Rotator cuff surgery

[Anonymouse]

So I had rotator cuff surgery a few months ago. The physical therapy is going well--range of motion is close to 100%, strength is coming back steadily.

I self-grounded since my injury, and I feel like I'm pretty close to being ready to get back up in the air. Are there any FAA standards I should be aware of in regards to my recovery, or time elapsed since the surgery? I'm BasicMed if that makes any difference.

Or am I just over-thinking this whole thing?

 

[Rgbeard]

overthinking.

 

[kyleb]

I would fly whenever you feel capable, but maybe fly with a friend first, just to be sure. I had a bone spur removed from my right (stick hand) shoulder a few years ago and was flying again in a week. Certainly, I didn't go up in nasty X winds, but there was no doubt I had the strength and touch to fly the airplane.

Now, if it was a 182 and was my yoke hand, it might have been different.

 

[Anonymouse]

overthinking.

It's not the first time, I'm sure it won't be the last. LOL

 

[Anonymouse]

I would fly whenever you feel capable, but maybe fly with a friend first, just to be sure. I had a bone spur removed from my right (stick hand) shoulder a few years ago and was flying again in a week. Certainly, I didn't go up in nasty X winds, but there was no doubt I had the strength and touch to fly the airplane.

Now, if it was a 182 and was my yoke hand, it might have been different.

Thanks! I'll probably have a CFI help me shake the rust off since it's been way too long. Dang tendon repairs take a long time to heal, and I've probably been erring on the side of caution in general. I really don't want to deal with that again.

 

[Stan Cooper]

I agree with Rusty; you're overthinking this. I severed my right rotator cuff in a 1995 accident and it was repaired by reattaching the tendons with four titanium microanchors. I wasn't flying at the time and it was a nine month recovery before I regained my full strength and range of motion. When I renewed my third class medical, I listed the surgery and my AME simply tested my strength and range of motion during the physical and issued the certificate.

 

[Clip4]

I had both done in the same calendar year and was back flying rather quickly. Gull wing doors are a limiting factor normal operations and ability to emergency egress out of an airplane was my determining factor on when to come back.

 

[Dry Creek]

I agree with Rusty; you're overthinking this. I severed my right rotator cuff in a 1995 accident and it was repaired by reattaching the tendons with four titanium microanchors. I wasn't flying at the time and it was a nine month recovery before I regained my full strength and range of motion. When I renewed my third class medical, I listed the surgery and my AME simply tested my strength and range of motion during the physical and issued the certificate.

I am interested in this reply. By "my AME simply tested my strength and range of motion during the physical", what exactly does that entail? The reason I am asking is that I am one month out from shoulder replacement on my left shoulder. I figure on two more weeks of physical therapy being completed before I go in for my first third-class medical examination. I am five months out from right shoulder replacement. I have much better range of motion on the right side than I've had for the past five or six years, and it's wonderful to be pain free on that side again. My left side is still only about 50% of what it was prior to surgery, but I've only been out of the sling since Saturday, and today was my first bout of PT.

 

[Lachlan]

I am interested in this reply. By "my AME simply tested my strength and range of motion during the physical", what exactly does that entail?

If the AME is any good, they will hand you a 2 lb tub of cole slaw and monitor which hand you hold it with, and how aggressive the scoop is. Joyfully shouting out, “Any bbq in the area, please advise!” will get you issued.

 

[Dry Creek]

If the AME is any good, they will hand you a 2 lb tub of cole slaw and monitor which hand you hold it with, and how aggressive the scoop is. Joyfully shouting out, “Any bbq in the area, please advise!” will get you issued.

That would be cool. Here in Central Texas, good BBQ is plentiful. Heck, if that's all it takes, I'll bring a platter of ribs and sliced brisket from Hammond's up in Glen Rose.

 

[TCABM]

I am interested in this reply. By "my AME simply tested my strength and range of motion during the physical", what exactly does that entail? The reason I am asking is that I am one month out from shoulder replacement on my left shoulder. I figure on two more weeks of physical therapy being completed before I go in for my first third-class medical examination. I am five months out from right shoulder replacement. I have much better range of motion on the right side than I've had for the past five or six years, and it's wonderful to be pain free on that side again. My left side is still only about 50% of what it was prior to surgery, but I've only been out of the sling since Saturday, and today was my first bout of PT.

If you have a regular AME, just ask them. When I completely dislocated my left shoulder, my .mil flight surgeon had me pull and push, lift up and press down against his fist. When it was pain free and I could over power him, I was good to go. Really simple in that aspect.

My PT regimen was focused not just on ROM and strength, but also on the motions and things I had to do to keep my flying status…could I operate the stuff I needed to operate pain free with the required dexterity. In the outside world, I think they call that occupational therapy in addition to physical therapy.

 

[Dry Creek]

If you have a regular AME, just ask them. When I completely dislocated my left shoulder, my .mil flight surgeon had me pull and push, lift up and press down against his fist. When it was pain free and I could over power him, I was good to go. Really simple in that aspect.

My PT regimen was focused not just on ROM and strength, but also on the motions and things I had to do to keep my flying status…could I operate the stuff I needed to operate pain free with the required dexterity. In the outside world, I think they call that occupational therapy in addition to physical therapy.

Thanks for the reply.
I don't really have a regular AME right now. I am in the process of working my way into Student Pilot territory (already passed written test). I am looking to set up a pre-exam meeting with the AME to let him go over my recent surgeries and two other special items needing CACI's.

 

[TCABM]

Thanks for the reply.
I don't really have a regular AME right now. I am in the process of working my way into Student Pilot territory (already passed written test). I am looking to set up a pre-exam meeting with the AME to let him go over my recent surgeries and two other special items needing CACI's.

That is a great plan. We normally call those a consult. Take the time to go over each question, to include the “have you ever in your lifetime…” question 18. Details matter for the first medical, so treat it like a critical process.

 

[Dry Creek]

That is a great plan. We normally call those a consult. Take the time to go over each question, to include the “have you ever in your lifetime…” question 18. Details matter for the first medical, so treat it like a critical process.

Consult. That's the word my mind was feebly trying to find!

Is question 18 "Have you ever been convicted for violation of any Federal or State statutes relating to narcotic drugs, marijuana, or depressant or stimulant drugs or substances? Do not include alcohol offenses involving motor vehicle mode of transportation as those offenses are covered on the FAA Form 8500-8, Airman Medical Application Form."?

If so, then I have absolutely no problem answer with an emphatic NO. I must be some kind of unicorn - I've never even considered trying marijuana. Not even tempted in the least. It was illegal, and "dangerous", and there was always alcohol in the house if I decided to needlessly impair my thinking. Funny thing is, almost nobody believes me when I tell them this. I just can't comprehend that.

 

[TCABM]

…It was illegal, and "dangerous", and there was always alcohol in the house if I decided to needlessly impair my thinking. Funny thing is, almost nobody believes me when I tell them this. It just can't comprehend that.

Good news, keep in mind that alcohol is covered elsewhere, too. Generally speaking for those two, no substance related use, treatment, or legal/work issues is the standard.

The other big gotchas are heart attack, ADD/ADHD history or SSRI usage, even if off label.

If all you’re dealing with is standard biomechanical body problems and/or high BP treated in an approved manner then it’s usually a certifiable record. Note that re: record. From a medical standpoint you are what your records say, not what you think they say or report.

 

[Dry Creek]

Good news, keep in mind that alcohol is covered elsewhere, too. Generally speaking for those two, no substance related use, treatment, or legal/work issues is the standard.

The other big gotchas are heart attack, ADD/ADHD history or SSRI usage, even if off label.

If all you’re dealing with is standard biomechanical body problems and/or high BP treated in an approved manner then it’s usually a certifiable record. Note that re: record. From a medical standpoint you are what your records say, not what you think they say or report.

Oh yeah. Alcohol "issues" require immediate reporting for my line of work too. Any "issues" and you are off to counseling and not given security access for at least two months. You are also subjected to more frequent random drug/alcohol screening.

Never had a DWI/DUI. Never been arrested for or cited for any alcohol related issues. Hmmm, to be honest, never been arrested period. I did get one speeding ticket back in 1982 for speeding through Arizona on a change of duty station trip from San Diego to Norfolk (63 in 55). Oh, and one citation for some kind of improper operation of a vehicle. I was out on a beach in Florida showing off for my girlfriend. I was doing donuts on the beach at three am. The cop laughed and he said he figured it had to be some dumb, young sailor (1981, I was 17, in Nuclear Power School Orlando) because only dummies did donuts with their headlights on. At night. Might as well have sent up a flare marking the spot.

No heart attacks, and I'm way too focused to be accused of ADD/ADHD. No SSRI prescriptions ever, at least that I am aware of. Mostly pain relief stuff such as heavy duty NSAID's, one round of Tramadol (couldn't take it at work or 8 hours prior to) which didn't do much. All of that was before knee replacement in 2016. I also used to be prescribed antibiotics in the spring of each year for sinus infections caused by hay fever / seasonal allergies. About six or seven years ago, that stopped. That was about time the finger joints started swelling and getting stiff. My Rheumatologist says that the one benefit of having an immune system that is out of control is that the usual small illnesses become less frequent, if at all.

 

[Stan Cooper]

I am interested in this reply. By "my AME simply tested my strength and range of motion during the physical", what exactly does that entail? The reason I am asking is that I am one month out from shoulder replacement on my left shoulder. I figure on two more weeks of physical therapy being completed before I go in for my first third-class medical examination. I am five months out from right shoulder replacement. I have much better range of motion on the right side than I've had for the past five or six years, and it's wonderful to be pain free on that side again. My left side is still only about 50% of what it was prior to surgery, but I've only been out of the sling since Saturday, and today was my first bout of PT.

The tests my AME gave me were similar to those @TCABM described. While we were both standing, the doc had me press against his fist with my right hand at several extreme angles of my arm at the shoulder (my rotator cuff surgery was on my right shoulder). Then he repeated this on my left (uninjured) arm. These tests were pretty subjective since no objective tools (scales, etc.) were used to measure the force I applied to his fist. This was over a year after I had completed rehab.

 

[Dry Creek]

The tests my AME gave me were similar to those @TCABM described. While we were both standing, the doc had me press against his fist with my right hand at several extreme angles of my arm at the shoulder (my rotator cuff surgery was on my right shoulder). Then he repeated this on my left (uninjured) arm. These tests were pretty subjective since no objective tools (scales, etc.) were used to measure the force I applied to his fist. This was over a year after I had completed rehab.

Thank you!

That is very helpful, and pretty much along the lines of what I would have expected.