The shoulder is a complex joint, one that physiotherapists have spent decades studying and getting their diagnoses and treatment down to a fine art. It’s a good thing too, because shoulder injuries are amongst the most common suffered by Aussies, especially those on the Northern Beaches. Something about all that sun, surf and sand mixed with plenty of beach volleyball and other sports that are stressful on the shoulder joint makes shoulder injuries far too common.
One of the common knock-on effects of all these shoulder injuries is the number of shoulder reconstructions that are performed each year. Most shoulder injuries such as dislocations and fractures can be treated without surgery and with a solid dose of physiotherapy, but some injuries are a little more complex and require the surgeon’s scalpel to sort out once and for all.
The anatomy of the shoulder
The shoulder joint is made up of: the arm bone (the humerus), the collarbone (the clavicle) and the shoulder blade (the scapula). These connect to the glenoid, which is a ball-like shaped object that then connects with the socket of the scapula at the upper end of the humerus. When you injure your shoulder it is likely that one of these bones will be injured or that there will be damage to the surrounding ligaments or rotator cuff.
What is a shoulder reconstruction?
If your injury is a bit of a doozy, or your ligaments have been torn (remember that ligaments can’t heal themselves like other parts of the body) it’s likely that you’ll need some surgery.
A shoulder reconstruction involves repairing the torn or stretched ligaments so that they are able to hold your shoulder joint in place properly. During shoulder reconstruction surgery the torn ligaments will be stitched back to the shoulder socket with special anchors and your over stretched ligaments will be tightened back to new.
Shoulder reconstruction can usually be performed by keyhole microsurgery, but some patients may need an open surgical procedure which involves a larger incision over the shoulder to perform the repair. You’ll look a bit chopped up, but chicks dig scars right?
What can I expect after shoulder surgery?
Pain – It’s normal to have some pain and discomfort after shoulder surgery; they have been chopping around in your body after all. However, it is important to not be a hero and let someone know about your pain so it can be treated and managed. Your pain shouldn’t be that bad you are unable to cough, breathe deeply and do your exercises without hitting the roof. A bit of ice never went astray either.
Decreased movement – Your arm is probably going to be in a sling for at least 4-6 weeks so you better get used to it sooner rather than later. That sling is going to stop your shoulder dislocating again while it is recovering and it’ll also stop you from getting your arm in a painful position.
Blocked bowels – Anaesthetic is fantastic for putting you to sleep and stopping super sharp scalpels from hurting, but it’s not as great for a regular bowel. Most people come out of general anaesthetic a bit blocked up, so along with everything else, make sure you take any medication the hospital gives you and eat a high fibre diet.
How does physiotherapy help recovery from a shoulder reconstruction?
Your shoulder and most of your arm are going to be immobilized for well over a month, so it means they’re going to lose a bit of function and feel awfully tight and difficult to move after surgery. Shoulder injuries are also among the most common to re-injure so your musculoskeletal physiotherapist is critical for helping alleviate your current pain and movement woes while also helping to avoid further injury down the track.
Physio plays a critical role after surgery; it will affect how quickly you get back to your work, sport and the things you love. Regular exercises and mobilisation is needed to restore motion and flexibility to the affected shoulder.
Strengthening your rotator cuff muscles is the best defence against further shoulder dislocation, subluxation, and instability and your physio will design a program with exercises that build up these muscles around the shoulder. Adequate warming-up before an activity and avoidance of high-contact sports may help prevent a recurrence of instability.
If you’ve got questions, if you’ve got a surgery coming up, or if you’ve already had shoulder surgery get in touch with us, don’t wait until the pain becomes severe or chronic, give the team at Fixio a call.
