Thursday, October 26, 2017

Ream and run for a decentered arthritic shoulder - progress report at one month

A month ago we had the opportunity to see an active man from Hawaii with shoulder pain and stiffness and these x-rays.



 Note the posterior decentering of his humeral head on the axillary 'truth' view.
He elected a ream and run procedure. His post operative x-rays are shown here.
Note the centering of his humeral head on the conservatively reamed glenoid.



Yesterday he emailed this progress report that contains some helpful observations.

"Hi

Things are going well at 4 weeks and one day.

A couple of days ago I noticed that my stretching sessions were much easier if they were done closer together. Yesterday, I started doing them essentially once per hour during my waking hours and, in general my shoulder is much looser all the time. I spoke to Sarah about this today.

I’ve got four stretches I’ve been instructed to do (see this link): 

1) The guided overhead reach while laying flat

2) Over door pulley

3) Tabletop Drop down slide

4) Assisted External Rotation to neutral

#1 I do most often since it is the most difficult/painful and I therefore presume I’m getting the most from it.

#2 I sometimes alternate with #1

#3 I do when I’m out and about somewhere and it is inconvenient to lie down someplace

#4 isn’t a stretch since I can get there without feeling anything so I really don’t bother with this one.

When I started stretching hourly (vs 5 sets per day), I don’t have to psych myself up to do #1 since it hardly hurts to do at all.

I’m using Ice and 800mg doses of Ibuprofen to manage inflammation and aching." 

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The reader may also be interested in these posts:





Information about shoulder exercises can be found at this link.

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