Matthew DiPaola 
The other day a patient asked me if he should exercise his shoulder before getting a shoulder replacement. A little background, the patient is about 60 years old and is an avid weight lifter. I was a little confused by the question so I asked him to clarify.
He thought that if he increased his shoulder and chest strength before surgery, this would make it easier for him to recover and for me to do the surgery.
Rotator cuff tears can be tricky. And unfortunately not all rotator cuff repairs are fool proof. Older studies showed that rotator cuff repairs failed to heal in up to 3/4 of attempts in some patients.
Newer studies tend to show more favorable results but on average still report at least a 1/4 chance of retiring of the rotator cuff repair.
The patient was about 40 years old. My hunch was that she had a repair that never healed. The evidence was there: she already had one failed repair, a re-repair and her symptoms were exactly the same as when she first came to the previous doctor: popping, catching, pain with reaching across her body and … Read more
Research has shown that the ability to walk unassisted is likely the single most important factor in maintaining your independence as you age. Targeting this simple metric may offer the secret to staying independent and new research supports this conclusion.
A recent study of over 1600 men and women in their 70’s and 80’s with mostly sedentary lifestyles aimed to examine whether a basic exercise program focused on lower body strength could help to maintain independent walking status in older adults.
Frozen shoulder is one of the most frustrating problems for patients and doctors alike.
It’s painful, it comes out of nowhere, it causes sleepless nights and it often seems to drag on forever – 12 months is not uncommon.
As doctors we like quick fixes as much as you do. So it’s hard to see a patient come back to you for months on end and the best you can offer is:
Most people think that you need an MRI to “see” everything that is going on in your shoulder. But it’s simply not true. And there are a few ways that you can be fooled by this line of reasoning.
1. You fail to put findings in context
I can show you MRI reports of normal shoulders that will scare the daylights out of you. These are full page documents that describe in great detail, essentially normal findings in medical lingo. Unfortunately as a layperson and even many medical professionals who are unfamiliar with the problem, most of this language will sound scary and can be misinterpreted.
A recent study from the Mayo Clinic examined the relationship between clinical outcome and obesity in elbow replacement patients. The Mayo Clinic has the most extensive experience with elbow replacement in the world. They studied a large group of patients and approximately one quarter of these patients met the definition of obesity.
Overall obese patients had more complications, shorter average survival of the implants, and increased rates of failure of total elbow replacement compared to non obese patients.
We don’t know a millionth of one percent about anything.
Thomas Edison
A recent presentation at the American Arthroscopy Association of North America tried to answer the question of why some adolescents re-dislocate their shoulder and others do not after shoulder instability repair.
I take call about 5-6 days per month which means that I take care of patients that come into the hospital with fractures. A few weeks ago I treated a woman who had a hip fracture (I treat a lot of hip, ankle and wrist fractures when on call).
The ER staff who gave me her initial story told me that they thought she was a bit incoherent when she came to the hospital.