Rehabilitation after two shoulder surgeries


Q: Approximately one year ago I had a slap repair. I followed up with PT and thought I was recovered. I went back to work. 2 and a half months later I was unable to do much because of pain and discomfort in the same shoulder. In Feb, I had a rotator cuff repair and am currently attending PT. Passive range of motion is good, however I can barely get my arm above my head when holding it straight out from my body. I am concerned that if I return to work, the motions that I must perform on a regular basis will cause the shoulder to be reinjured. What are the statistics for reinjury after surgies like I've had, and do you have any reccomendations?


A:    Sometimes the recovery after shoulder surgeries takes time, consistency and effort, moreover in your case that this is your second surgery, according to your description, it seems that your Rehab is going fine, just keep working in the passive range of motion and also the shoulder muscles strengthening and regain an acceptable active range of motion, meaning functional that allow you to perform all your daily living activities. Regarding the work, I strongly recommend you avoiding overuse, because the most common injured group of tendons is the rotator cuff, but by the same mechanisms this can happen to other tendon as triceps or biceps for example. These tendons can be injured during weight lifting, when playing sports with a lot of throwing, after repetitive use over a long time or suffer degenerative changes with the aging process.  It is very important particularly in your case after the two surgeries, that before to do any exercise or straining physical activity to have an initial warm-up and stretching of the muscles, also when you start an exercise routine or you start at work, the demands have to be progressive and gradual, and the time and days that you dedicate to exercise/work must be consistent and regular to avoid injuries. There is a very well described entity in the medical literature called: Overuse Syndrome, which can affect any part of the body that is over stressed with movements or activities in a repetitive way, including occupational, recreational, and habitual activities. Repetition is part of the definition of overuse injury.

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