The shoulder is composed of bones, muscles, ligaments, and tendons that
work together to create comfortable movement. Damage sustained to any
part of the shoulder can result in pain and discomfort.
Is Shoulder Surgery For You?
Most patients with shoulder complaints don't need shoulder surgery.
Shoulder pains and discomforts can usually be treated with rest, ice,
therapy, and medication. One key is to avoid doing activities that cause
pain, however this can be a challenge given certain job requirements or
recreational preferences. Overusing the shoulder can prevent healing and
increase pain. Surgery is available when the pain or discomfort has not
been relieved. The decision to have shoulder surgery should be a cooperative
one made between you, your family, your family physician, and your orthopedic surgeon.
Common Shoulder Problems
There are several reasons why your doctor may recommend shoulder surgery.
People who benefit from shoulder surgery often suffer from:
Impingement / Bursitis
Also known as tendinitis, impingement is repeated overhead movements that
can inflame the shoulder joint, causing pain and problems with certain
arm movements. An injection may help, or a surgeon can smooth out the
bones, and detach ligaments to relieve pressure and allow the arm to move
Osteoarthritis is the wearing away of the cartilage and socket of the shoulder
joint. Eventually, the bone becomes exposed and develops growths called
spurs. Without a cushion of cartilage, the joint can become stiff and
painful and can feel as if the bones are grinding together as the arm
moves. A surgeon can remove parts of the joint, smooth out damaged surfaces,
and replace parts of the joint to allow easier, pain-free movement.
Fractures occur when you fall on an outstretched arm or on the shoulder
itself. A fractured shoulder is very painful. A surgeon can repair fractures
with various devices, ranging from plates, screws, and wires. Shoulder
replacement surgery may be necessary if the fracture is severe.
Rotator Cuff Tear
The rotator cuff is a group of four tendons and related muscles that stabilize
the shoulder joint and allow you to raise and rotate the arm. Injury to
the rotator cuff can occur after a fall, lifting heavy weights, and repetitive
arm activities. A surgeon can relieve the pain by repairing the torn tendons
back to the arm or smoothing out any bone spurs that are pinching the tendons.
Other Conditions Treated
The capsule is the part of the shoulder that holds the join firmly in place.
A stretched capsule is loose and is therefore not able to hold the joint
in place. A surgeon can repair this by folding the capsule over itself
and suturing it in place. This tightens the capsule, making the shoulder
joint more stable.
The labrum is a cuff of cartilage in the shoulder that forms a cup for
the end of the arm bone to move within. The labrum provides the shoulder
with stability and a variety of movements. Injury or overuse can cause
the labrum to tear, causing the joint to feel like its dislocated or slipping
out of place. A torn labrum is repaired by reattaching it to the glenoid
(the socket of the shoulder ball and socket joint). A surgeon will suture
the labrum in place and attach it to special anchors put into the glenoid
bone, granting stability and restoring movement.
Inflammatory (Rheumatoid) Arthritis
The synovium in the shoulder joint thickens and forms a tissue growth that
clings to the cartilage. This growth, called the pannus, releases chemicals
that gradually wears away the cartilage in the shoulder. The joint may
then become swollen and cause pain into the neck and arm. Medications
can help reduce inflammation and pain. A surgeon can surgically repair
the damaged joints to reduce pain if medications fail to remove the damage.
After surgery, patients will be given specific instructions on how to care
for their shoulder. Patients will be provided with exercises and medications
to help relieve pain or discomfort.
In addition, patients can also sign up for exercise programs. These programs
are an important part of recovery. Learning shoulder exercises will aid
in restoring strength and movement. Generally, patients will begin strength
rehabilitation exercises 4-6 weeks after surgery.
It will take time to fully regain the use of the shoulder after surgery.
Recovery times differ based on the type of operation and on the patient.
Patients will generally begin lifting exercises 6 weeks-6 months after
surgery, with strength training exercises continuing for up to 1-2 years.