replacement shoulder

Hi Janice , thank you for your reply.  Your treatment sounds amazing ! very different here in UK.   N,H.S. is only offering an appointment once every other week, somtimes not even that.  I do attend a private clinic once a month but it is so expensive.  I am making progress though albeit very slowley !  I also have an over door pully but I struggle with that.  I find I can get my arm up to 90deg. using a stick held in good arm and pulling up bad arm , this I do lying flat on my back.  I was in a sling for 6 weeks , then hydro pool which was amazing !  But only allowed one session a week for 6 weeks.  Glad your pain is decreasing now. I only have pain now after arm has been moved about by private clinic!  ( N.H.S.  have yet to do this)  it is sore for a few days after !  But reading you post had helped me realise this is ok ..I too feel I have at last turned a corner and am discovering movements I can now do again...small little steps .  Next step is to recover some muscle power.  I have none at all ..can barely lift a cup of tea. I am am 22 weeks post op now .  Good luck to you and thanks again for your post .

Hello Pauline! It has been 3 months since our exchange of information, when you were 22 wks post-surgery. How are you feeling and how is your shoulder recovery progressing? I now know what you meant about building muscle - an extremely slow process. It is now 17 Jan.'15 and I am 21 wks post-surgery. I am still going to physio 3 sessions per week (through employer private insurance/clinic) so have been able to do more because of that. The physiotherapist moves my shoulder up to 180 degrees (passive movement) but I cannot move it any further than just below my chest (active movement with muscle). The lack of muscle, as you know, is hampering that movement. How did you get along with your muscle strength increasing? On the days I don't have the shoulder stretched/turned/pushed/pulled (ha!), I feel more pain. After physio it is very tiring but feels much better in the shoulder. I believe you can relate to this. However, as you know there is still the lack of muscle. He assures me I just need to be patient and will gain back muscle. At this point I have begun to fear for the future regarding what range I will end up with. At the end of Nov. I met with my surgeon and he told me that at 9 months post-surgery I should have a good indication of where the range of motion will be for the future - 5 more months to find out. He also told me that a low percentage of people get full range. I am scheduled for an x-ray and another meeting with him on 22 Jan.'15. Pauline, do let me know how you are getting on. Bye for now, J.

Hi Janice.  Nice to hear from you again.   I am doing fine , slow but fine.  My Doctor tells me that movement of 90deg is proberly the most I can hope for.   He said this is the most common result. 

Like you with passive movement I can obtain 180 deg, while lying flat on my back.  I am still trying to build up muscle.  Problem being , apparently that at time of opperation they have to cut through the Roatator Cuff which is the main muscle to controll arm movement.  This can not be repaired. The excersizes I am performing are designed to re-train and strenghten the Deltoid Muscle to do the work, which has not been in use before.  A long and painfull process .   While flat on my back I can now activley lift arm up to 90deg and down again ,  as long as I have taken my pain killers I can do this about 10 times.    Standing I am like you ...arm movement to maybe 30deg.  Very frustrating .  I am 7 month post opp now so I was hoping for better at this stage but I have been told it can take 12-18 month to reach the maximum.   I just keep on with the excersises a bit at a time .  I have physio now only once a month , where he checks what I can do  and moves in onto the next stage.  I work hard at home and try to use the arm as much as I can although some days it is very painfull.

I would be interested to know how you get on  after X-Ray on 22nd .   I have never had an X-Ray since before the opperation.   

Take care , bye for now,  Pauline 

I too have had a shoulder replacement (12 weeks post op) as a result of complications from a skiing accident last year. I am 54 and was very active until last year when all my shoulder problems started! I can only lift my are to about 75 deg. Passively I can get it to about 160 deg. I have physio 2x a week and my physio says it is a matter of building the muscle so that the active and the passive motion converge. I am not so sure. My surgeon says I will never be 100% due to the nature of my injury but I had hoped to be able to lift my arm over my head eventually! I am interested in what your doctor says about ROM and how it should improve with time.

Hope he had encouraging comments for you this week.

Keep working that pully

ST

Hi Pauline,

I do hope you are doing better.

It is now 9th March '15 and 28 weeks/7 mos. post-surgery. The Jan. 22nd x-ray showed no change. I believe they look for any change in the position of the stem (with humerus head/ball) on the glenoid component. I am developing very limited increase in range of motion with the physiotherapist doing the stretching. I am still doing the passive exercises lying down, other home exercises and going to physio; some neck pain has developed; seems to be so much going on in that shoulder. Having returned to work in Jan. (part-time) and now full-time, my time for home exercise has decreased. My job consists of 85% typing and after 1-2 hrs, I rest and the day goes on like that if I have steady typing to do. A small pillow placed under the armpit when typing relieves pressure. I hoped to be further along and also not so dependent upon pain meds at this point. They don't ease the pain as well as the prescription pain meds did, so need to take more often, it seems. My doctor said I would experience a great deal of frustration throughout this and it is so true. As you know, simply trying to reach for dishes in cupboards, any reaching movements really, are frustrating. The brain wants to do it [and many other things :-) ] but the shoulder isn't ready. I am afraid there won't be enough muscle building; a very long road. The pain/stiffness on waking in the morning is a challenge. If having a sleepless night, I believe a lot of movement adds to discomfort. From day #1 there is much progress and less of a certain type of pain but on the other hand, a much longer road than one would have anticipated. It has proven to me what I was told by medical folks, this is a very serious injury. We have had a winter with a lot of freezing rain and snow here resulting in layers of ice and for the first time ever, I've had to be mindful of not falling; purchased metal tracks for my boots, didn't skate for fear of falling, etc.; the things I once took for granted. I will see my surgeon again in April and I believe that will be the last appointment before yearly appointments to check for wear and tear on the artificial shoulder. Pauline, an unrelated issue has arisen with scar tissue; I understand keyloids can form; a lot of itching, burning and sensitivity there, even though there is still numbness. Layers of clothing can be most irritating. Let me know how your shoulder recovery is getting on. Bye for now, Janice

Hello ST,

My injury was as a result of being thrown off the motorcycle and landing on the shoulder. If you read my exchanges of information over the last few months with Pauline41903, it will tell you my situation. I am in Canada and she is in the UK, had the same surgery and we've received a very similar prognosis. As noted in my last post to her, my surgeon told me I would be very frustrated and it is proving true every day. I do physio four times/week (up from 3) and home exercise and it is a VERY slow road back. I too am disappointed there won't be full ROM. By this time it sounds like you would be about 4 months post surgery. Let me know how you are getting on. Janice

Hi Janice

Well I am now 9 months post surgery. I dont feel I have improved much since I last wrote to you.   Like you I was expecting more at this stage.   I am still doing passive exercises while lying down, but now I can place the pillows on a slight slant .  More difficult of course , but first stage of being able to lift arm while sitting/standing.   I have not developed neck pain and am hopeing yours has eased by now.  It must be difficult for you at work.  You mentioned a pillow under armpit easing preasure, I have found this to be helpful at night also ..I dont sleep well because of the discomfort  but this does help a little in making myself more comfortable.  I am lucky to be retired now so work is not a problem.  N.H.S physio have discharged me now , as did hospital months ago.  They say now it is just continuing excersise, using arm for small work ( nothing over shoulder height )  and TIME !   Oh what a long and painful procces this is !  I still take pain meds, though not as many.   I am going to book myslf in to see a private physiotherapist.   I would like to know his opinion , and maybe get some more advice as I was a bit upset that NHS had called it a day.    

You must indeed be very carful not to fall on that ice!  I have friends in Nova Scotia who have mailed me pictures of all the snow and ice .   Cold weather does not help with the pain  does it.  

It is so frustrating .  Also now because of muscle loss in the shoulder , cloaths are not sitting nicely and are inclined to slip off my shoulder.  Had to buy sticky tape of ebay !   I did not know about keyloids.  That is such a shame .  I wonder what will they do for you regarding this?   

I had a Dexter scan because of the fracture and it showed up Osteoporosis .  So on meds for that now .   Well I must go and do more excersise.  Hopefully we will see some improvement by summertime .  

Take care , bye for now  Pauline 

Hi Pauline,

Is that scan for bone density? I am not familiar with it.

The decision to get an opinion from a private physiotherapist will at least confirm if you are doing all you can; they may be able to suggest something else. I too still have a lot of discomfort sleeping; have some small pillows which, when lying on my "good" shoulder, I stack for support so the new shoulder doesn't "fall ahead." With it getting stronger I find this isn't necessary as much. The new shoulder is lower and I have the same clothing issue; always look like I've thrown myself together in the morning! ha. However, I am working in the little gym at the physio clinic as part of my appointments and find it is helping: rolling the ball on the wall for scalpular movement; lifting 2 lb weights, and a few other little things. The ball exercise is difficult, trying to keep it on the wall with my hand while moving it around looks so easy. Also, I still use the over-the-door pulley at home and at physio. That worked well for me and if on a day I am tired that is the one thing that will "loosen" up the shoulder, especially on waking in the morning. Regarding keyloids I understand it will take this scar many months to mature and it may change over time and be fine later so I'm hopeful. Spring surely must be coming soon; we've just had another blizzard this weekend, hopefully the last. Keep up the struggle, Pauline, and best of luck with the physio appointment. Take care, Janice

Hi Janice,  I find the exercise you do at the gym interesting.  I don't have this and therefor I can follow your advise , to a certain extent anyway .  

I saw the new physiotherapist, he said my progress was fine and that improvement was going to be extremely slow  so it was pointless him seeing me more than every couple of months.   He advised swimming as being the best thing I could do at this stage.  Gentle  breast stroak and a range of arm movements done underwater.  He also suggested keeping a journal to prove to myself that over the months little improvements were happening.  

I did go swimming yesterday and must admit although it really tired me , my shoulder did feel better for it.  I will try to go twice a week at least. 

When you use your door pulley, do you stand facing the door or sit on a chair with your back to the door?  Do you have your arms out ahead of you , or do you pull upwards over your ears?    I am asking as I was advised to sit back to door ..but I find that so hard ..whereas to stand facing I can pull arm up well.   I did look up Keyloids on a scar , I now have a better understanding of them .  I hope they clear up or lessen for you .  I think I have been very lucky there,  my scar has healed great ,  some areas are hardly noticeable .  Your right , this was a big trauma and will take a long time to recover .  I was also told that I would never get full movement back , but I am not giving up yet ! ha!

Take care , bye for now  Pauline

Hi Janice Yes a scan for bone density.  I have a weekness in lower spine but apart from that all ok ..so hopefully no more replacement joints !  

Sorry about this little ammendment , I forgot to answer your question in my main reply below .

Hello Pauline,

I am now at 8.5 months post-surgery; still going at a snail's pace.  I should have commented to you about the pulley; the weeks fly by.  I use the pulley sitting with back to the door.  It took quite a time to get the hang of this.  As you pull up the injured arm, the shoulder must be kept down and after awhile that shoulder muscle will strengthen.  I find it difficult and while doing it, try to imagine something heavy sitting on the shoulder to remind myself to hold it down.  I do 5-10 minutes with the arm forward the same up toward my ear.  All my movements to the side are not progressing as well as movements out in front.  Mornings when I wake up in discomfort and stiff I do the pulley straight away and it sort of loosens up the shoulder.

Had anyone recommended the use of a stability ball to place your hand on and roll up and down the wall?  It doesn't have to be a large ball, anything your hand will fit on will work.  It is for scapular movement and I find it helpful.  I roll up/down about an 8 to 10-inch range on the wall at this point.  It is tiring with rest stops needed.  I find it helpful.  

Tell me if the swimming has proven helpful.

I saw my surgeon and had an x-ray today, first in 3 months.  He was pleased that at the top of the humerus bone where the rod was placed, the small bone pieces did not disappear and it appears the tendons in that area have healed with the bone pieces.  He said the top part of bone had been broken in small pieces along with the ball.  If the pieces go away then it leaves the metal area exposed.  The artificial parts appear to be lined up and it is healed.  I suspected the pain I am feeling now is muscle pain and he confirmed that.  It is so painful when exercising, at times, that I feel it is something more serious than muscle.  I find it surely takes discipline to do the exercises.

So, the same advice was given by the doctor as given earlier:  patience, time and exercise.  He was encouraged the muscle will return, albeit slowly.  He still says 90 degrees is probable for range of motion.

Hoping all is well with your recovery for your shoulder and the spinal issue.  Please let me know how you are getting on.

   

Hi Janice.  I can not believe how fast time goes.  I am almost 11 months post opp.  I too am still improving at snails pace , but as long as I am improving I am happy.  

Swimming is enjoyable  , well, I can not actually swim much as my bad arm is lower that good arm and not as strong so I tend to almost swim circles  lol . Also of course I can only do a few breast stroakes then rest but keep arm moving in the water. I do this for 30 minutes.  I expected the arm to ache after but was plesantly supprised that my arm and shoulder felt great .  Maybe working my shoulder in the water will help , maybe not, but it is definatly not doing any harm .  

I also used the puly rope sitting back to door.  I find this so very painful so only manage 5-6 lifts .   The rolling of the ball is good ..painful , but I will do a bit each day now.  I am also throwing ball to wall outside , overarm ...which helps with reaching out. 

I do find now I am 'forgetting '  and using right arm ( the bad) more and more  and only when I cant reach etc do I then bring in the reserve.  LOL

It was great for you to have the reasurance of the X-ray .  I too think like you , worry , that all is not well because of the pain .   

I went for a Mamogram two weeks ago but could not get right arm into possition well enough for a good X-ray.  Unfortunetly they could only confirm  the left side was clear. Maybe next year I can try again. 

It is as you say Patience, Time and Exercise...sometimes its hard to be patient .  I start to have negetive thoughts , thinking this is as much movement  I will get  ...Then out of nowhere I do somthing which I could not do only weeks before and that spurs me on again.  Small little things.  

As for the Osteoporosis, thats fine.  I have meds now to stop any more detoriation , and vitimin D3 as we dont get a lot of sunshine here in UK. LOL 

Although the last week has been glorious . I have been sat in the garden soaking up the sun. :-)

Take care Janice .  I hope your managing better at work these days .

Pauline x 

 

Hi Jane,

It sounds like you have had a really bad time, 2 replacements in 9 months! 

I am 55 had a replacement last November after complications from a shattered humeral had in a skiing accident. My replacement isn't working well so I'm going back for revision surgery in 2 weeks to have a smaller head implant and some bone grafts to try and reestablish the anatomy of the humerus. I'm not looking forward to it (this will be my 5th shouder op in less than 2 years) . All I can say to you is; don't give up. I have very poor ROM at this point and hope that the next surgery will improve things, but, I can tell you that all the PT causes alot of pain and once you get to a point where you stop PT then the pain gets better even if the ROM isn't great. I also think that alot of the doctors really underestimate the length of time that you have unworkable pain, by this I mean pain that is sleep depriving and exhausting. I took pain meds for a long time after my initial injury (I was pinned and plated initially) and then again after the replacement. Most people have to take some pain killers for several months. Maybe you can move to a non narcotic? 

My implant is in my dominat arm so I am frustrated and complain that I can't do alot but I get by. I can run and walk the dog. No more yoga and ironing is difficult (I can live with that!) You DO need to get out with friends, you sound very down. I have to walk my dog 2x a day so she forces me to get out as do my kids who are teenagers. No one will be bothered about how you eat, can you drink? 

I hope you see some improvement in the coming months, stay positive and go watch "The Theory Of Everything" again, will give you some inspiration!

I'll comiserate with you again in 2 weeks after I get me next implant.

Wish me luck!

ST

Dear Jane .  I expect you have read through all the postings in the  thread.  

I am so sorry to hear you are in such a lot of pain.   It does sound excessive.  I am sure the doctor could perhaps change your painkillers , there are so many to try and a change may help. 

it took me 9 months to be able to drive becaus of pain ROM. Each time I drove a little further and the shoulder addapted , pain lessened and now I am up and away!  :-)    It does take a long time to recover from this but if you persevere you can do it.  Sometimes when my pain was at its worst I found a bit of excersise. .ie ...a good ole streatch while lying on my back pulling arm up with a short stick/pole  actually helped the pain ease off.  A very basic excersise I know but still helps me today.  Do this with heat or ice pack if it helps .

I was told all along that the more I used the arm the better it would recover and the pain would reduce.  So I always try to include the bad arm in all the daily chores.  Even wiping down counter tops used to cause a lot of pain , but the more I did it the easier it became.  I only ever take over the counter painl killers  now  but I take them reguler 2x4 a day.  I find that this keeps the pain away better thus enabeling me to do these sort of things.  

As I said , its a long job but there is light at the end of the tunnel , but you have to help the arm get there.  It is 15 months since my opp, and I only have one , not two like you , so you see it is a long road to recovery so you cant let it get you down.  My pain is lessening now with each month that passes thank goodness.  I am 64 at the end of September .  It can be done ..perservere please and use your arm ..dont let it win ..tiny steps ..do tiny things all day,  reach out  for you book ,  use you arm to wash up ..just a few things .....the more you can use it the faster the pain will go .   I am no expert , just passing on what worked for me  and also Janice in this thread.   Good Luck 

And write again to me , let me know how you are doing.  xx