Sports after Shoulder Arthroscopic Surgery

Reconstructive Shoulder Arthroscopic surgery is one of the most effective procedures to improve quality of life, relieve pain, improve function and provide you with a stable lifestyle. Shoulder injury could be regarded as one of the cruelest sports injuries.

Whether you’re a professional or amateur footballer/cricketer you are likely to seriously hurt your shoulder during the course of your playing career. There have been many instances when players have been ruled out for months while playing various tournaments like the IPL, EPL, Euro Cup, World Cup etc.

Returning to sports after shoulder Arthroscopy should be a realistic goal for all, but it shouldn’t be just that. Good sportsmen should always aim at prolonging their international career and that’s only possible when a rehabilitation regime specified by the therapist is strictly followed by all.

Post- Shoulder Arthroscopy Rehab:

After your shoulder Arthroscopy, it is important to perform certain exercises to help strengthen your shoulder and arm and encourage recovery.

The following exercises may be recommended by your doctor and should be performed as instructed.

Elbow Range of Motion:

Before starting this exercise, remove your sling. With your arm bent at a 90-degree angle, bend and straighten your arm as though brushing something off the front of you. This exercise should be repeated 30 times, three times a day. This exercise will help avoid stiffness in your elbow after being in a sling for long period of time.

Grip Strengthening:

Begin this exercise by making a tight fist or by gripping a rubber ball. Hold this position for 10 seconds and then release. Repeat this exercise 30 times, three times a day. This exercise works your hand and helps prevent clotting of blood.

Scapula Retraction:

Begin this exercise by standing straight. Pinch your shoulder blades together and hold them for 10 seconds. Then relax and repeat the exercise again. Repeat this motion 30 times, three times a day. This exercise strengthens the muscles around your shoulder blade and allows your shoulder to move more effectively.

Supported Arm Pendulum:

Start this exercise by bending over at your waist. Support yourself by placing your hand, on the side that did not undergo surgery, on a table or chair Using your other arm, make small clockwise and counter clock wise circles. Repeat this exercise 30 times, three times a day.

External Rotation:

Begin this exercise by bending the arm, on the side of the recovering shoulder, at a 90-degree angle. Keeping your elbow against your body, use your other hand to gently rotate your forearm outward until your arm is pointing in front of you. Repeat this exercise 30 times, 3 times a day.

Knee Surgery is Must to Cure Knee Joint Damage

Types of Knee Surgeries:

  1. Knee Replacement (Total Or Partial)
  2. Arthroscpy of the Knee
  3. Osteotomy

Total/Partial Knee Replacement:

Although there are many conditions which may lead to the need for knee replacement surgery, (Osteoarthritis, Rheumatoid Arthritis & Traumatic Arthritis), Osteoarthritis is the most common reason. A number of other factors may also contribute to joint diseases, which include: genetics, developmental abnormalities, repetitive damages & obesity.

Damaged Knee Joint Illustration:

The knee joint is the largest and most complex part of our body and hence, the most stressed joint in the body. It is this complexity and pressure which can cause arthritis. Knee replacement surgery (whether total or partial) – is an effective treatment for degenerative arthritis in the knee joint. Arthritis affects over 45 million people in the US &over 12 million people in the UK.

Results of a Knee Surgery:

  • Decrease in pain
  • Increased mobility
  • Improvement in activities of daily living

Most surgeries are done by Arthroscopy. The types of operations include the following:

  • The torn meniscus can be repaired based on the condition of the patients. However, in many cases this is not possible.
  • In several cases where repair is not possible, a small portion of the meniscus may be operated to up the surface.
  • Sometimes, the complete meniscus is removed, but this is rarely done because the long-term result is not good.
  • Meniscal transplants have recently been introduced worldwide, particularly in the U.S and UK. The missing meniscal cartilage is substituted with donor tissue, which is screened and sterilized in the same way as other donor tissues.

What exactly is Arthroscopy?

Arthroscopy is a minimally invasive knee surgery generally done by inserting lighted scope and narrow instruments through small incisions in the skin over the knee. Arthroscopic knee surgery can be performed in the following conditions:

  • Toeliminate or repair torn menisci
  • To repair a torn cruciate ligament
  • To trim torn pieces of joint cartilage
  • To remove loose bodies
  • Toeliminate an inflamed joint lining (Synovectomy).

While knee arthroscopy as a technique may be helpful for many people, there is controversy over the usefulness of some arthroscopic procedures.

What exactly is Osteotomy?

If the damage to your knee is mostly limited to one section of your body, your knee surgeon may recommend a surgery called Osteotomy. In an Osteotomy, the surgeon reshapes the bones and then re-positions them to take the weight off the injured part of the knee. In doing so it can help to relieve pain and improve function, particularly for someone who is not ready to go for total knee replacement. An Osteotomy may also be used to correct a broken knee that hasn’t cured properly.

Frequently Asked Questions Related to Arthroscopic Rotator Cuff Surgery

“Arthroscopic repair” can be an intimidating phrase, and those considering for arthroscopic rotator cuff repair often have several questions. Rotator cuff damages may be as straightforward as tendinitis or as complex as a major tear to several tendons. They are usually the result of repetitive strain or overuse, although they can also happen due to direct trauma to the shoulder. Repetitive heavy lifting over a long period of time and overhead motion (such as swimming or throwing a ball), and bone spurs can all cause rotator cuff damages.

Do all rotator cuff injuries require surgery?

Not all cases of rotator cuff damages require surgery — mainly if treated in the early stages. The appropriate treatment depends on the type of damage you have and the severity of it. In more serious cases, operation may be recommended in order to deliver long-term relief.

How long is the recovery after an arthroscopic rotator cuff repair?

Though it varies from patient to patient, an arthroscopic rotator cuff repair usually means a recovery period of numerous months, with immobilization directly following operation and a physician-supervised light exercise program starting after 3-4 weeks. Most patients have a functional range of motion and sufficient strength by 4 to 7 months after surgery.

What makes rotator cuff injuries worse?

Rotator cuff damages cause pain, particularly when lifting and lowering your arm. You may also have weakness in the affected arm and shoulder. The pain may be worse when you’re resting or when sleeping particularly at night, mainly if you’re lying on the injured shoulder. You may also feel a crackling or popping sensation when you move your shoulder.

Anything that puts pressure or strain on the shoulder may make symptoms worse, including:

  • Carrying a purse or heavy bag on your shoulder or in the crook of your arm
  • Sleeping on your side
  • Anything that forces you to hold your arm in one position for too long
  • Holding anything heavy for a longer period of time, whether it’s a bag of groceries or a child

What should I expect if I decide to undergo arthroscopic rotator cuff repair?

There are numerous types of rotator cuff repair operations, and your orthopedic surgeon will recommend a technique after assessing your unique needs. Arthroscopic repair is the least invasive type of rotator cuff operation. It uses a small tube called an arthroscope, which is inserted directly into the joint through a small incision.

High Tibial Osteotomy Surgery Recovery Process

Knee Osteotomy

Knee osteotomy is generally used to realign your knee if you have arthritic damage on only one side of your knee or if your knee is deformed. The goal is to shift your body weight off the damaged area to the other side of your knee, where the cartilage is still in a healthy condition. When knee surgeons remove a wedge of your shinbone from underneath the healthy side of your knee, the shinbone and thighbone can bend away from the injured cartilage.

Some of the benefits of this operation are:

  • There are no restrictions on your activity once you have completely healed from HTO surgery
  • Well suited to younger patients who are trying to delay knee replacement surgery

Some of the disadvantageous of an H.T.O. are:

  • May make a future knee replacement more complicated
  • Pain relief not as predictable as partial or total knee replacement
  • Longer recovery than a partial knee replacement

Precaution to be taken before Surgery:

You will likely be admitted to the hospital on the day of surgery. Before your procedure, a doctor from the anesthesia department will check you thoroughly. He or she will review your medical history and discuss anesthesia options with you. Anesthesia can be either general (you are put to sleep) or spinal (you are awake but your body is numb from the waist down).Your surgeon will also see you before operation and check your knee to verify the surgical site.

Knee Osteotomy Recovery Goals and Priorities

Regardless of the precise timeline, a knee osteotomy recovery and rehabilitation program mainly focuses on pain control, wound healing, guarding the osteotomy, improving flexibility and range of motion, and building muscle strength.

  • Pain control: Recovery from knee osteotomy surgery is painful. Pain medication will be given in the clinic and also after discharge. If at any time pain is not being controlled well with medicines, patients should immediately consult surgeon/ doctor. Pain is easier to manage when it is addressed in its early stages.
  • Soft tissue wound healing: While in the hospital, a patient will be taught how to take care for the wound once he or she gets home, which includes: changing bandages and bathing. Keeping the wound clean and free of infection is very significant.
  • Reduce swelling and prevent deep vein thrombosis: In the first two weeks following the operation, steps must be taken to lessen swelling in the knee, avoid blood pooling in the leg veins and prevent Deep Vein Thrombosis (sometimes also called DVT). The leg should be kept elevated, and ice packs may be used intermittently to lessen swelling.

Preparing Yourself for Shoulder Replacement Surgery

Careful planning and preparation will play a significant role in the success and recovery of your shoulder surgery. The following guidelines can help you to best prepare in the weeks leading up to shoulder replacement.

If you’re preparing yourself for the shoulder replacement surgery then it’s very important to have the strongest and healthiest body possible. Your surgeon will likely recommend attention to the following items in the weeks before surgery:

Nutrition: Eat well balanced, nutritious meals at regular intervals. However, the time just before the operation is not the time to diet or to add any new over-the-counter supplements or medications. Eat healthy foods, get plenty of fiber rich food in your diet and drink adequate water in the time leading up to surgery. Protein in particular will help your bones and muscles recover from surgery.

Medications: Make a careful list of all medications you take, including prescribed drugs and any other items you might be buying at the supermarket or drug store. Include vitamins, herbs and other supplements. You will be required to show this list to your shoulder surgeon before surgery. Your doctor may recommend tapering off and stopping few medications before your surgery date, as they can impact bleeding during the operation or other medications you will be given during and after the surgery.

Stop smoking: Smoking impacts your blood vessels and lungs, and can even slower your recovery process from surgery.

Exercise: Ask your doctor about any exercises you should do before your operation. You may be able to practice them now to help prepare for your post-surgery rehabilitation. Expect at least 6-8 weeks of range of motion exercises before you will be allowed for active or strengthening exercises. This means absolutely no lifting until permitted by your surgeon.

Rest: Get sufficient sleep in the period before your surgery. You will want to be as rested as possible to face the impact of a major surgery.

Mental Preparation: Undergoing joint replacement surgery is a very big undertaking. For awhile after surgery, you will be more disabled than you were before and will need help from others to perform basic tasks. You’ll want to prepare yourself mentally and emotionally for these realities, gathering your inner strength and focusing on the ultimate outcome of better mobility.

How to Prepare Yourself Before Knee Replacement Surgery

Overview:

Going for a Total Knee Replacement (TKR) is a far cry from your typical doctor’s visit. It’s a serious undertaking that will have a complex effect on your life, both immediately following the surgery and for years to come. It’s significant to take time to do your homework before hand and also taking proper precaution before going for the surgery. Here we will discuss few important tips before you prepare yourself for the surgery.

Pre-operative and Pre-admission Testing:

You’ll have to undergo pre-operative evaluation and tests after you’ve made the decision to go ahead with a knee replacement. Your knee surgeon will determine whether you’re an appropriate candidate for surgery. They’ll identify any potential complications in the first stage of examination and this will help to make your operation a successful one.

You’ll most likely undergo Pre-admission Testing (PAT) one to two weeks before your operation. This testing can include:

  1. Physical exam
  2. Detailed questionnaire
  3. Complete blood count to rule out anemia
  4. Urinalysis testing
  5. Coagulation testing
  6. Baseline metabolic analysis of your kidneys, liver, and electrolyte status

Anesthesia:

You’ll also have to meet with an anesthesiologist to review your health history. They’ll do pre-admission testing to check which anesthetic is best for you. The anesthesiologist may choose to use general anesthesia, which makes you unconscious during the surgery. Another option is spinal or epidural anesthesia, during which you are conscious, but can’t feel pain from the waist down.

X-rays and an MRI scan:

Your knee surgeons will request you to go for X-rays and an MRI scan to fully understand the condition of your knee. These images will help your surgeon to see the details about your knee. The results will help them to make the right decision about the sizing and placement of your implant. The images will also help decide the best on the surgical approach.

Exercises:

The exercises recommended to you by your surgeon to do before surgery will help your rehabilitation by making your body more strong and you’ll be recovered soon. These include exercises to increase your upper body strength which will help you to use crutches after your surgery as well as exercises to strengthen your legs. Exercises which you may want to try are given below:

  1. Ankle pumps and circles
  2. Straight leg raises
  3. Heel slides
  4. Leg slides
  5. Thigh squeezes
  6. Lying kicks
  7. Chair push-ups
  8. Knee bends
  9. Sitting kicks

Your surgeon might also recommend you to attend a class that thoroughly explains the method. The class will help you understand what will take place at every stage of the knee replacement procedure. Trained and skilled nurses usually take these classes, and the class may be hosted at your scheduled hospital as well. You might also get a DVD that explains all the steps from admission to discharge.

Recovery Process After Total Knee Replacement Surgery

After knee replacement surgery, even though you will be able to resume most activities, you may have to avoid doing things which will put excessive stress on your “new” knee, such as participating in high-impact sports like jogging, running even brisk walking.

Hospital Discharge

Your hospital stay will typically last from 1 to 5 days, depending on the speed of your recovery and your health. Before you are discharged from the hospital, you will need to achieve several goals, such as:

  1. Getting in and out of bed all by yourself
  2. Having tolerable pain control
  3. Being able to eat, drink, and use the restroom by own
  4. Walking with an assistive device (such as; a cane, walker, or crutches) on a level surface and being able to climb up and down at least two or three stairs.

Short-term Recovery

Short-term recovery usually includes the early stages of recovery, such as; the ability to get out of the hospital bed and getting discharged from the hospital. On days 1 or 2, most total knee replacement patients are generally given a walker to stabilize their condition. By the third day after the operation, most patients are allowed to go home. Short-term recovery also involves getting off the main pain killers and having a full night sleep without medicines. Once a patient no longer requires walking aids and can walk around the house without any difficulty; in addition to being able to walk two blocks around the house without discomfort, pain or resting–all of these are considered as the signs of short-term recovery. The average short-term recovery time for a total knee replacement is about 11-12 weeks.

Long-term Recovery

Long-term recovery includes: the complete healing of surgical wounds and internal soft tissues. When a patient can return to work and the activities of daily living, they are on the way to succeeding the full term of recovery. Another indicator is when the patient finally feels normal and back to life again. The average long-term recovery for total knee replacement patients is between 4 to 6 months.

Facts about the Recovery Time for Total Knee Replacement

  1. Most patients can stand and initiate basic movements the day right after surgery
  2. You can expect the patient to walk with support beforethey even leave the hospital
  3. Some knee surgeons recommend using a cane for extra support during 1st three weeks
  4. Swelling is normal (for as long as within 6 months), but can be reduced by regularly applying ice.

Physical Therapy in the Treatment of Sports Injuries

Most Common Sports Injuries That Physical Therapists Treat

Sports and physical activity can be very beneficial for your health. The benefits of exercise offer stress release, improving one’s mood swings, and can provide a good night’s sleep. However, with sport activities comes the risk of an injury as well. Here are some common sports injuries we see at IRG Physical & Hand Therapy:

Torn Ligaments & Tendons: Some of the most aching injuries stem from tearing muscles in the knee, groin, hip, and shoulder. At times operation is required to repair the tear, followed by some months of physical therapy to recondition the injured tissue.

Tendinitis: Tendinitis is a common condition that includes inflammation of the soft tissue around muscles and bones, generally in the shoulder, hip, wrist, elbow, knee, or ankle.

Fractures: From skiing to walking, people have been hurt and put into a cast. During this time the fracture is restrained, and the muscles are weakened. Physical therapy actually helps to return the muscle tissue to a healthy state following an injury.

Arthritis: A number of athletes suffer from arthritis as a result of repetitive motion, such as swinging their racket or throwing a ball while playing cricket. Similar to other injuries such as tears or strains, arthritis can be treated with physical therapy.

Dislocations: Dislocations are a joint injury that usually forces the ends of your bones out of position. The cause is generally a fall or a blow, most often from a contact sport.

When Physical Therapy Can Help

Move It to Improve It

This active rehabilitation approach is backed by a host of different research. Recent research compares surgery to physical therapy for the treatment of problems like knee and back pain indicate that seeing a physical therapist can actually result in a better outcome with less medication and reduced expense.

What Happens in Physical Therapy

A big question that comes into our mind is that, could you benefit from a few sessions of Physical Therapy? If you have a pain that lingers even after a week of complete bed rest, get a consultation, is advised by many sports surgeon, knee surgeons and shoulder surgeons.

If you’ve never visited any physical therapy, picture a facility not unlike your local health club. Several clinics are housed in gyms, hospitals, or even in private offices and contain advanced equipment such as; exercise balls, treadmills, weights, and foam rollers.

Can Physical Therapy Prevent Injury?

Physical Therapy isn’t just for the wounded. Many clinics offer preventive measures to determine muscle weaknesses or other injuries that could lead to damage. If a problem is recognized, the therapist will provide a list of exercises to keep the issue like tight hamstrings from turning into something more serious, for instance: a hamstring tear. Most damages are the result of long-standing weaknesses, says many sports injury specialist in Mumbai. Improving those problems now can actually save you a lot of stress and expenses later. Several studies have proved that PT reduced ACL injuries by 40 percent.

Shoulder Injuries, Conditions, Surgery and Treatment

The shoulder consist of several joints that combine with rotator cuff tendons and muscles to allow a wide range of movements in the arm — from scratching your back to throwing the perfect ball at the pitch. Mobility has its price; however, It may lead to growing problems with instability or impingement of the soft tissue or bony spurs in your shoulder, resulting in discomfort. You may feel pain only when you move your shoulder, or all the time. The pain may be short-term or it may continue and need medical diagnosis and treatment.

What Causes Shoulder Pain?

Most shoulder problems comprise the soft tissues, muscles, ligaments and tendons, rather than bones. And most of these problems fall into three major classifications:

  • Tendinitis/bursitis
  • Injury/instability
  • Arthritis
  • Tears of Rotator Cuff

Other much more rare causes of shoulder pain are tumors, infection and nerve-related issues.

Warning Signs of a Shoulder Damage

If you are experiencing discomfort in your shoulder, ask yourself these questions:

  • Does it feel like your shoulder could pop out or slide out of the socket?
  • Is your shoulder stiff? Can you rotate your arm in all the regular positions?
  • Do you lack the strength in your shoulder to carry out your everyday activities?

Treatment

Treatment normally involves altering activities, rest and physical treatment to help you improve shoulder strength and flexibility. Medicine may be prescribed to reduce swelling and reduce pain. If medication is prescribed to get rid of pain, it should be taken only as directed. Injections of drugs may also be used to cure pain.

Surgery may be needed to resolve shoulder problems; however, 95% patients with shoulder ache will respond to simple treatment methods such as; altering activities, rest, workout and medication. Certain types of shoulder problems, such as recurring dislocation and some rotator cuff tears may need operation.

Common sense solutions such as avoiding overexertion or overdoing activities in which you usually don’t participate can help to stop shoulder pain.

Treatment options

The main treatment options for shoulder pain comprise:

  • Avoiding activities that make your symptoms worse
  • Painkillers
  • Using ice packs
  • Anti-inflammatories
  • Physiotherapy
  • Surgery (in some cases)
  • Arthrographic distension (Hydrodilatation)

Avoiding activities

Depending on what is causing your shoulder pain, your shoulder surgeon may recommend that you avoid certain activities or movements that could make your symptoms bad. For instance, in the early, painful stage of frozen shoulder, you may be recommended to avoid activities that include lifting your arms above your head and stretching energetically. However, you should continue using your shoulder for other physical activities, because keeping it still could make your symptoms worse. If you have shoulder instability, you may be recommended to avoid any movements that are likely to make the instability more worse, such as overarm throwing or bench pressing.

Arthritis: The Cause of Joint Replacement Surgery

Possible Benefits of Surgery

Arthritis is generally a chronic condition and sometimes can lead to disability. On the other hand, there are several ways you and your doctor can minimize these problems. One of the ways may be the total joint replacement surgery. Joint surgery can offer numerous benefits: Relief of pain is the most vital benefit of joint Replacement. Several people with arthritis have endless pain. Some of this pain can be relieved by rest, heat and cold treatments, workout, splints, and medicines. When these therapies don’t decrease the pain, operation may be considered. Better movement and correction of the deformity are added benefits. Continuous swelling and the wearing a way of bone and cartilage can cause joints, tendons, and ligaments to become injured or pulled out of place. Losing the use of a joint such as; a hip, knee, hand, elbow or shoulder, can totally hamper a person’s activities. When this happens, joint replacement surgery may be recommended by the orthopedic doctors in mumbai.

Learn about the surgery

The decision to have surgery is a most important one. It is not a decision to be made rapidly or without good reasons. Before you decide to go for surgery, be sure to learn what operation is being recommended, what are the substitutes, what are the risks and what is involved in the rehabilitation process? Don’t be shy about asking several questions of your knee surgeon, including information on his or her success record with the particular procedure. As you consider whether or not to have operation, keep in mind that every person’s requirements are different. Your surgeon may inform you that surgery won’t give you the results you want. If your surgeon thinks that knee surgery can help you, there are still several things you need to know.

Treatment for Arthritis of the Knee

Depending upon the severity of arthritis and the patient’s age, knee arthritis may be overcome in a number of different ways. Treatment may comprise of operative or non-operative methods, or a combination of both.

Non-operative

The first line of cure for knee arthritis includes activity alteration, anti-inflammatory treatment, and weight loss. Giving up activities that make the pain worse may make this condition tolerable for some people. Anti-inflammatory medicines such as ibuprofen, naprosyn and newer Cox-2 inhibitors help to alleviate the soreness that may be contributing to the pain. Physical treatment to strengthen the muscles around the knee may help absorb several shock imparted to the joint. This is mainly true for knee-cap (patello-femoral) arthritis. Different kinds of braces, designed to transfer load to a part of the knee that is less arthritic may also help get rid of the pain. Injections of medication inside the knee joint may also help to lessen the pain temporarily. A combination of these non-operative measures may help to ease the pain and disability caused by knee arthritis.