Mr Matthew Ricks is a Consultant Orthopaedic Surgeon specialising in the shoulder, elbow and hand.
In this Q&A he shares how shoulder pain can impact daily activities and details how The Horder Centre supports those suffering from related symptoms, including the specifics of rotator cuff surgery.
He also provides advice on managing shoulder arthritis, discusses various shoulder replacement options, and explains how The Horder Centre has embraced digital technology to support shoulder replacement surgeries.
Q1. What can I do for shoulder pain?
A. Shoulder pain can impact upon every aspect of your life. It's a pain that usually is centered over the shoulder, can radiate up towards the neck and down to the arm. It can keep you up at night, it can stop you doing the sports and activities that you want to do. If you find you've got shoulder pain that's impacting upon your day-to-day activities, then come to us here at The Horder Centre and we'll provide a full investigation for your shoulder and then develop a care pathway for you to support you to recover from this.
Usually, the treatment will involve conservative measures first, which can include physiotherapy and injections and aim to try and get you back to your functional state. If there is an indication to go immediately to surgery or if you have already tried these aspects, then the surgery is usually performed as a day case through small stab incisions around the shoulder and usually in the form of keyhole surgery. This allows you to get back to earlier function and have less pain following the surgery. If you do go down the surgical route, you'll be supported with a pain killer pathway, and with our skilled physiotherapy team will help get you back to function as early as we can.
Q2. What does rotator cuff surgery involve?
A. The rotator cuff is an area of tendons and muscles around the head of the humerus, it holds the ball within the socket. It's a key part of maintaining your motion of the shoulder and your function for the shoulder. These cuff and muscles around the shoulder can be injured with sports, with activities, with life in general, or work. You can also get associated generative changes that occur over the years. If you have an injury of a rotator cuff, this will be assessed by appropriate clinical examination, appropriate imaging, and then our treatment pathways will either be down the conservative measure route, which will be a combination of injections, analgesic support, and physiotherapy, or if there's indications for surgical involvement, then this is usually performed through keyhole incisions around the shoulder as a day case. Actual reattachment of the cuff muscles is via a keyhole surgery. We gain access into the shoulder joint and use complex anchor systems to reattach the cuff back on.
Q3. What can you do for shoulder arthritis?
A. Shoulder arthritis can be significantly crippling to your life, it can impact upon all aspects of your activities, and more importantly can keep you up at night. So shoulder arthritis, again, it's a spectrum of management that will provide, depending upon the degree of symptoms you have and the degree of arthritis that you have as well. If you've got destruction of the joint surface and severe arthritis, then sometimes you can't achieve that range of movement through physiotherapy and the only real options are joint replacement or injections.
Joint replacements of the shoulder are mainly broken up into two main areas, an anatomical and a reverse shoulder replacement. We perform one of these dependent upon the quality of the soft tissues that we find within the shoulder, and both of these types of shoulder replacements are aimed to give you hopefully a pain-free range of movement arc that will restore your function and get you back to doing those activities that you want to do.
With relation to an anatomical shoulder replacement, this is where the ball is replaced for a ball and the socket is replaced for a socket, and the reverse reverses this with a socket being replaced for a ball and the ball being replaced for the socket. This is very much dependent upon that rotator cuff and whether this can help maintain the stability of the joint.
Q3. What developments have there been in shoulder replacements?
A. One of the big new developments is the ability to plan your surgery on a computer. All of my patients get a CT scan prior to surgery and behind the scenes we plan the surgery on the computer to get the best implants in the best position for you. The reason we do this is it maximises the range of movement that we can achieve for you to get the best function and also the best longevity of the joint replacement that we'll do for your shoulder. This is a new area of orthopaedic replacement that we've embraced here at The Horder Centre and hopefully in the future there are other developments in the pipeline where that can assist us doing our shoulder replacements for you.
Book a consultation with The Horder Centre
If you are experiencing significant shoulder pain and want to discover the treatment options available to you, book a consultation with The Horder Centre. Our team is on hand to support you through the treatment process, from your initial consultation to any aftercare you may need.
We provide outstanding patient experiences
The Horder Centre is an award-winning Centre of Excellence that offers patients a unique therapeutic environment. Specifically designed for orthopaedic surgery, our facilities include a physiotherapy inpatient gym and courtyard gardens designed by clinical experts to enhance recovery. Finance options available.
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