Complex Shoulder Surgery
Dr. Jon Paley specializes in the treatment of shoulder injuries, and in innovative new treatment options. Dr. Paley’s medical team ensures that each patient’s problem is thoroughly evaluated and that all treatment options are considered so the most appropriate health care can be provided. Treatment options include rehabilitation, which involves exercises and motion analysis, medication, surgery, and postsurgical care.
What is a torn rotator cuff?
The rotator cuff is a group of tendons and their related muscles that help keep the shoulder and upper arm bone securely placed in to the socket of the shoulder blade. The rotator cuff stabilizes the shoulder joint and helps you to raise and rotate your arms.
There are three stages of rotator cuff tears:
A stage 1 tear is a partial tear less than 1 cm in size. It is accompanied by some pain following overhead arm movements, but range of motion is not limited.
A stage 2 tear is a partial tear greater than 1 cm but less than 5 cm in length. Pain is common during and after overhead arm movements, as well as at night. It may be accompanied by a slight decrease in range of motion.
A stage 3 tear is a full tear greater than 5 cm in size. Stiffness, weakness, and pain occur during and after overhead arm movements and during sleep. There may be a slight to severe decrease in range of motion in the shoulder.
Arthritis of shoulder
Osteoarthritis is the most common type of shoulder arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage surface of the joint is worn away by shoulder arthritis, bare bone is exposed within the shoulder.
The other common type of shoulder arthritis is rheumatoid arthritis. Rheumatoid arthritis is a systemic condition that causes inflammation of the lining of the joints. This inflammation can, over time, invade and destroy the cartilage and bone.Treatment Options:
Dayton Orthopaedic & Sprots Medicine’s rehabilitation program provides patients with various therapeutic options, including:
- Physical therapy - body movements or exercises designed to improve flexibility of the rotator cuff and shoulder muscles, and provide balanced strength in the shoulder muscles. Depending on the severity of the injury, physical therapy may last from three weeks to several months.
- Motion analysis - evaluation of how the patient’s sports activity, job tasks or other physical activity may be causing the rotator cuff injury and development of activity modifications and exercise interventions that reduce stress and strain on the rotator cuff.
- Recovery from surgery - physical therapy and in home exercises are ways to prevent the injury from recurring.
Patients with severe and persistent pain from shoulder injury may benefit from a corticosteroid (a form of steroids) injection. The medication is injected around the affected muscles, helping to reduce pain, swelling and inflammation.
Surgery may be the best option for patients who have rotator cuff tears or those who have not had success with nonsurgical treatment. Several types of minimally invasive surgery may be performed, including subacromial smoothing (decompression); rotator cuff repair; tissue transfers; and, in cases of severe arthritis, partial or full shoulder replacement (hemiarthroplasty and reverse ball-and-socket).
Recovery from Shoulder Surgery
Following surgery, the patient will begin a customized rehabilitation program based on the surgery performed and the condition of the bone and soft tissue. Patients may need to continue to rebuild their strength for up to a year after surgery, but many patients can return to activities, such as golf or tennis, in four to five months after surgery.
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