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When to get a shoulder replacement?
Joint Replacements | Last Active: Oct 26 11:29pm | Replies (36)Comment receiving replies
In regard to what you said -
"If your RC is already damaged, you'll need a reverse TSR. Initial recovery is a little quicker, but I think there are permanent limitations on how far you can raise your hand to play racquet sports, for example."
In my case, I luckily have no racket use limitations on how far I can raise my arm/hand after my reverse TSR. As I see it, the problem is that without those frontal rotator cuff muscles, you lose the ability for a fast, hard snap to the ball that you need for upper level play. I'm sure I could still play, but it would be at a much slower, non-competitive gentle pace. What I don't know, is whether with dedicated muscle development of the other surrounding groups, you perhaps compensate and adjust your stroke.
Replies to "@heyjoe415 In regard to what you said - "If your RC is already damaged, you'll need..."
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Thank you for the correction ddsack! This will be good news for people needing a rTSR, but concerned about recovery and limitations. Based on your experience, those limits are very small, if any.
I'm very happy for you that you can still play racket sports with a rTSR! I'm betting you were fannatical about your rehab, and are overall in very good health. Good for you.
As far as your point of not being able to generate a sharp, forward snap since rTSR - that's probably because the anterior RC muscle, the subscapularis, is torn or otherwise weakened, and it's left alone during rTSR. You describe internal rotation of the shoulder, and that's the domain of the subsapularis. (In my anatomical TSR, the subscapularis is intact, released to allow access to the shoulder joint, and then stitched back onto the scapula and clavicle. This made my initial recovery a few weeks longer, as time has to pass to allow healing to begin.)
I would ask a trainer if there is a way to compensate for that lack of snap with a racket. The deltoids take over for the RC after a rTSR, holding the joint together. I'm just not sure if the loss of some inward rotation is permanent, or if there are exercises to address.
Anyway, thanks so much for your reply, and congratulations on your recovery. 70% of all TSRs are reverse. The guys my age who need it seem afraid. Honestly, I don't get it. I will share your story though of what is possible if a patient has will and determination, as you clearly do.
(Side note: I do have one permanent restriction in the gym after the aTSR. I cannot do tricep dips, where I'm lowering and raising my body weight, usually with weight assistance. My PT says this requires my elbows to be well behind my back, and a no no now that I have the new shoulder. Other than that, I'm at 2 months post-op and back in the gym everyday. I have to slowly increase the weight Ilift, but recovery is very doable.)
Great work my friend!
Joe