Physical Rehabilitation Medicine/Shoulder tears part 2


  Thank you for writing back on my shoulder dilemma. I am afraid I did not receive a email. I saw the reply on line. So to answer your questions about the hip I needed to start another question.  
  Because of a congenital hip, I had a hip replacement done. In 2007, had the top revised. Did not go well, in the next 3 years had the top part revised 4 more times. I was on crutches from 2007 to 2011 straight. I got off crutches for 9 months and then the bottom femoral unit came loose. So in Dec of 2011 I had to go back on crutches. Had a trochanteric osteotomy done 11/2012. I am still on crutches. It is healing but very slowly:) could be that this was the 9th surgery.
  So, I seem to be in a catch 22! Need the crutches for the broken femur. Hate the crutches my shoulders. Just found out I have carpal tunnel. Ugh tell me that can go away. Did I mention I am 49. Haha
I am just looking for no more surgery:) any ideas. A wheelchair? But I can not push with my arms.
Thank you for any advice you have.

ANSWER: Ok...first off I hope you have a good surgeon.  I would consider a second opinion with a very well known hip specialist.  I'm not sure where you live but I'd look into it.

Carpal tunnel isn't a shocker since you've been putting so much stress on it with the crutches over the years.  It may go away with eliminating the stress but it would probably mean you would have to go to a wheelchair.  I understand your dilemma since you can't push with your hands.  You could try a walker with some type of handle adaptation.  Try the company DRIVE.  They make lots of stuff like that.

I'm not sure of your weight but if you are overweight I'd look into losing some since it will ultimately reduce the stress into your lower (and upper) extremities.

If you had to have the carpal tunnel released it would put you off of crutches for about 5-6 weeks.

---------- FOLLOW-UP ----------

QUESTION: Thank you for advice:). Is there a possibility that when my hip is healed, that I can have the carpal tunnel done at the same time as the shoulder surgery? On my previous MRI that I sent you, can you tell how long it would take for rehab? Once I get the hip healed of course.
I am 5' 10" and weigh 150 pounds so overweight has never been a problem. Thank goodness!
I am hoping to go in a electric wheelchair for a couple of months to take the stress off my body. Would shoulder tears ever heal by themselves?. Thank you

It depends on the level of compression.  A nerve conduction test (NCV) is usually the gold standard with diagnosing and evaluating the level of compression.  If it's severe then you may be advised to have it done ASAP since the nerve may be permanently damaged if not released.

Think of shoulder tears as a can pull a few strands off and it will still function correctly.  Pull too many off and it's weak and unable to do it's job.  Not much difference other than ropes can't feel pain!

SO...I'd prioritize.  If the CTS is bad enough get the release first.  If your surgeon says do both then do both.  Whatever your treating physician recommends.  Just make sure you're going to a good one first.

Good luck!!!!

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Brian Neville, OTR/L, CWCE


I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!


10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

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Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

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