At Home with Chris Jessen 2018 - 157
J O I N T H E A LT H ▲
GOOD AS NEW
Damaged parts of the shoulder can be taken
out and replaced with prosthetics, such as
a plastic socket and a metal ball. Shoulder
replacement surgery can include:
HEMIARTHROPLASTY Replacing the head
of the humerus (the bone running from the
shoulder to the elbow)
TOTAL SHOULDER ARTHROPLASTY
Replacing the head of the humerus and the
glenoid (the joint socket in the shoulder)
REVERSE TOTAL SHOULDER
ARTHROPLASTY If a total shoulder
replacement risks increasing pain or such
an operation has failed, surgeons can switch
the socket and metal ball in the shoulder.
Reversing the geometry of the shoulder like
this can improve movement.
Also known as adhesive capsulitis,
frozen shoulder is when the shoulder
capsule - the sleeve surrounding the
shoulder joint - swells up and
thickens, restricting movement.
It causes pain and stiﬀness, making it
hard to move your shoulder. It can be
linked to injury, or health problems
such as diabetes, heart disease, thyroid
disease or Parkinson's disease.
ROTATOR CUFF TEARS
The rotator cuﬀ is made up of four
tendons that connect the arm to your
shoulder joint. These tendons can
partially or fully tear because of an
accident, repetitive movements or
heavy lifting. The tear causes sudden
pain (accompanied by a popping
sound), stiﬀness, diﬃculty raising
your arm, swelling and pain at night.
WORDS: SIDNEY HARGREAVES, IMAGES: GETTY IMAGES, SHUTTERSTOCK
Frozen shoulder usually recovers
by itself, but slowly. Treatment can
include pain relief, physiotherapy,
steroid joint injections and muscle
and nerve electrical stimulation.
It's extremely rare to need
surgery, but it may be an option
if your symptoms are severe and
unresponsive to other treatments.
Surgery options include: shoulder
manipulation - under general
anaesthetic, your shoulder will be
moved around to stretch the capsule
around the joint; arthroscopic
capsular release - a keyhole surgery
alternative to shoulder manipulation,
where the surgeon removes bands
of scar tissue in the shoulder capsule
and hydrodilatation - also known
as arthrographic distension, where
surgeons use an X-ray to guide them
as they inject anaesthetic, saline and
corticosteroid into your injured joint.
This stretches the joint capsule to
release sticky adhesions.
You'll usually be able to go home
the same day as these treatments but
you can expect to need physiotherapy
sessions to help with movement
and encourage the muscles back
to their normal functions.
If you have a complete tear, you'll
need surgery to stitch the tendon(s)
back onto your arm bone. This will
either be through two or three small
incisions via keyhole surgery, or open
surgery. If the tear is large or complex,
it might not be able to be repaired or
only repaired partially.
For at least three weeks after
surgery to repair a rotator cuﬀ tear, it's
crucial not to put any weight through
your arm. This means avoiding even
the simplest thing like ﬁlling a kettle.
You'll also need to wear a sling to
protect your shoulder - depending
on your injury, for up to six weeks -
plus regular physiotherapy.
skin), ankylosing spondylitis (arthritis
that aﬀects parts of the spine) or gout.
It's rare to need surgery but if rest,
painkillers, physiotherapy and steroid
injections haven't worked, it might
be an option. Surgery can take the
form of arthroscopic subacromial
decompression to remove the
inﬂamed bursa, thus making room
for the rotator cuﬀ tendons to move.
After the op, it might take a few
months for you to see an improvement
as your shoulder gradually recovers.
Many cases of shoulder pain are
rotator cuﬀ tendonitis (swelling of
a tendon) or bursitis (swelling of a
bursa, which is one of the ﬂuid-ﬁlled
sacs over joints, tendons and bones).
Your shoulder may appear red, with
painful swelling and stiﬀness.
Causes of tendonitis and bursitis
can include injury or overuse of the
shoulder, or by conditions such as
rheumatoid arthritis, scleroderma (a
condition that causes hardening of the
shoulder joint replacement
Depending on your operation, your arm may
be in a sling for weeks after the procedure, and
you should avoid any heavy lifting. You'll also
need physiotherapy sessions to help your new
shoulder build strength and mobility. People
typically take at least three months to fully
recover from a shoulder replacement.
www.athomemagazine.co.uk FEBRUARY 2018 | 157