Wake Orthopaedics Sports Medicine Center's Dr. Mark Wood sat down to discuss minimally invasive options for your painful shoulder if conservative methods have failed.  Luke Hudson, DPT, also discusses what to expect prior to your surgery, immediately following your surgery, and your rehab.

Did you know that your shoulder is a complex joint that is capable of more range of motion than any other joint in the body?  Having the most range of motion also means the shoulder joint is the most common joint for dislocations and instability.

With your shoulders working so hard on a daily basis, it is easy to see why injury, overuse, and age-related wear and tear are responsible for most shoulder problems.

Let's talk about options to relieve your shoulder pain and other issues.

If you have exhausted all conservative options, it might be time to consider shoulder arthroscopy.  Arthroscopic shoulder surgery is a minimally invasive procedure that can be performed for a large number of shoulder issues such as rotator cuff repair, shoulder instability stabilization, labrum repair and removal of inflamed tissue and damaged or loose cartilage.

What sets shoulder arthroscopy apart?  Both the arthroscope (camera) and instruments are specialized and thin, so only small incisions are required, as opposed to the larger incisions required for traditional, open surgery.  Smaller incisions and advanced techniques lead to less pain, less need for pain medications, outpatient procedures instead of hospitalizations and a quicker road to recovery.  What's not to like about that?

Now, let's talk PT with Luke!

How do I prepare for surgery?

~To best prepare for shoulder surgery, the patient should focus on improving strength of the rotator cuff muscles at the shoulder, as well as the muscles that surround the shoulder blade.  This can be achieved with light weights and/or resistance bands.  Any exercise that leads to acute pain or replicates symptoms should be avoided.  Typical areas of weakness include the shoulder external rotators, scapular stabilizers like the rhomboids and serratus anterior.  Reducing pain and inflammation prior to the time of surgery can also lead to better outcomes with post-operative rehab.

What can I expect after surgery?

~It is largely dependent on the type of surgery that is done.  In some cases, there is an extensive protective phase that requires the patient to be in a sling for several weeks.  This is common following procedures such as SLAP repairs and rotator cuff repairs.  In other cases, progression of rehab would depend primarily on pain level and early post-operative goals.  The first several days after surgery are typically best spent focusing on rest and recovery.  Applying ice to the shoulder and using TENs to help with pain can help expedite recovery.  Physical therapy will typically start within the first 4-7 days after surgery.

What does rehab look like?

~Rehab following shoulder arthroscopy typically involves 3 phases:

1. Focus on improving passive range of motion at the shoulder and reducing pain/inflammation.

2. Focus on improving active motion of the shoulder and return to independence with daily activities.

3. Improve strength and stability of the shoulder.

During the final phase, focus is placed on correcting any deficits that may have left to injury in the first place.