Que: Is it necessary to strengthen your shoulder or upper back muscles before going for Shoulder Arthroscopy Surgery?
Dr Shekhar : It is not a prerequisite to strengthen your shoulder before going for Shoulder Arthroscopy surgery. Of course it helps in rehabilitation and one should strengthen the shoulder muscles before arthroscopy surgery but if its rotator cuff tear or bankart tear then one must not wait for strengthening exercises. So exercises does help but its not mandatory
Que: Is it normal to have Frozen Shoulder after Shoulder Arthroscopy surgery?
Dr Shekhar : No, if the arthroscopy surgery is performed in a proper way, it does not usually lead to a Frozen Shoulder. The patient gets full range of motion. There are different arthroscopic surgeries for different problems in the shoulder joint.
For instability like Bankart Repair, usually the patient does not have any stiffness in the shoulder joint after arthroscopy. After Rotator Cuff Repair, sometimes patient do get some stiffness but that is usually recoverable and can be managed with physiotherapy exercises
So it is wrong to say that all patients get Frozen Shoulder after Shoulder Arthroscopy surgery. In Fact in most of the cases, because Arthroscopy surgery is minimally invasive, there is less pain and so recovery is faster and results are very good.
Que: Is there any restriction in motion after arthroscopic surgery for shoulder? Are there any complications?
Dr Shekhar: It all depends on which procedure is being performed. Like if it is a Rotator Cuff tear, you must wait for a while till the tendon heals to the bone. So in that case you have to restrict movement from 6 to 8 weeks after which you start exercises to gain full movement.
Similarly for Bankart repair also you have to restrict the movement for 3 to 4 weeks but the patient is allowed to do his or her normal activities like earring, surfing mobile, walking etc . But rigorous activities are restricted.
Dr. Shekhar Srivastav heads the Orthopedics department at Sant Parmanand Hospital & is the FAQs on Rotator Cuff by Dr. Shekhar Srivastav leading Joint Replacement & Arthroscopic Surgeon in Delhi, India. Trained at some of the best centers in India & Abroad he has vast experience of treating problems of Knee & Shoulder joints. He has been an integral part of DITO, Sant Parmanand Hospital for more than 18+ years & with the legendary Orthopedic Surgeon Dr. Shekhar Agarwal has helped Sant Parmanand Hospital gain its present reputation & respectability.
He has treated thousands of patients with complex Orthopedics problems. He’s well known for performing Knee replacement surgeries (Total & Partial Knee replacement), Knee Arthroscopic Surgeries (ACL Injuries, Meniscus Injuries, Cartilage Damage) & Shoulder Surgeries (Arthroscopic Bankart Repair, Rotator Cuff Repair, Shoulder Replacements)
Frozen Shoulder is the most common problem of the shoulder. It normally happens in the age of 40-50 , especially in sugar and thyroid patients. Our Shoulder joint is like a ball and socket and around it is a capsule. In Frozen shoulder, this capsule gets shrinked restricting the shoulder movement and causing pain. Initially the patient gets pain while moving the shoulder but then gradually he can also feel the pain during the rest period. Sometimes it even disturbs the sleep.
Frozen Shoulder Treatment
Exercise is very important in the treatment of Frozen Shoulder. The main task is to cure the capsule which has shrunk through stretching exercises. If the problem persists, the patient is advised Physiotherapy for 3-4 weeks. Most of the frozen shoulder problems can be treated with physiotherapy. If the pain is too much or unbearable, we put injections in the shoulder. In 90% of the cases, physiotherapy, medicines and exercises cure Frozen Shoulder.Sometimes the stiffness is too much and it may persist for months together.
In some cases, if the problem still remains, Arthroscopic surgery is done. Arthroscopy is a key hole surgery in which two small holes are made in the shoulder. From 1 hole , a camera is inserted and from the other hole, an instrument is inserted to release the shrunken capsule. So the patient gets his motion and pain also decreases. But this is reserved for only those patients who don’t improve with medications and exercises. The mainstay of the treatment remains medications and exercises.
Dr. Shekhar Srivastav heads the Orthopedics department at Sant Parmanand Hospital & is the leading Joint Replacement & Arthroscopic Surgeon in Delhi, India. Trained at some of the best centers in India & Abroad he has vast experience of treating problems of Knee & Shoulder joints. He has been an integral part of DITO, Sant Parmanand Hospital for more than 18+ years & with the legendary Orthopedic Surgeon Dr. Shekhar Agarwal he has helped Sant Parmanand Hospital gain its present reputation & respectability.
He has treated thousands of patients with complex Orthopedics problems. He’s well known for performing Knee replacement surgeries (Total & Partial Knee replacement), Knee Arthroscopic Surgeries (ACL Injuries, Meniscus Injuries, Cartilage Damage) & Shoulder Surgeries (Arthroscopic Bankart Repair, Rotator Cuff Repair, Shoulder Replacements)
Q 1). What is the difference between shoulder Arthritis and frozen shoulder?
Ans). One of the commonest problems which we see in the shoulder in FROZEN SHOULDER. Frozen shoulder is usually seen in persons between 40 to 60 years of age. If the joint is ok but the capsule around the joint becomes infringed, the shoulder becomes stiff and the movement causes pain.
Most of the time the problem starts spontaneously on its own without any reason. It is a self-limiting disease. If you don’t give any treatment then it also heals itself but that takes a long time (around 1 ½ -2 years). But if treated properly with exercises, physiotherapy and medication that it can be treated within 2 – 3 months.
Whereas SHOULDER ARTHRITIS is degeneration of the shoulder joint. The cartilage around the shoulder joint gets degenerated and the joint is damaged because of wear and tear. Shoulder Arthritis is seen in elderly people around 60 to 80 years of age. In this case the joint becomes permanently damaged. It may recover with exercises, medication and if that doesn’t help it may require KNEE REPLACEMENT
Q 2.) Why is rotator cuff surgery so painful?
Ans.) Rotator cuff surgery is usually seen in elderly people and it is of degenerative nature. Because of poor vascular supply, the rotator cuff becomes inflamed, gets torn and most of the time it gets degenerated without any injury. In young persons, the rotator cuff is torn when there is an injury. In elderly persons, Rotator cuff injury happens because of degeneration. Rotator cuff surgery is usually arthroscopic surgery wherein we make 3-4 small keyhole incisions and through our camera we repair the rotator cuff. Here the results are very good but the biological healing takes around 2-3 months. So till that time there is some pain and stiffness. When done with proper technique, it’s not that painful and usually gives very good results.
Q 3.) What are the other treatments for rotator cuff tear other than surgery?
Ans.) The rotator cuff tear can be of various grades. It can be a small tear, medium tear or a large great tear. A medium or a large tear requires surgery as it won’t heal on its own and will gradually progress . The torn rotator cuff retracts back and it becomes difficult to bring it back. So that definitely requires surgery. But small tears can be managed conservatively with physiotherapy, strengthening of muscles around the shoulder or pain medications. In fact, there are many patients who have tears but no symptoms. That doesn’t mean that all tears require surgery. Only those tears which are causing pain and problems to the patient require surgery.
Q 4.) What is the best way to recover fast from ‘ Rotator cuff surgery ’ ?
Ans.) When we do rotator cuff surgery, we put the torn rotator back to its footprints and we try to restore the anatomy. we can only fix the tear and not heal it. Healing is a natural process. It normally takes two to three months and we cannot fast forward it.Everything depends on how well you fix the tear . If the tear is fixed properly , the healing is better. I always tell my patients that I will fix it but god will heal it.That will take around three months .
Q 5.) What muscles make up the rotator cuff ?
Ans .) The rotator cuff is a group of muscles that surround the shoulder joint. It is made up of four muscles – Subscapularis (in the front) , Supraspinatus (in the top ) , Infraspinatus and Teres minor (behind ). These four muscles surround the shoulder joint and are responsible for its movement and stability.
