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Thursday, November 20

Should I have surgery for frozen shoulder?

Frozen shoulder is a problem that will eventually get better on its own.  The bad news:  that can take more than a year.  If injections and medications don't help, some patients choose surgery.  In my practice, about 25% of patients with a true frozen shoulder choose surgery after trying everything else.  Surgery for frozen shoulder is very successful, but depends on careful physical therapy post-operatively.  It's important to remember that there is no time where surgery is absolutely necessary for frozen shoulder; it's just an option if pain and stiffness are so bad that a patient can't wait for it to get better.  Here is a video of the surgical procedure, where thickened ligaments are released to regain motion.  Surgery is done arthroscopically, through small incisions, and patients go home the same day.  Therapy is starting on the day after surgery, to prevent the shoulder from "re-freezing." 

For more general information on frozen shoulder from a previous blog post, including injections for frozen shoulder, click here:  http://blog.doctorfrisella.com/2012/11/more-about-frozen-shoulder.html

Monday, October 6

New Rotator Cuff Repair Video

Just finished a new rotator cuff repair video.  A rotator cuff repair is the most frequent surgery that I perform.  Most patients with rotator cuff tears are in their 50's or 60's.  Tears can occur from wear over time, or be the result of an injury or accident where the tendon is torn away from the bone.  Thanks to John Dattilo for the video editing!

Thursday, July 17

Arthrex Teaching Event with Dr. Burkhead

Had the opportunity to lecture and teach arthroscopy at the Arthrex-Apollo Surgical Master Shoulders Course, along with Dr. Matt Smith M.D. from the University of Missouri and Dr. Buzz Burkhead M.D. from Dallas, Texas.  These guys are truly experts in shoulder surgery and I was honored to be included.

Thursday, April 24

Why does my shoulder hurt at night?

Shoulder Inflammation
Many patients will tell me that their shoulder doesn't bother them much during the day, but at night, if they roll over on it, it hurts.  Sometimes shoulder pain keeps people from getting to sleeping at night, or wakes them up during the night.  This can be very frustrating.

Many different shoulder problems can cause pain at night, but the most common are tendonitis and bursitis.  These conditions cause inflammation, and inflammation bothers is the worst when the shoulder is resting, not moving.  You can think of inflammation like sunburn: red, hot, and painful, and worst at night.

For many people, taking two Tylenol, two Alleve, and a Benadryl about 30 minutes before bedtime can help significantly with nighttime pain.  the Tylenol acts to control pain, Alleve is an anti-inflammatory, and the Benadryl provides sedation to help stay asleep.  Of course, do not try this without first asking your physician if it's OK for you, but I have found this very helpful in getting patients to sleep through the night. 

If nighttime shoulder pain continues beyond a few weeks, it's probably worth seeing a doctor to see if it's something more serious (like arthritis, a frozen shoulder, or a rotator cuff tear).  Cortisone injections can be very helpful for nighttime pain.

Monday, February 17

Bench press injury: It's a pec tendon tear!

The pectoralis major is the large muscle on the front of the chest wall, and attaches the arm to the rib cage.  The pec major tendon can tear (or rupture), just like any other tendon in the body.  However, the pec tendon almost always tears in young, muscular men, usually while doing the bench press.  Using steroids can increase the risk of this muscle tear, because steroids allow the muscle to grow so large that the tendon can no longer handle the force that the muscle generates.  A pec major tendon rupture often feels like being hit with a bat, and usually causes an obvious bruise and deformity.

Someone with a pec tendon rupture needs surgery to repair the tendon for full function, especially the typical patient who is young, healthy, and active.  The repair is done through a small incision near the armpit, and stitches (sutures) are used to pull the tendon back into its normal position.


Pec tendon tear: Note bruising and dimple on the right side of the chest.