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Back in the Game After Shoulder Surgery

When Mike Gyarmaty dislocated his right shoulder, he hoped corrective surgery at Mayo Clinic would return him to his normal way of life. But that surgery, along with the intense rehabilitation that followed, helped Mike go far beyond those hopes.

When Mike Gyarmaty dislocated his right shoulder, he hoped corrective surgery at Mayo Clinic would return him to his normal way of life. But that surgery, along with the intense rehabilitation that followed, helped Mike go far beyond those hopes.


As
Mike Gyarmaty raced toward home plate during a corporate softball tournament in
Austin, Minnesota, back in 2013, he had a split-second decision to make: slide into
the base feetfirst or headfirst. “I slid headfirst,” he says. “I
was 45 years old at the time. It was not one of my proudest moments.”

While his slide beat the catcher’s tag and propelled Mike’s team to victory, it came at a painful cost. “I blew out my shoulder,” Mike says. “I’d never dislocated a shoulder before. But I knew right away I’d suffered a severe dislocation of my right shoulder when I hit the ground.”

As
he lay in pain near home plate, Mike’s first instinct was to try to pop his
injured shoulder back into place. “I couldn’t do it,” he says. Mike
was taken to the local Emergency Department in Austin, where physicians reset
the shoulder and informed Mike of the full extent of his injury. “In addition
to separating my shoulder, X-rays showed I’d also suffered a labral tear and
broken bone,” he says. “So I knew that wasn’t going to be the end of
my care.”

Expert surgery

Mike was referred to Diane Dahm, M.D., an orthopedic surgeon at Mayo Clinic in Rochester. During an initial examination, Dr. Dahm quickly determined that Mike needed surgery.

“The first time I saw Mike, he could only lift his arm 90 degrees,” Dr. Dahm says. “He was complaining of pain that was 10 out of 10 on our pain scale with use, but only 1 out of 10 with rest. So if he didn’t move it, he was OK. But if he tried to move or use the arm at all, the pain was severe. His MRI also showed a displaced fracture of his right glenoid (shoulder socket), which looked fairly large.”

“I wanted to be able to get back to playing with my kids the way I had before the injury.”

Mike Gyarmaty

After performing a CT scan to better determine the true size of Mike’s fracture, Dr. Dahm and her surgical team went about fixing it with a procedure known as arthroscopic bony Bankart repair. The team had to repair the fracture along with damage to the labrum — the tissue that surrounds the shoulder socket.

“Mike had an extensive tear of the labrum, as well as a displaced fracture which involved a significant amount of the glenoid surface,” Dr. Dahm says. “What we do in that case is first visualize the damaged area through the arthroscope, placing traction stitches through small arthroscopic portals to pull the fracture back into place. We then put anchors in the bone that have stitches attached to them. Multiple stitches are placed through the labrum and around the bone fragment. The stitches are tied, securing things in place. We then make sure everything is stable before completing the procedure.”

Demanding rehabilitation

Leading
up to his surgical date, Mike says his hope was that surgery would not only
help him get back to being the kind of athlete he wanted to be at that point in
his life, but also to return to being the kind of active father he wanted to
be.

“My
goals for surgery were, worst-case, to get back to playing golf and doing
normal exercise as it relates to something a person of my age would do,”
he says. “My best-case scenario was to be able to return to everything I’d
been doing before the injury: lifting weights, playing basketball, pitching
baseballs and softballs, throwing footballs, serving tennis balls. More than
that, though, I wanted to be able to get back to playing with my kids the way I
had before the injury.”

While
Dr. Dahm and the rest of Mike’s care team wanted all of that for him, too, they
knew getting there wouldn’t be easy.

“Everyone
was so professional, so compassionate and so caring,” Mike says of his
care team at Mayo Clinic. “At the same time, they didn’t sugarcoat or
overpromise anything. They said, ‘Your shoulder injury is very bad, but we’re
going to do everything we can to get you back to a normal way of life.’ In
order to do that, they were very up front about how brutal my rehab was going
to be after Dr. Dahm’s surgery.”

Before Mike’s rehabilitation could began, however, Joe Eischen, a physical therapist in the Department of Sports Medicine at Mayo Clinic’s Dan Abraham Healthy Living Center in Rochester, wanted to know more.

“One
of the things we do really well at Mayo Clinic is to ask our patients what
their goals for rehab are and what they’re trying to get back to,” Eischen
says. “We then design a rehab program specifically for them based on their
answers. We do have a standard rehab protocol that we follow with all of our
patients. But every patient is a little different, so we modify that for each
particular patient based on their desires and needs.”

“There was a lot of pain throughout my rehab, but I prided myself on being a very diligent and hard rehabber, and doing whatever Joe asked me to do.”

Mike Gyarmaty

Because
Mike wanted to return to a lifestyle of recreational sports and roughhousing
with his children, the rehabilitation program Eischen designed for him was more
aggressive than most.

“Athletes
are treated a little differently than somebody who doesn’t play sports and who
just wants to get back to living their life,” Eischen says. “Some of
the rehab is the same, of course, but it changes if a patient wants to get back
to playing sports or a job that requires a lot of physical movement.”

Regardless
of a patient’s long-term goals, Eischen says, they’re not allowed to start down
that path until they recover from surgery. “In the beginning, Mike was protected
quite a bit by a brace and couldn’t really do a lot,” Eischen says. “Basically,
we were letting what Dr. Dahm did — the surgical procedure she performed —
heal.”

Once
the healing was complete, it was time for Mike to go to work. “We transitioned
him into getting his range of motion back by starting some basic strength-training
exercises,” Eischen says. “At three months post-op, we wanted him to
have full arm elevation. We also wanted him to have external rotation — meaning
his arm at 90 degrees vertically from the floor, perpendicular to the floor, and
his hand moving backward.”

That
may sound easy. But for someone coming off a severe and painful shoulder
injury, it was anything but. “Just moving my arm back and forth — the most
basic kind of arm movements — would hurt, but I had to do them,” Mike
says. “There was a lot of pain throughout my rehab, but I prided myself on
being a very diligent and hard rehabber, and doing whatever Joe asked me to do.”

Eischen
says the amount of diligence and determination that Mike put into his rehabilitation
is directly proportionate to the results he experienced and how quickly he
experienced them. “Most patients are back to doing a lot of what they want
to be doing six months after this procedure, but everybody’s a little different,”
Eischen says.

Better than ever

Four
months after his surgery, Mike started to see results. “My surgery was in
September, and I can remember playing nine holes of golf in January in Florida,”
he says. “That was a huge milestone for me. I was thrilled. But it was
just a testament to the surgical acumen of Dr. Dahm, as well as to how hard I
rehabbed.”

Today,
six years later, Mike says his injured right shoulder is not only fully healed
and rehabilitated, it actually feels better than his uninjured left shoulder.

“Not
only have I gotten back to doing everything that I was doing before the injury,
I’m now better off than I was before because while Dr. Dahm was fixing my
shoulder, she also went out of her way to clean up the pre-existing damage I’d already
done to it from being a baseball pitcher and serving tennis balls throughout
much of my life,” Mike says. “The surgery has far exceeded my best
hopes and expectations. Forget about getting back to normal, I’ve come out better
than ever.”

“I’m fortunate to have a very good surgical team here at Mayo Clinic, and it’s that whole team who makes stories like this happen.”

Diane Dahm, M.D.

For
Eischen, that represents the best possible outcome. “I got into this
business because I like helping people — helping them achieve their goals in
life and get back to whatever lifestyle it is they want to get back to,” Eischen
says. “So to hear that Mike’s doing so well now is awesome. That’s why we
do this. But it’s also a testament to how hard he worked. Mike should be proud
of himself for following through on his rehab, for doing all that we asked him
to do, and for not going rogue on us along the way.”

For
Dr. Dahm, Mike’s success is also her team’s success. “I’m fortunate to
have a very good surgical team here at Mayo Clinic, and it’s that whole team
who makes stories like this happen,” she says. “It starts in the operating
room with great anesthesia, great surgical nurses and techs, great recovery
room staff, great assistants, great residents, and great physical therapists. It’s
the whole team the whole way through. Every step of the way, you have people
who are doing what’s best for the patient, and when you have that, that’s when
you get patient outcomes like this.”

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