The rotator cuff is the muscular covering of the shoulder joint between the humerus and the scapula and is composed of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. The tendon of the long head of the biceps muscle is also closely associated with the rotator cuff.

Do you need rotator cuff surgery? Well, if you go to a guy who makes a living doing surgery on shoulders, what do you think the answer to that question will be?

I have learned a lot about orthopedic surgeons from being married to a physical therapist. When I actually desperately needed surgery for a lower back problem a few years ago; a problem that was putting me in so much pain that I couldn't get out of a chair, she gave me a list of available local surgeons. Most of the names on that list were marked NO WAY WILL YOU LET THIS GUY TOUCH YOU. There were a few "So-So" doctors in the middle, and there were two guys at the top of the list marked "Best guy in town." I managed to get one of those two guys at the top of the list to do the job. That worked out good for me, and when I went to him and he said, "You need surgery," I knew he was right. I knew it because I was going to faint if the pain got any worse. And the immediate relief after the surgery made up for all the hassle. In that case, the recovery time was short and sweet. It took me about a month to get back to 100%.

If you have to have rotator cuff surgery, the recovery time for 100% recovery is more like six months. That's half a year. You ever think about your lifespan here on this ball? Half of one of those years without the full use of an arm is a meaningful event. So you should be in a lot of terrible pain before you let the surgeon talk you into what makes his lake house payments. That is, unless you make your living from the use of that arm, such as a starting pitcher for a major league baseball team or a professional porn wanker. I understand that has spawned an entirely new career for young men who were unsure of what they wanted to do with their lives. "How's your brother these days?" "Oh, he's doing great. He's a self-styled porn wanker now and has quite a following."

With me, my left arm just isn't all that important. However; I realized one day that I had shooting pain down that arm when I did something awkward, like reaching into the dryer to pull out the clothes in the back. I know, a real man would have his wife doing the laundry. Don't think I don't know that's what you're thinking. But I'm a man who works from home. I'm at home all day while my wife is doing physical therapy on folks who have been operated on several times for the exact same problem, over and over, by the same surgeons who were included on the bottom portion of that NO WAY list. So I don't mind. Even though I do wonder sometimes about you ladies and your underwear. I run through Shout like a wino runs through MadDog 20-20. Is there a remedial asswiping course for adults in your town? Would it be crude to enroll your life partner in such a course if one existed? Like, for a birthday present? I know she got pissed when I gave her a vacuum cleaner one year.

Anyway, the pain in my shoulder got to the point where it was keeping me awake at night. If you have a rotator cuff injury, you'll notice shooting pain when you make awkward movements with your arm, usually something behind you, like slapping the shit out of that kid in the back seat who just called you a baldheaded dumbass while you're driving him to a movie where you'll be paying for his ticket. But the real reason you'll go see a surgeon is when it starts keeping you up at night. If you don't get a good night's sleep, it will ruin your fucking life. Literally. Aside from the sexual overtones there, it is the deep REM sleep which allows your body to heal itself, and if you don't get it, it doesn't happen.

So the surgeon tells me that he'll give me a shot of cortisone and that'll fix it, UNLESS I need surgery. Guess what? Then he suggests I have an MRI which will tell him definitely whether I need surgery or not. Guess what? So I play the devil's advocate (which isn't hard when dealing with either a doctor or a lawyer, since you're already paying them for the pleasure of every minute you spend with them) and say, "What will happen if I just put this off and do nothing?" He tells me the pain will get to the point where I will come back to him (thankfully leaving out "on bended knee") and beg him to do what he's telling me I should pay him thousands of dollars to do right now.

I considered a six-month recovery program, with my left arm in a sling for at least a month. And then I did what all men should do when they have an important decision to make. I asked my wife what to do. She said, "Go get some physical therapy and see if that helps." I said, "You're a physical therapist. Give me some right now." She said, "I'm not going to take responsibility for your shit. Go see someone you can yell at if it doesn't work." So I did.

After six weeks of intense 3 times a week physical therapy and daily stretching and strengthening exercises, I am happy to report that I no longer have pain that keeps me up at night. And I can almost reach into the back of the dryer. There's still a lot of work to be done, but as my wife and my new physical therapist both say, "If you can fix a problem without surgery, do whatever you can to do so."

And let me just say this to you kids who are sitting at a desk farting around on a computer every day: If you don't do something about your posture and your core muscle strength, all of these medical problems I post writeups about here will be owned by you one day. When you're in your 20s you can count on nature. When you're past your 40s, you better have a back up plan. (You see what I did there with "back up" plan? Yeah, you see it.)

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