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Recovery delay after reverse shoulder replacement
I need to decide what I should do.
I had reverse shoulder replacement (non-dominant arm) on 23 May but four months after RSR I am still in worse pain and function than before my surgery - the surgeon has not advised me why. What should I reasonably expect and should I be insisting on further attention/diagnostics from him? The post-operative physiotherapist progressed me through exercises that- I can see now- I shouldn't have complied with due to the pain they caused, but I was ignored by physio and surgeon and told to push through the pain, now I have damaged my muscles. The pain is worse in biceps - its tendon has been flicking over the prosthetic since I first started mobilising the joint after surgery. I don't know if this is ok or not. The biceps pain has got worse, also painful pectoralis minor, latissimus dorsi, subscap and rhomboids. I am disapppointed to say the least especially since I did strengthening exercises under supervision of a trusted physio for 18 months before reverse shoulder replacement top optimise my recovery. This trusted physio, unfortunately for me, then went on extended leave before my surgery and has only returned 2 weeks ago, but at last I am seeing them again. I stopped all exercises about 3 weeks ago and began independent research to work out what to do. Now the physio has taped my shoulder and given me arm length compression to protect the shoulder muscles while restarting gradually on much gentler muscle work this week.
The surgeon reviewed me at 2 weeks, 6 weeks and 13 weeks, now next review is not until November, but prior to surgery he said the other shoulder would be done at 90 days after the first one. He has not explained my poor recovery or forecast when the second side will be done. He has not ordered diagnostics for the soft tissue problems I am experiencing. They include limited range of movement and sharp pain that prevents me doing most things I could still do before surgery. This was despite severe osteoarthritis and rotator cuff disease in 3 out of 4 of the cuff muscles- leaving only subscapularis functional. Subscap remains, I can see from the operative report.
Any advice or comparison with similar situations would be appreciated so I can plan a way forward together with my physio's advice and prepare for the surgeon's review in November, which will be 6 months after surgery.
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Damn, sorry you are experiencing this. I really don't have any experience with RSR, but I can tell you with rotator cuff repair on my non dominant shoulder, it was 2 years before I was pain free, which was double what the dr. said.
I would think at 4 months out you should not be in severe pain all the time. I would let the doctor know about the pain and limited ROM now...No sense waiting in pain 2 more months!!
One thought, if you just weaned off pain meds, that will make pain flare for a month, if you have been on them a while....Or even a big reduction in pain meds can do this.
I need a replacement on my dominant shoulder now, for the past 5 years, and am holding off because of this very problem....and cortisone still works for me.
Good luck!
Hey thanks for your reply!
Yes I truly believe that the doctors should discuss their patients' concerns. Especially when, like you and me, the pain took twice as long to resolve. How do we know what to think and what we should put up with or not? Keep questioning our own management and attitudes? Yes all the literature says it can take up to 12 or 18 months to feel the full benefits of RSR. Nothing about reasonable limit of pain.
Yes I did let the doctor know but he would not discuss my pain at the 13 weeks review, so when I woke up the next morning realising I just could not leave it another 3 months I called an ambulance. Waited in ED and a very nice doctor did xrays and tests for nerve response. No fracture or nerve damage could be found and so he agreed with me that my muscles were tearing. I have been treated "one-size-fits-all" rehab exercises, despite my clearly expressed concerns from the start. It started with biceps tendon painfully flicking over the prosthetic when I first started ROM exercises at about 2 weeks. Despite my pain, I have been off the big analgesics since about 2 months. Yesterday I felt my muscles were starting to heal. I stopped all exercises about 3 weeks ago, and a kind new physio will now be working with me to rehabilitate and build muscle at a pace to suit me. I hate this. I can't get on with my life. I do not think I will be getting the other one done. I would much rather have the arthritis. It is my dominant arm and was not as damaged as the left shoulder so I think I should put up with it rather than take the risk of surgery and all the lost life.
It does sound like PT did more damage than good. I've also had a surgeon force a joint that was stiff, and it most definitely made things worse.
I hope you get your pain under control, and although a PITA, the new, slower approach to physio makes sense.
This is why I've done 15+ cortisone injections...It's my dominant arm and I'm scared I'll wind up worse than I am now. But I know at some point, I'll probably have to do this.
Then on the flip side I hear stories like my dentist, who's 75 y.o. mom had 2 shoulders replaced and is now pain free.
Best of luck to you!!
Yeah, good luck to you too! My left arm was almost useless. There really wasn't an alternative. I can see from the experience of many others that the results can be incredible, even pain free within 2 weeks post op.
I think I will leave the dominant arm shoulder until it gets worse or until I can be convinced the medical people around me know what I have been through and why, as well as offer me a realistic out;look for the second time around.
I am not convinced it was entirely the fault of poor PT advice as I live with persistent pain and tend to underrate the pain I am in. I do not think my contributing health situation was taken into account.