Thursday, November 10, 2011

Ream and run and stiffness - prevention and treatment - manipulation and surgical release - chondrolysis

At the time of the ream and run procedure we assure that the shoulder has excellent range of passive motion: over 150 degrees. However, in some cases it is a challenge for the patient to maintain this range of motion. The key to maintaining the range of motion achieved at surgery is a commitment to five times per day short stretching exercise sessions . See also all of our other posts on stretching (use the "search the blog" function to the right). Maintaining the range may be especially difficult if the shoulder was very stiff prior to the manipulation or if the ream and run was performed for chondrolysis.

If it becomes difficult to maintain 150 degrees of flexion, we have found that a gentle manipulation under anesthesia (no surgical incision required) can get the shoulder back on track. This is ideally performed within the first 8 weeks after surgery, so careful attention to the progress in range of motion is important. In this procedure, the patient is put to sleep for five minutes during which muscle relaxation is achieved and the shoulder is gently moved through a full range of motion to break up any adhesions. Because nothing is cut in this procedure, the patient can resume exercises and activities immediately afterwards.

If stiffness is a problem later on, after healing is complete, we use a formal open release to re-establish the range of motion.


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You may be interested in some of our most visited web pages including: shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery.