♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Here we are the most famous
physical therapists on the internet.
- In our opinion, of course Bob.
- Today we're gonna talk about the seven most
important questions to ask your shoulder surgeon.
We actually have more than seven,
but we have kind of seven categories of questions.
- Sure right.
- Let's start right into them.
In any surgery that you have,
has to be taken very seriously.
And you wanna to give it much consideration.
- And I think that's really important,
because I can't tell you how many times
I've had patients or myself go to a doctor
and you leave and you say,
"I forgot to ask them that question.
It was a really important question."
It could give other feedback
that would be helpful for the therapist
or for you and your family.
- So yeah, if you're watching this program,
if you go to Bob and Brad, our website,
and go to the program section,
find the shoulder program and look for this section,
this video, I can talk.
- Spit it out.
There's a printout that you can actually do
that has all these questions listed for you.
- Yeah which is really nice.
And you can just highlight the ones
that you want to ask your surgeon
and just carry this with you to the doctor.
- Right and make sure they answer all your questions.
So let's start off with the first one.
Now this isn't self promotional here
but can you try physical therapy first?
That's really the first question you should ask.
- Right it is.
- Because if you can avoid surgery,
obviously you want to avoid surgery.
- Some surgeons, that's what they do.
And they will skip the PTA,
the physical therapy option,
unless you ask for it.
And then they'll say, "Oh sure, we'll give it a try."
So don't be shy about it.
- Right and this second one kind of ties into that.
You'd ask, "What is the risk to not performing surgery now?
What would happen if you waited six months or a year?"
Because in some cases let's say,
the tendon was actually ripped away from the bone.
Maybe the muscle is gonna atrophy so much,
it's not gonna heal.
That's what we're gonna ask the surgeon.
Can I wait at all?
Let's see.
Also if the conditions are like,
if you have an impingement
and it's the shoulder tear
gonna actually get worse, if you wait?
So these are all things to keep in mind.
So this is a good question for also
for people who are under the age of 30
who are considering surgery due to shoulder dislocation.
Quite often when you're younger than 30
and you have shoulder dislocations,
they wanna do surgery because you're
most likely to happen again.
And they don't wanna have you experience a damage
that occurs with dislocations.
- Sure right, that unstable joint.
- Yeah, I always hate to tell people that
but if you're younger than 30
and your shoulder has been popping out quite often,
my recommendation you have the surgery.
- Get it tightened up.
- Get tightened up yeah.
- And be done with it.
- So number three kind of ties into all the other ones.
What are the alternatives to shoulder surgery?
So besides physical therapy, there's injection,
taking anti-inflammatories.
Sometimes just the education.
Sometimes you need to avoid.
Sometimes let's say, you're an older person,
has shoulder dislocations,
don't be doing stuff like grabbing back like this
or grabbing behind the seat.
- Like when you're driving, you need your bag
And then awwh, that can really cause pain sometimes.
- You wanna avoid shoulder dislocations,
bring in the arm, yeah back.
- This way. - This-
Any beyond this plane.
- Right that's where it can really get unstable
and cause some pain when it pops out.
- Number four, this is a general question.
And then there's some sub-questions here.
It's basically about the length
of recovery off from the surgery.
How many days will you be in the hospital after surgery?
The norm seems like now it's in it's out, right?
- Right, same day.
Maybe one night sometimes for observation,
depending on the person's
if they got some other medical conditions.
- I just wanna state this spread.
So the first time I worked in a hospital as a student,
as a physical therapy student,
the first four patients I had, had rotator cuff surgery
and they were all men and they were all,
I hate to say it, but they were all
the biggest babies I've ever seen. (laughs)
They were like, they were having so much pain
and maybe I'm gonna be judgmental
after I find out how bad it is after.
But I had some women after that and they were like,
they acted like they didn't surgery (laughs) .
- They typically are tougher.
- They're tougher so.
Alright some sub-questions here.
Will you need full-time or part-time care?
You might.
You can't, if you're down to one arm,
so you have to plan ahead and know this.
- Sometimes after surgery, your arm is gonna be completely
immobilized for so many days where you can't move it.
Other times it's gonna be in a sling
where there is some mobilization.
- Yeah and that's the next question, Brad.
How long will you be in the sling?
You may be in the sling four to six weeks.
Your restrictions may be continual for up to six months.
Again, your family has to plan
from a functional and from a mental standpoint.
- Right or can you work?
If you got a job, you have to have that arm disability.
If you're going to have some kind of insurance
so you have coverage financially
during that time, if it's available.
- Absolutely.
When can ask the surgeon?
When can you expect the shoulder to be pain-free?
When can you lie or lay?
It should be lay on the operative side.
- Lay or lie?
- I think it's lay.
- Well, we'll have an English major QA on a timer.
- Sure, when can you drive?
Somebody's be driving around for a long time.
When can you return to work?
When can you return to sporting activities?
If that's your thing right now.
And how can, how soon can you resume
housework and gardening and stuff and so on?
So that one for me, if I can't ever get back to it, okay.
(laughing)
- Yeah no housework, no gardening,
Let's go (indistinct)
- (laughing) That's fine.
- May be you can emphasize that to the doctor.
- That's right.
Give me a note.
Number five, okay we're back to the main questions now.
This is kind of determining the competence
of your surgeon and you shouldn't be afraid
to find this information out.
You don't wanna ask the surgeon,
maybe ask his nurse
or get the information from the hospital.
How many procedures do you perform every year?
How many surgeries of this type have you done?
Not surprisingly, they found out that the more people,
the more times a person does a surgery,
the better they are at it.
Not shocking there is a bright.
- Right it's just a pretty basic thing
in practice makes perfect sort of thing.
- If they're general surgeon
and they rarely do this surgery,
I'm sorry, I'd go find someone that's done
a 100 of these last year.
- There's one thing, I have a friend
who was gonna get the ankle surgery
and he said, "Oh, I wanna go to Rochester, go to Mail
and have the guy who does all the athletic, the top people."
And I'm sorry, he was not an athlete.
He just wanted to walk.
So I don't know if that's the best fit
because he's working with someone who wants to-
- That's high level.
- He's working with athletes.
So there may be a difference in treatment afterwards.
- I understand completely.
- All that kind of people need to understand that.
- Yeah just because they're the best
at treating athletes doesn't mean
it's good for you who is not,
if you're not an athlete.
- If you're a standard person, like us.
(laughs)
- Right.
Number six, what are the risks of complications?
And what is your complication rate?
Again, you don't necessarily have to ask the surgeon,
but you wanna find this out.
I remember this was a different doctor,
he was a radiologist
but they do the test where they stick
the catheter up through your femoral artery.
- Right up into the heart.
- There's actually a high,
generally a high percentage of problems with that.
And at the time I'm just throwing a number out there.
I don't remember what was like 5% of people have problems.
And he was one that would be like less than 1%.
And he's like, I am meticulous at everything I do.
And so that's the kind of person you want.
It's funny how I had a test done
and I just could tell by meeting the guy,
he was one of those guys that really particular
and I'm like, good, he's my guy.
Aright number seven, the final question.
So these are, if you're gonna have
a shoulder joint replacement surgery,
you should ask these specific questions.
Brad, do you wanna throw one out there?
- What is the implant made of?
- Yeah you want to know if you're gonna set off
metal detectors in the airport.
- Right and you know it's amazing
because there's the plastic component,
there's the metal, there's ceramic.
I'm trying to think of some
of the other things that they use.
- I don't now how long shoulders are supposed to last.
Do you know?
I know knees are like 15 to 20 years.
- Yeah and they get better. - I'm not sure of shoulders.
- I'm not sure either because really shoulder replacements
have just really gotten popular
in the last five to 10 years I think.
- When you think about it,
a shoulder there's not as much stress on it as a knee.
- Yeah the weight bearing.
- No weight bearing.
So I don't know if shoulder replacements,
we got to find this out, we don't know.
And that's one of the questions.
How long will your shoulder replacement last?
Number three or C Brad, what's that one?
- Oh letter C. (laughs)
What can you do to make the new joint
last as long as possible?
- What do you wanna do?
What do you wanna avoid?
The do's and don'ts.
- Because there's different types of replacements.
There's the reverse in placement.
So that'll all be informed.
They'll probably give you some literature
to read on your own as well.
- Exactly.
And that last one ties right into that.
What activities or factors could make
your joint replacement wear out more quickly?
So you wanna avoid those things obviously so.
That's it.
If you just happen to stumble upon this video,
this video is a part of a series of videos
on shoulder pain and rehab.
And just go to bobandbrad.com,
go to the program section
and other programs you're gonna see
all these different programs we have.
We have one on shoulders.
Going to shoulders you'll see all the list and names
and you can pick out the ones you wanna watch.
- Right so if you just wanna know shoulder exercises
for rotator cuff, click on that.
And there'll be a short video on that.
If you wanna know how to reduce shoulder pain,
there's one on that.
So it's very efficient. - And there is a print out
with this video, so this video if you go there,
there'll be the printout for, with all these questions.
You don't have to write them down.
- Yeah what a deal.
- I think we have a link below too, you can find it.
- A link?
- A link in our description.
We have link to get to this.
- To the PDF.
- Yeah.
- Oh well, that's what I thought.
- Yeah alright.
- Don't get confused.
- Alright thank you so much. - Take care.
(upbeat tune)