Friday, March 1, 2019

Huge rehab effort 6 months after a ream and run

We often get photos and videos from patients after their ream and run procedure. While some patients have a difficult time regaining use of their shoulder, others have achieved extraordinary results.

Here is an email we received recently from a 50 year old man who presented to us with a stiff painful shoulder, an SST of 6 out of 12 and these images.




He elected to have a ream and run procedure. At surgery his shoulder was found to be extremely tight, so that a thin (15 mm) humeral head was used. Due to his history of weight lifting, his humeral cortex was very thick, so a thin stem (6 mm) was used with impaction grafting.




Here's his report:

"I wanted to share with you an update.  In 10 days, it will be my six month anniversary of my surgery.   In this regard, per our conversation I started lifting again on January 11, 2019 on my four month anniversary.  I started back slowly doing all of my compound lifts with light weight for four sets of 12.  After two weeks, I gradually increased the weights and decreased the reps to sets of 10.  I did each body part (Chest, Back, Shoulders, Arms) twice a week.  

Beginning on February 11, 2019, on my fifth month anniversary, I started training regularly.   Thus, I have compiled a video for you of some of my compound exercises that I have performed this past week for Chest, Shoulders and Back.

During an exercise for the most part I am pain free, but on a rare occasion, I may have some pain at most at a level 2.  After completing a set, I am normally pain free but on a rare occasion, maybe 2% of the time,  I would have at most a level 2 pain that last for maybe 30 to 45 seconds. 

When I am finished with my workouts,  95% of the time I am pain free.  However, of the 5% where I would have some pain it would be at most at level 2.  This would  last for about 5 or 10 minutes at the maximum.   

Of any pain that I may experience either during or after performing an exercise or after I am finished with a workout, 90% of the time the pain would be located where the bicep tenodesis was performed. On a rare occasion, maybe 10%, it would be located in my shoulder. "

Here is the video he sent along with his permission to show it here.




Again, many individuals having this procedure may not desire to pursue or achieve this level of function. Yet it is an inspiration to see what has become possible for some.

Our basic approach to rehabilitation after shoulder replacement is shown in the post on stretching (see this link) and in the post on strengthening (see this link)
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We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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