Sunday, June 28, 2015

Ream and run shoulder arthroplasty - what it takes to get a super result

Our experience is that super results after the ream and run come from super effort by the patient in the rehab program. The high achievers routinely report that, "I have not missed even one of my five daily exercise sessions in the 6 weeks since my surgery."

Here's an example of a person 6 weeks out from a ream and run. At the time of the visit the patient was eager to show off his range of motion and photo documentation of his rehabilitation program. He followed up his visit with this email, 

"Thank you for the great six week appointment. I am so excited about my progress over the six week period, it has been a true journey though. I have attached some photos of my wall chart, accountability chart, floor video and how I use my IPad to watch my progress during my stretching. These items have played a large success in my stretching and my ability to stay accountable every day.
You have my permission to use these photos and video as you wish. Have a great weekend."


Wall Chart (note pulley at left)


Wall Chart #2


Floor Chart


Workout Schedule


IPad


The results at six weeks speak for themselves!


To see the video of this patient's motion see the original posting of this page here.

Basically, the key is getting 150 degrees or more of forward elevation. 

**If this range of motion is not achieved at 6 weeks, we recommend a gentle manipulation under anesthesia and complete muscle relaxation.


One of our friends suggested an easy way to illustrate the angles.

Take a piece of paper 



and fold the upper right corner down to the bottom edge so that it looks like this, making a 135 degree angle between the upper edge and the horizontal



Fold the upper edge down on the lower edge, making a 157 degree angle as shown below.





This is essentially the same angle as that between the arm and the floor shown in the photo below, which was sent in by a patient 6 weeks after a ream and run procedure.





Note that it is important that the back not be arched, but rather remains flat on the floor. We encourage our patients to send photos taken from this perspective so that we can be assure that the desired motion is taking place.


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