Dealing With Shoulder Pain – Scott P. Stephens, M.D.
To be the best you possibly can as a surgeon, as a physician is to specialize as much as possible.
And I was always intrigued by the shoulder because it offers me the opportunity not just to do minimally invasive surgery, such as shoulder arthroscopy, where I can repair large rotator cuff tears. It also allows me to do fractures as well as do shoulder replacements.
So it gives me the full spectrum of orthopedics in one body part and allows me to work with all age ranges from the young patients to the much older patients who are the weekend warriors that want to get back to the hobbies they love.
For the patients I see, as pain progresses, we always try to avoid surgery. So we start with physical therapy, focusing on a rehab directed at the activities that they were doing prior to the injury, anti-inflammatories, we sometimes consider steroid injections and eventually transition into surgery if all else has failed.
We have two different types of shoulder replacements. We have either a total shoulder replacement that’s anatomical. We simply replace the ball and socket just as it is. And we see those in patients who have normally function rotator cuff tendons.
Now, in situations where we have rotator cuff tendons that have torn, sometimes that’s not an option and we have to use a newer technology known as that reverse total shoulder replacement. The normal ball and socket is the balls on the outside allows us and gives all this range of motion.
By reversing this, it allows us to constrain the joint a little bit and allows the larger muscles that we have in our shoulder, specifically the deltoid muscle, to function as a main activator to allow full range of motion.
It can allow us to restore some of the function that we’ve had for patients who have lost some of the normal tendons that we have for daily functions and go back to some of the normal daily activities that they’ve been missing from in their life.
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