A patient with a supraspinatus tendon reconstruction operation at one month after the surgery is still feeling pain on 90 degrees of flexion and abduction. What should be the best treatment for pain relief?
thanks
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Age: 60, Female, Aggravating Factors:: moving the arm, Investigations: mri, No Diabetes, High Blood Pressure: 90/150, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: no
Major problem / Symptomatic Areas
Shoulder - Anterior - Right
A patient with a supraspinatus tendon reconstruction operation at one month after the surgery is still feeling pain on 90 degrees of flexion and abduction. What should be the best treatment for pain relief?
thanks
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This is totally normal as a repair to a supraspinatus tendon can take many months to become more pain free. The 90 degree range is likely to be where the work that has been done comes into contact with other soft tissue structures. You can benefit from gentle soft tissue massage to desensitize the area being careful not to over do it. In my experience you should not push range of motion but let it return as the tissue swelling/thickening resolves. Don't be surprised if this takes up to 12 months.
You really should be working with a physiotherapist during your rehabilitation of this repair to monitor and plan your home exercises so that they are a steady, progressive return to full normal function.
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You didn't say, but hopefully this is passive range. Continue with joint mobs and PROM. By 2 months they should be > 85% WNL PROM and at around 50% AROM and over here by 3 months 95+ and 95 respectively. Preventing adhesive capsulitis is much easier than trying to correct it. We generally use scaption rather than straight plane ABD. After mobilizations and PROM we use cold packs and interferential electrical stim to decrease their pain. Pain is normal at this point in the process.