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.