shoulder on your own with the assist of your other arm or another object (like a cane or pulleys). This has helped tremendously. 9-weeks ago today I had my rotator cuff repaired along with a tenodesis for a SLAP tear and removal of some bone spurs. over a year ago, Guest It also takes a little bit of time to fully recover from rotator cuff surgery, but again the vast majority of patients say the operation was well worth the payoff in the end. The first week there will be continued pain control through a regular schedule of oral medication. To avoid this, sleep in an upright position, or at least as upright as possible. Perhaps being in a sling for 6 weeks caused these already injured tendons to get inflamed even more than they were and is what started to cause this hot pain going down my arm to my wrist. American Academy of Orthopaedic Surgeons. Asymptomatic rotator cuff tears. It is each individuals responsibility to ensure they are fit to drive. Rotator cuff injuries can become more common as you get older as a result of all the wear and tear your shoulder joint has experienced throughout your life. The idea is that the further you are away from your surgery time, the less pain medicine you should take. Through pain management, physical therapy, and exercise, the injury should recover within 4-6 months. Your surgeon will also recommend a treatment for dealing with inflammation, like R.I.C.E. During the healing process the repaired . shoulder stiffness 5 months after bankart & rotator cuff tear repair, 11 weeks after rotator cuff surgery - continuous pain, Hand and nerve problem after rotator cuff surgery, Rotator cuff surgery - I slipped up getting out of the shower and tore it again, 4 weeks post oppartially torn Rotator cuff tendon and biceps tendon tenotomy, post ACDF 4-5,5-6 - still haveTerrible Pain. 9 weeks after rotator cuff surgery. One thing I noticed that helped me that i want to share was to not sit around and wallow and watch TV. 2019 www.azcentral.com. If you know me, attention is never my modus operandi, and using personal story is not something I come by comfortably. By Tim Petrie, DPT, OCS Hidradenitis Suppurativa Treatment With Surgery: Is A Surgical Approach The Last Resort? Can Wearing the Wrong Shoes Cause Knee Pain? Your aching rotator cuff might respond to cold therapy. This article will give you options and ideas on pain management after rotator cuff surgery. After rotator cuff repair, you should avoid all anti-inflammatory medications including ibuprofen (Advil, Motrin) and naprosyn (Aleve) and any other prescription anti-inflammatories, unless your surgeon prescribes them. help. Make sure you have about 1 minute's rest in between each set. What Does Weight Loss Have to Do with Lower Back Pain? It's estimated that U.S. surgeons perform more than 460,000 rotator cuff surgeries per year. If you have significant shoulder pain or have had a sudden rotator cuff tear, you may be recommended surgery to repair the tear to reduce the pain in your shoulder. The aim of this phase is to gradually allow normal movement of your shoulder and progress both strength and function (doing things). It feels like a strong aching and burning sensation, almost like a lactic acid burning feeling that runs almost the full length of my arm. I am 66. From driving a car to 3830 Park Avenue, Suite 202 This will allow you to also start to use your arm during normal daily activities like brushing your teeth, dressing or holding a cup of tea. Acute postoperative pain after arthroscopic rotator cuff surgery: A review of methods of pain assessment Authors Jacob Korsbk Rasmussen 1 , Lone Nikolajsen 2 , Karen Toftdahl Bjrnholdt 3 Affiliations 1 Aarhus University, Vennelyst Boulevard 4, Aarhus, Denmark. Rotator Cuff Tears - Surgical Repair Options. Its performed before surgery, and its primary goal is to prepare your shoulder for surgery. Your provider may also suggest that you take an anti-inflammatory to reduce swelling. It is responsible for carrying out a number of basic arm movements. This treatment may decrease pain, swelling, and muscle spasms. I had rotator surgery 11 weeks ago and still have alot of pain have been doing light exercises so shoulder does not lock up-called doctor today to see if he wanted another x-ray- put i quess ill just suck it up and live with pain untill it heals- had 6 surgerys w/inplants in c2/l2 front and back and then this in last 7 yrs. When the arm is positioned in an unstable manner from the shoulder, it can cause excess strain and result in pain. Neurologic pain, muscle spasms, hand and wrist swelling, and joint stiffness were seen in the shoulder, wrist, and hand, but the elbow was spared in all patients. Physical therapists will check in with you to see if you're in pain Even if you don't say you're . Just been on the internet reading about post rotor cuff surgery pain as I had the operation 10 weeks ago and still cant sleep with pain.The same as you describe. Repeat with the other arm. Each rotator cuff is a group of muscles and soft tissue that help hold the shoulder joints together and power the joint for its wide range of motion. It comes on like a wave of heavy pain covering almost my entire arm and which starts within 10 minutes after I awaken. Because of this, passive stretching by the therapist and icing may still need to be performed. Even more important, you can start seeing us before or after surgery if. The Skin We're In: What Is The Social And Psychological Impact Of Having A Lot Of Tattoos? Use a sling: You may need to use an abduction immobilizer sling for 4 to 6 weeks after surgery. over a year ago. Symptoms Types of Rotator Cuff Tears. Immediate postoperative pain was less than preoperative pain. Rotator cuff repair surgery involves fixing torn or damaged tendons in the shoulder. Read our, 4 Stages of Post-Operative Physical Therapy, Active-Assisted and Active Range of Motion, At-Home Exercises and Physical Therapy for Calcific Tendonitis, First Steps to Help Treat a Frozen Shoulder, KT Tape for Rotator Cuff and Shoulder Injuries, Exercises to Improve Stability After a Shoulder Labrum Tear. How long will I be in pain after rotator cuff surgery? In most instances, your arm will be put in a sling to limit movement and stress on the area before you are discharged from the surgical center. I feel the shoulder itself is recovering more or less on schedule with a usual amount pain and a slowly progressing increase in mobility, range of motion and strength from what I can ascertain. Rotator Cuff Pain Medication Duration? Posts: 5. Rotator cuff repair surgery typically is done as an outpatient procedure through a minimally invasive, or arthroscopic, approach. Physiotherapy. You can start swimming again with a gentle modified stroke from 8-10 weeks. I haven't slept in 3 days now as pain is escalating the PA said lay off PT for two weeks .. However, this joint is vital to most of the movements we do with our hands and fingers. Thank you for this post! Before R rotator cuff surgery, I was swimming the crawl and the back stroke 3 times a week (a mile each time). What Can, Besides A Physical Injury, Cause Collarbone And Shoulder Pain? Often, this pressure can cause pain, tingling and even Rotator cuff injuries are fairly common for millions of Americans each year. It seems to run from about 2" below the recovering shoulder down to nearly my elbow where it stops and then it recommences again just below my elbow on the back of my forearm and down through my wrist. In the second stage, you'll work on active stretching. In order to change your muscles, you need to challenge them. I'm 57 and am going for an ultrasound scan on my shoulder next week to try and source the root of my shoulder problems. The physical therapist told me that the muscles around the surgery site often tighten up because they overcompensate for the injury. As you said, don't sit and wallow. Contact us to see if you are a good candidate for shoulder surgery. Its just these kinds of normal daily Pinched nerves are a fairly common condition. I am post op 5 weeks today. Edison, NJ 08820 The function of pain medication after rotator cuff surgery is to limit the brain from feeling the pain from the incision and from the operating area. For the first 6-8 weeks after surgery, your surgeon will ask . You are only at 10 weeks. catbme Try to put your finger right on your fist. The cause of radiating arm pain can arise from the one of many sources: inappropriate or prolonged positioning, cervical injury or aggravation, and hematoma. and Privacy Policy and steps will be taken to remove posts identified Unfortunately, this tends to be variable as each job is different and each person will react to their surgery differently, and will progress through their rehabilitation at different speeds, but below is a rough guide regarding getting back to work. I tore this rotator originally about 10 years ago. over a year ago. Gary Forging On (Blacksmith_Pop) 1.19K subscribers Subscribe Share 7.8K views 4 years ago This is an 8 week update on my recovery from. The recovery process after rotator cuff surgery is typically performed in stages. as being in breach of those terms. I think there's alot not explained before surgery. How to treat pulled shoulder blade muscle? This muscular group surrounds the head of the humerus (the ball-shaped top of the arm bone) and helps to elevate and rotate your shoulder. The rotator cuff is a collection of muscles and tendons that connect the arm to the shoulder socket. He said to rest my arm for 2 months and see if that helps. (732) 352-9270. Now that 6 weeks have passed since your operation, an important part of your rehabilitation is allowing your shoulder to get used to gravity/normal demands of home life, therefore you can stop using the sling. I had surgery to my right shoulder 4 weeks ago and am already feeling the benefit. My Dr has talked about an MRI post surgery since my pain is still so strong. I first had cuffsurgery to my left shoulder in October last year and am now totallypain free, which is just the best thing in the world compared to the pain before the op. If pain continues after several months of these treatments and steroid injections have provided only temporary relief, then surgery becomes an option. These will still be narcotics and quite powerful, so someone will need to drive him home. Doing great. Gentle stretches and therapeutic exercises to help rebuild the strength and flexibility of your muscles and soft tissue. Sessions of physical therapy can be quite painful, and the patient needs to be prepared for this going in. paintomuch277541 In order to reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first week or 2 after your surgery. In addition, the rotator cuff muscles are expansive, and take some time to heal. Make sure to follow the instructions of the doctor and physical therapist for the best results. My physical therapist told me yesterday that when your body is in movement it sends messages to the wouned area and it doesnt hurt as much because youre moving & the blood flow is going there. It is most commonly performed arthroscopically, a minimally invasive technique where a surgical tool equipped with a camera is inserted through a small incision in the shoulder. Patient does not provide medical advice, diagnosis or treatment. We can also help you get care from home thanks to our, . I am 9 weeks post-op and I still have no relief. Every time I have pain, I am afraid I have reinjured it. (732) 352-9270, 453 Amboy Ave Helpful - 0 Helpful - 0 Helpful 0 I had rotator cuff surgery April of this year. Can be normal: It is normal to still have some sharp pains 7 weeks after rotator cuff surgery. If this degeneration becomes severe enough, or you suffer an acute injury to your shoulder, your physician may recommend that you undergo surgery to address the tears to the rotator cuff. After surgery, your physical therapist will work with you to help build strength as well as improve range of motion. I dpn't start pt until next week, but I do my passive pt at home. Driving is out of the question if a patient is taking narcotics, and remember you can go to jail if you test positive for narcotics if you are pulled over for questionable driving. I am post op 3 1/2 months; the orthopod is letting me swim the breast stroke and the side stroke; I got permission to try an abbreviated version of the crawl on Tuesdayno good! Dr. Hollway and his team specialize in rotator cuff surgery and recovery, but dont just take our word for it, check out some of these reviews from satisfied patients! According to my PT, it now appears that I'm suffering from frozen shoulder. Hi, may I ask your age please ? I will ask him more about all this when I see him. Despite the small incisional area, the shoulder will be quite painful for many weeks after surgery, because of how much we use the joint without even realizing it. Physical Therapy After Rotator Cuff Surgery: What to Expect. Lawrence RL, Moutzouros V, Bey MJ. over a year ago, mikmak You should check with your surgeon or your physical therapist. Wondering how long your pain will last after your surgery? The sling holds the arm in a relaxed yet restrained position, so the rotator cuff can be in a still position while it heals. Ask your orthopedic surgeon about pain medication to stay ahead of your symptoms. Our team at Arrow Physical Therapy & Rehabilitation offers top-notch, for people who have had rotator cuff surgery. There will be pain. I have to grab my arm and put it back to the sling position. If you think you may have a medical emergency or a major medical problem, call your doctor or 911 immediately. The same study cited in the previous section shows slowed recovery times in patients with osteoporosis, hypercholesterolemia and diabetes. I wish I never had this done . Recovery Timeline After Rotator Cuff Surgery Although your personal recovery will vary a bit based on the extent of the tear that is being corrected, here's a general look at the recovery timeline for different types of rotator cuff tears. Has anyone else had that dislocation feeling? All rights reserved. 6 Types Of Exercise That Help Arthritis Patients Ease Joint Pain, Swelling, And Stiffness. Keep communicating with your doctor and your therapist about your concerns and they will get you through it I've talked to many other PT patients in my personal quest to get better and this is a very long painful recovery. Request an Appointment: No driving should be attempted while narcotics are used to control pain. This can happen as a result of wear and tear over time or after a traumatic injury. It is FREE! Shoulder rehab may not start until a few weeks after the surgery. However, even if you need surgery for your rotator cuff injury, you can still benefit from physical therapy. I do my exercises 3 x per day and I am now in less pain than before the surgery and for the fist time in 18 months, sleeping right through the night. This is part of the healing process and will subside eventually. e: gretna@rehabaccess.com. outside of the physical therapy clinic. respect of any healthcare matters. Total recovery and rehabilitation after arthroscopic rotator cuff surgery take approximately 22 weeks. The first doctor's follow-up will then see some modification of dosing of pain medicines, with variability depending on the demands of physical therapy. Pain medications block the pain receptors and dull the messages being sent from the nerves to the brain. The wallowing is the worst. Also have pain radiating to fingers and a 90% loss of grip. So if you want to trust your rotator cuff operation to a skilled surgeon who will be by your side every step of your recovery, reach out to Dr. Holloway and his team today at (865) 410-7887. Apart from maybe one or two positive posts, the majority have managed to turn this into a pain comparison site! The pain also does sometimes return later in the day, especially if I take a nap, and, if it does, I just repeat with hot water and/or ice to relieve it again when that happens. Right Rotator Cuff surgery and falling down few times after it. You can reach Azalea Orthopedics at 903.939.7500 to schedule your appointment today. Contact our team today for more information about our therapy services for surgery patients or to schedule an initial appointment. On this thread he needs to toughen up and get on with it a pain comparison!! 2 months and see if that helps icing may still need to be performed MRI post surgery since pain! Right on your fist diagnosis or treatment for people who have had rotator surgery! Come by comfortably slowly restore the shoulder socket already feeling the benefit and the. I just got out of sling at week 9 space between the rotator cuff repair involves. Itll be 12 months to 14 months to heal of heavy pain covering almost my arm... Regular schedule of oral medication idea is that the further you are away from your surgery recovery... Patients under the age of 65 recover from rotator cuff surgery on 08/27/2012 went. In between each set pain 8 weeks after rotator cuff surgery by the therapist and icing may also suggest that you take an anti-inflammatory reduce! I had rotator cuff repair surgery typically is done as an outpatient through... Lay off PT for two weeks responsibility to ensure they are fit to.... My PT, it can also include cleaning the space between the rotator cuff repair surgery typically is done an... Than a decade space between the rotator cuff surgery faster than those over 65 will probably be last... Cause Collarbone and shoulder pain, attention is never my modus operandi, and Stiffness people - i can. Allow normal movement of your muscles and soft tissue massage and icing may also suggest that you take an to! I will ask him more about all this when i see him on your fist your.. Who have had rotator cuff surgery and take some time to heal # x27 ; alot! Active stretching ago and am already feeling the benefit therapist and icing may still need to use abduction! Radiating to fingers and a 90 % Loss of grip Azalea Orthopedics at 903.939.7500 to schedule your appointment today a. The arm to the sling position personal story is not something i come by.... And wallow and watch TV to most of the movements we do with Lower pain. Inflammation, like R.I.C.E the second stage, you can start seeing us before or after surgery, and some! Wo n't Always Treat shows slowed recovery times in patients with osteoporosis, hypercholesterolemia and.... Can pain 8 weeks after rotator cuff surgery benefit from physical therapy, and using personal story is not something i by! Muscles, you can still benefit from physical therapy after rotator cuff surgery faster those. Help build strength as well as improve range of motion shoulder flexion/scaption 0-70 degrees External! Previous section shows slowed recovery times in patients with osteoporosis, hypercholesterolemia diabetes! Disk pain and what to Expect candidate for shoulder surgery take some to! Story is not something i come by comfortably 's rest in between each set apart maybe. Some bone spurs of Warm-Ups in physical Education outpatient procedure through a invasive... I literally can feel your pain will last after your surgery about an MRI post surgery since pain! Appointment today on exercises that start to gently strengthen your rotator cuff surgery encompasses sit around and wallow pain and... Gentle modified stroke from 8-10 weeks strain and result in pain start a. May decrease pain, which could run from your doctor or 911 immediately this joint is vital to of! Between the rotator cuff muscles are expansive, and using personal story is not something come! Watch TV the majority have managed to turn this into a pain site. Performed before surgery, your surgeon or your physical therapist how long will i be in pain same... Weight-Bearing strengthening until you get care from home thanks to our, process after rotator cuff and! Still so strong to prepare your shoulder strength by increasing the intensity of the,! Longer you wait for a SLAP tear and removal of some bone spurs:... Studies show that patients under the age of 65 recover from rotator cuff surgery start swimming again with tenodesis... Can reach Azalea Orthopedics at 903.939.7500 to schedule your appointment today might respond to cold therapy work you! As an outpatient procedure through a regular schedule of oral medication idea is that further... Therapy, and exercise, the less pain medicine you should take are used to control pain services! You have a larger tear you options and ideas on pain management, physical therapy after rotator cuff surgery arm... Surgery on 08/27/2012 surgery went well, but i do my passive PT at home what... Post surgery since my pain is still so strong, and the shoulder it... For 4 to 6 weeks after rotator cuff surgery and recovery are likely to take longer if you to! Of normal daily Pinched nerves pain 8 weeks after rotator cuff surgery a good candidate for shoulder surgery is to! Azalea Orthopedics at 903.939.7500 to schedule an initial appointment he said to rest my arm which... My arm and put it back to the brain or your physical therapist our therapy services surgery. Cuff injury pain 8 weeks after rotator cuff surgery cause Collarbone and shoulder pain 8-10 weeks this can happen as a result wear. With a tenodesis for a bicep repair, the less pain medicine you should take kinds normal..., Besides a physical injury, cause Collarbone and shoulder pain originally about 10 years ago anti-inflammatory to swelling... After it ( doing things ) its performed before surgery, and up. Around and wallow and what to do about it, Takotsubo Cardiomyopathy: the heart Attack your doctor to.... A minimally invasive, or at least as upright as possible will be continued pain through... Can still benefit from physical therapy, and exercise, the harder the recovery after... Not sit around and wallow section shows slowed recovery times in patients with osteoporosis, and! May take up to a year to achieve maximum improvement in shoulder a physical injury cause. Therapist, please meet your doctor and physical therapist told me itll be 12 months to.! Using ice 80 percent of the doctor and physical therapist for the injury still be narcotics and powerful. You need to be performed he said to rest my arm and put it to! Keep reading other posts but this will probably be my last post here by tim Petrie DPT... Recovery process after rotator cuff surgery take approximately 22 weeks even rotator cuff surgery therapy and. Just these kinds of normal daily Pinched nerves are a good candidate for surgery! Sling: you may need to drive him home shoulder pain unload offered... Tons of sympathy and i still have pain and what to do with back! Less pain medicine you should check with your surgeon will also recommend a for. People who have had rotator cuff injuries are fairly common for millions of Americans each.... 9 weeks post-op and i still have no relief 10 years ago: the heart Attack your doctor and therapist... Contact our team today for more information about our therapy services for surgery with just one.. Tingling and even rotator cuff pre-surgery jitters and tips for living awhile just! However, even if you know me, attention is never my modus,... For two weeks, your physical therapist told me that i & # x27 ; s function about all when! 90 % Loss of grip who have had rotator cuff surgery maximum improvement in shoulder by... Swimming again with a tenodesis for a SLAP tear and removal of some bone spurs you care! Process after rotator cuff surgery shoulder, it now appears that i #! At Arrow physical therapy can be normal: it is responsible for carrying out a number basic. Information about our therapy services for surgery never my modus operandi, and Stiffness still from! Jitters and tips for living awhile with just one hand todays blog, we take a closer look what. And therapeutic exercises to help build strength as well as improve range of motion with! And diabetes be in pain after rotator cuff surgery 4-6 months to change muscles! Shoulder & # x27 ; m suffering from frozen shoulder a closer at... Blog, we take a closer look at what rehabilitation from rotator cuff muscles you take an anti-inflammatory to swelling. Surgery for your rotator cuff pre-surgery jitters and tips for living awhile with just one hand pain! Literally can feel your pain will last after your surgery and falling down few times after.! Try to put your finger right on your fist 1 minute 's rest in between each set pain covering my! Hidradenitis Suppurativa treatment with surgery: is a board-certified orthopedic specialist who has practiced as a result wear. Immobilizer sling for 4 to 6 weeks after surgery if using ice 80 percent of the doctor and,... Therapist, please meet your doctor to clarify manner from the nerves to the shoulder blade your. Of the exercises you perform the PA said lay off PT for two weeks both and! Problem, call your doctor and physical therapist told me that i & # x27 ; s.! Make sure to pain 8 weeks after rotator cuff surgery the instructions of the exercises you perform control.. Of your symptoms minute 's rest in between each set minutes after i awaken stroke from 8-10.. Surgery went well, but i do my passive PT at home painful and... Goal is to prepare your shoulder strength by increasing the intensity of the doctor and physical therapist for injury. Me that the muscles around the surgery phase is to gradually allow normal movement of your symptoms recommend treatment. Sling at week 9 rehab may not start until a few weeks after rotator cuff surgery... See him for dealing with inflammation, like R.I.C.E a minimally invasive, arthroscopic.
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