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Minimal Surgery, Maximum Gain

Retired Football Great Tom Flores

His own words exemplify the focus, determination and discipline that football great Tom Flores brought to his professional career. The first Hispanic quarterback in American professional football, Tom played for the Oakland Raiders from 1960 to 1961 and 1963 to 1966, and was the first quarterback in Raiders history to throw for 400 yards in a game. He went on to become the first Hispanic head coach in NFL history, leading the Raiders to two Super Bowl championships (1980 and 1983) during his tenure.

So when Tom needed surgery in February of 2010 to repair a torn rotator cuff, he exhibited the same kind of commitment in order to get back to the activities he enjoys, including golf and playing catch with his grandsons.

“My right shoulder was a mess,” he says. “It’s really a pain to not be able to use your right arm when you’re right-handed,” he adds, noting that he couldn’t raise his arm without severe discomfort. “My wife even had to help me blow dry my hair!”

Tom had torn the same rotator cuff before, in 1994, when he was head coach of the Seattle Seahawks, and had had surgery to repair it. “Then it happened again 16 years later,” he says. “I wasn’t doing anything overly strenuous. I guess it was just the years of wear and tear from playing football.”

A year-round Indian Wells resident, Tom turned to Eisenhower Desert Orthopedic Center for help.

“I knew some of the doctors there, but wasn’t familiar with anyone who specialized in shoulders,” he says. “They pointed me to Dr. St. Pierre.”

“Tom had a massive rotator cuff tear,” notes Patrick St. Pierre, MD, a Board Certified, fellowship-trained Orthopedic Surgeon who specializes in sports medicine and shoulders. “For someone Tom’s age, we sometimes think about doing a shoulder replacement instead of a rotator cuff repair. The determining factors are how big a tear we’re dealing with and how much muscle atrophy there is.

“Because Tom was such an active guy and in good shape, we decided to go for the repair since his function was good and he wanted to get back to golfing,” Dr. St. Pierre explains.

“If the repair didn’t work, we could always go on to do a replacement, which is a bigger operation and doesn’t give the patient as much function in the long run. But repair was out of the question if we did a replacement first.”

Most rotator cuff repair surgeries today are minimally invasive procedures performed using arthroscopic techniques, and Tom’s was no exception. With arthroscopy, the surgeon uses a special thin tube (arthroscope) designed for viewing and treating problems inside a joint. The scope is inserted into the joint space through a tiny “keyhole” incision, and is fitted with a miniature camera that enables the surgeon to view joint structures on a high-definition monitor.

Unlike traditional “open” surgery which requires a long incision to cut through skin, muscle and sometimes bone, minimally invasive procedures are performed through one or more short incisions. The benefits of this approach include less scarring, less blood loss, reduced pain and faster recovery.

“I haven’t done an open rotator cuff repair in almost ten years,” Dr. St. Pierre says, underscoring his extensive arthroscopic experience.

“The first time I had my rotator cuff repaired, it was an open procedure,” Tom says. “When Dr. St. Pierre showed me how he would do it arthroscopically, I was amazed at what he could accomplish. They have some neat ‘toys’ nowadays.”

“A total commitment is paramount to reaching the ultimate in performance.”
—Tom flores

Another “neat toy” that Dr. St. Pierre employed is called platelet-rich fibrin matrix (PRFM), a leading-edge technique that helps stimulate bone and soft tissue growth, and accelerate soft tissue and bone healing.

To create PRFM, one or two ounces of blood are taken from the patient and spun into a platelet concentration by centrifuge. This platelet concentration is then made into membranes that are rich in white blood cells and blood vessel growth factors. The membranes are placed in the area where accelerated healing is desired.

“In cases like Tom’s, with such a big tear, we want everything to be in our favor to enhance healing,” Dr. St. Pierre says of his decision to use PRFM.

Tom’s surgery was successful, and he healed well. But recovery from rotator cuff repair surgery takes more than surgical expertise.

“Rehabilitation is so important,” Dr. St. Pierre says. “And the patient has to take responsibility for this. It’s not up to the doctor or the physical therapist. The patient has to do the exercises. And an hour a couple of times a week doesn’t do it.”

A lifelong achiever in professional football, Tom understood all too well that total commitment is paramount to reaching the ultimate in performance.

“It was nearly four months before I could do any kind of exercise due to the severity of the rotator cuff tear and my, ah, maturity,” he says. But once he got started, he was steadfast.

“I did everything the physical therapist said I should do, to the letter,” he says. “There was no way I wanted to mess this up!”

Today, Tom is back playing golf for fun, traveling with his wife Barbara to visit family and friends and, during football season, he is color commentator during radio broadcasts of the Raiders’ games. “It keeps me occupied in the profession I’ve been in for 50 years,” he says.

He and Barbara stay fit by walking, stretching and exercising with light weights, and eating healthfully. “I’m only five pounds heavier now than when I played ball,” he says proudly. “We have our sometimes food and our everyday food. Cheeseburger and fries are our sometimes food, lean meat and salads are our everyday food.”

Tom also has written two books: an autobiography entitled Fire in the Iceman and Tom Flores’ Tales from the Oakland Raiders: A Collection of the Greatest Stories Ever Told. He also started the Tom Flores Youth Foundation. Now in its twenty-third year, the foundation donates money each year to 14 schools in his hometown of Sanger, near Fresno.

“One year we donate money to the arts department, the next year to science, and the next year to athletics,” he says. “It enables them to do things they ordinarily wouldn’t do because of the money crunch.”

This goal-driven man walks the talk when it comes to living and enjoying life fully, taking care of his health and giving back to others. To other athletes, professional or otherwise who are sidelined by an injury, Tom offers this advice.

“Get it fixed and do your rehab,” he says. “The longer you ignore your problem, the worse it can get, possibly affecting other parts of the body. And do what your doctor and physical therapist tell you to do.”

“We always focus on non-operative treatment first,” Dr. St. Pierre adds. “If you’re having shoulder pain and don’t know the cause, get it evaluated. If you get started on a non-operative program early on, it can often prevent surgery later.”

Postscript
Six months ago, Dr. St. Pierre performed arthroscopic surgery on Flores’ other rotator cuff (his left shoulder) and Flores reports that he feels great and has full range of motion in both shoulders.

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