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  • in reply to: shoulder replacement #76489
    AvatarMichelle Polson
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    Kevin,


    At 29 years old, you are really young to be staring down a shoulder replacement.  I have had multiple shoulder dislocations and at least one grade 2 separation.  (I was a competitive swimmer in my youth, a bit of gymnastics in my late teens, then whitewater kayaking, and downhill mountain biking)  When I was in my early 30’s I was told my shoulders looked like that of a 70 year old in X-rays.  My left shoulder lost significant range of motion by 35 and I could not even raise my arm level with my shoulder, although I would still do push press using a messed up 1 handed technique when I’d hit the stop in my joint.  Didn’t get into Crossfit until I was 38 and was hoping that I could get the bone to strengthen and remodel through force and loading.  It was pretty obvious that no improvements in ROM were occuring and the pain was not improving.


    After getting opinions from 10 different ortho docs, I finally agreed to having a shoulder replacement done, however I had a procedure done called the “ream and run” or Hemi-arthroplasty.  This means that instead of replacing both the head of the humerus and the glenoid socket, they only put in a new head and just lightly reamed an exact match to that head slightly forward of the old socket which had been consistently wearing backwards (posteriorly).  So you know, out of the 10 docs I spoke to, this was the only doc who would do the procedure, Dr. Metcalf (he trained under the surgeon who invented it in WA state).  Several of the docs told me to just wait until the pain was too much and get a total shoulder, but a total shoulder would mean NO LIFTING of ANYTHING over ~25#overhead for all time and the poly glenoids have a high failure rate, so don’t push it, no more hard mountain biking either.  Others straight up told me… do whatever Metcalf wanted, because he is that good. He did warm me that there was ~5% chance he would have to do a Total if the glenoid bone was of too poor quality.
    Please note – Recovery for a Total shoulder SUCKS, but even it is way faster and less painful than a Hemi.  I can’t stress that enough, shoulder replacement is ridiculously painful…I had to shift my whole pain scale, but I refused to take opioid pain meds after the first couple days. They warned me that it could take 12-24 months for the shoulder to not hurt.  At 12 months, it still hurt a ton and I was regretting the decision, but just focusing on PT cause it’s not like I can go back.  At 18 months I had turned a corner and the pain was quickly going down and function was coming around.  I have never gotten quite full range of motion back.  Squat Snatch and Overhead Squats are things I avoid due to shoulder mobility.  However, my X-rays at 2 years looked amazing.  I have a perfect socket and it even formed something resembling smooth cartilage.  Bones only get stronger and reform due to loading and crossfit has likely improved the joints structure although I try to give it a day between hard days of overhead work to recover.  I have NO weight or activity restrictions other than being smart about what I do because the repairs from here are never as good.

    ~8 months after having the shoulder replacement, I went to work designing and developing joint replacements for a startup orthopedic company because I wanted to learn as much as I could about these implants and the overall durability of them.  I am now ~3 years out from the procedure and still happy with the outcome.


    Here is a page about the procedure… http://www.orthop.washington.edu/ReamandRunwithPT.pdf
    There are not tons of us who have had this and lift, but there are a few out there, but you have to find the right doctor and PT for success in active patients.

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