When facing a shoulder injury, some conditions can be improved working with a primary care doctor and physical therapy.

Sports medicine physician associate Kevin Bell said if that first line of defense isn’t working, then it’s time to visit an orthopedic team.

“There are some injuries where surgery is the best first step, particularly if it’s an older patient who had a fall, something is broken or there is a rotator cuff tear — something where the pain is debilitating,” Bell said. “With that, we anticipate seeing good improvement with surgery.”

Shoulder surgery techniques

There are two main types of surgery techniques for shoulders. The first is arthroscopic, where a small incision in the skin is used as a portal for a camera to do the work in a minimally invasive way.

An open procedure, often used for a shoulder replacement, is a larger incision that allows orthopedic surgeons to directly visualize the problem.

“We like to do things arthroscopically for less risk of infection and quicker healing time of the skin, when possible,” Bell said.

One option outside of surgery is cortisone injections. Bell said that’s a good alternative for people who are not appropriate candidates for surgery.

“People who have other medical problems, such as significant heart or lung problems, it may not be appropriate to put them to sleep for surgery. So we look at conservative options where we can,” he said.

Recovery time

If surgery is the best tool, the physician associate said it can take up to a year to heal. Patients will wear slings and transition from formal physical therapy into home therapy during that time.

Within four to six weeks, many patients are back to daily activities such as showering and cooking.

“Getting back to more strenuous activity, like people who work in construction or playing sports again, that can take six months or more,” Bell said. He added that all of the healing happens within a year, but that most people are functional well before the one-year mark.

Orthopedic care

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