Reverse Shoulder Replacement Hello! New member

[greyg8r]

Hi, my name is Richard, I wanted to introduce myself. I am a 64yo semi-retired wetland scientist and owner of a mangrove trimming company.

Starting about three years ago, I started getting occasional shoulder pain after weight training, pushups or overhead lifting. Once I rested a few days, the pain subsided and I didn’t think in about it.

Anout two years, the pain became more common and I gave up overhead lifting and pushups.

Last year, I gave up throwing the ball to the dog and I started fly fishing with both hands and saw my orthopedist. He said my osteoarthritis was so bad he had to do a reverse shoulder replacement.

On December 6, 2023 I had the surgery. After two weeks, I was out of the immobilizer. Now, 100 days later, I am pain-free but certain movements with my right, repaired arm are limited:
1. Putting hard pressure with my hand on the center of my chest.
2. Reaching my left shoukder
3. Reaching the bottom of my neck
4. I have very little flexibility reaching the small of my back.

I’d like to know how much of this lack of range of motion is permanent from the biomechanics of reverse shoulder replacement and how much will improve as the musculature improves and tendons and ligaments become more flexible.

Thanks again.

Richard

 

[CricketHip]

Hi Richard, Welcome to BoneSmart! From what you've written, I am guessing that the reverse shoulder replacement was to your Right shoulder?
As soon as you verify this we will make your signature so anyone reading any of your posts will know what kind of surgery you have had.
I think some of the symptoms that you are describing are still a result of healing the involved soft tissue.
I've heard surgeons say that you lose mobility with a reverse, but personally know three people who've had this type of replacement and they say they are very pleased with their ROM. They did a good bit of PT to help strengthen their arm.. are you currently in any rehab program?

You can also do a search by typing in "reverse shoulder replacement" and some post surgery threads should show up. Maybe reading them will help. The search button is on the upper right of this page.
You will also see that you now have the prefix of "Reverse Shoulder Replacement" title in front of your thread name. It's in a blue box, which when reading other's shoulder threads, you can look for that blue box.

I've just spent 2 weeks in Marathon Key amongst the Mangroves..their roots fascinate me.
@greyg8r

 

[greyg8r]

Yes, thank you, my surgery was to my right (dominant) arm.
I have done two PT sessions, shortly after surgery but I was not impressed with their plan. It was less intense than my daily activities, e.g., throwing a cast net; fishing; and light swimming mostly dog paddling, and the surgeon; a former neighbor; knows me fairly well and my activity level and did not think I would benefit much from PT (or thought I wouldn't see the value in it and wouldn't go - not sure).

 

[mendogal]

Maybe I'm reading incorrectly in which case feel free to disregard this reply....
In my limited experience, shoulder PT does by necessity start very slowly.
In fact, all the good PT I ever received to any part postop started slowly because 1) we haven't healed yet and 2) if it were safe for us to resume our usual activities we wouldn't need PT

 

[CricketHip]

This is a shame about the PT. You’ve lost a good bit of mobility while struggling, with your shoulder limits, Pre-Op.
Then you have an invasive surgery and now have some weak and (most likely inflamed) muscles and tendons. Sometimes you need the baby steps before taking huge strides.
Rushing things could land you with some tendinitis and that’s no fun.
Maybe since your surgeon knows your lifestyle.. I wonder if he would suggest some exercises for you to do?
Or? Consider getting some good therapeutic massages from a good, licensed massage therapist.. some of your limits are from tight muscles and fascia. Especially in your pectoral muscles and rotator cuff muscles.
But! As the months go on your ROM should gradually improve. You really aren’t that far along with your recovery yet.

 

[greyg8r]

Cricket,

The big question for me is how much of my loss of range of motion is from having to now rely on the deltoids, rather than the rotator cuff muscles. As my surgeon explained, I have new muscles moving my shoulder, the deltoids, that are replacing the rotator cuff muscles. These deltoids and tendons with their greater responsibility may have to strengthen and lengthen which will take time. I realize that. I also know the biomechanics of a reverse shoulder results in some loss of range of motion. What I don’t know is what is the maximum range of motion that I can get from a reverse shoulder. My surgeon was fuzzy on that. He said at 100 days, my ROM is exceptional. But have I achieved max ROM, or will it improve more?

Thanks for listening,

Richard

 

[greyg8r]

Mendogal, my surgeon gave me the go ahead to live my life as long as it doesn’t hurt, e.g., fishing but did strongly discourage certain activities for life: throwing a ball, freestyle swimming, deadlifts over 50 pounds, overhead presses over 50 pounds, and pushups. I think he did not push PT because I think he felt my activities will develop the musculature and lengthening.

 

[greyg8r]

And I really trust my surgeon. He is a former team orthopedist for a major D1 college football team.

 

[mendogal]

Typically, whether we are discussing post op joint ROM or neurological gains after an injury, there's a consensus that major progress can occur in the first year, with both research and anecdotal evidence supporting that incrementally smaller gains can continue beyond that.
People may plateau, but with a continued appropriate level of challenge, they can then see a difference.
So I'm going with that realistic optimism for you!

 

[greyg8r]

Mendo, I’m fine with continued progress through one year! At 100 days, I have a lot of progress to look forward to. Thanks.

 

[CricketHip]

As my surgeon explained, I have new muscles moving my shoulder, the deltoids, that are replacing the rotator cuff muscles. These deltoids and tendons with their greater responsibility may have to strengthen and lengthen which will take time

This is true, but the pectoralis muscle works closely with (or against, dependent on the motion involved) to let your arm move in ways that you said you are currently limited in, like touching the opposing shoulder. It's a good stabilizer, too. I do think your rotator cuffs can still contribute? But definitely, your deltoid muscles are key.
There are several muscles involved in any of our movements.. that is what I am referring to. Hopefully your deltoid muscle is already fairly strong from coping pre-op.
From what I've noticed, I think the ROM improves, it's the strength that's limited? That's why my friends opted for a good bit of PT to ensure a controlled strengthening.
Like you said though, they aren't doing the activities that you are doing, so that does make a difference.
Overall, aren't our bodies amazing? They have the ability to overcome physical obstacles and adapt.
You have many more months to observe your progress and I sure hope you stay with us or come back occasionally to update with us!

 

[greyg8r]

Cricket, even more amazing to me than the human body, which is amazing, are the medical advances. If you had told surgeons 100 or even 50 years ago that a patient with an arthritic bone-on-bone rotator cuff shoulder could be treated by surgically flipping the ball and sockets and their recovery is in the high 90 percentile of success?

 

[CricketHip]

This is so true! We live in a great time to receive help for our joint replacements.

 

[djklaugh]

@greyg8r You are so right! I saw my grandparents and my father all suffering from debilitating arthritis. They would all be totally amazed (and probably envious too) that I have 4 man-made joints and can live a life free of arthritis pain!

 

[greyg8r]

@greyg8r You are so right! I saw my grandparents and my father all suffering from debilitating arthritis. They would all be totally amazed (and probably envious too) that I have 4 man-made joints and can live a life free of arthritis pain!

Dk, absolutely! And that is why I hope no one interprets me as whining, on the contrary, I am pain free and extremely grateful but just curious what the final outcome a year or two from now looks like.

 

[djklaugh]

@greyg8r During the recuperation period from ANY surgery whining and grousing are par for the course! That initial period is often almost worse than the getting to needing surgery stage. So no worries about the need to complain!

As for the long term out come ... I'm now 11years and 7 years out from shoulder replacements and am delighted with the results. I can do most everything I need to do in my life without pain. I can sleep on either side without pain. I have good ROM and average strength for a woman my age ... (though I did have to have my housemate open a very tight top to an eye drop bottle recently but even he said it was hard to open )

The only things I've found that the new shoulders don't handle are doing a crawl stroke when I swim (can't get a smooth around and down motion) and scratch an itch in the middle of my back .... but neither of those has much of a negative impact on my life.