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March 06, 2021  
FORUMS: Read-Only

Topic Title: Capsular Release?
Created On: 02/10/2008 05:51 PM
 05/25/2012 05:55 AM

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My aunt has gone through the [url=]shoulder joint replacement[/url] few days before. She has started some exercises as per suggested by a physiotherapist.
 02/11/2008 09:59 AM

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Hi Mike...

thanks for the kind response and the knowledge you interject. It's good to know there are others out there that have had similar experiences and are willing to share them. I will e-mail you with some additional info/questions if that is ok. The e-mail you receive will be from [email protected] thanks again...

 02/11/2008 06:43 AM

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"Does this sound like you? Before your TSR, your arm should have felt heavy, clunky, and sharp pain followed by dull aches. Now, it just has dull aches, localized pain (not down to your hand), tightness, correct?"

Yes, that's exactly how it feels. The pain, like yours, is mostly in the back and on top of my shoulder. I last saw my surgeon about three weeks ago and he wants me to do at-home therapy only b/c my most recent EMG showed a lot of swelling around the nerves. I had been going to PT 2-3 times a week since July.

I don't see my surgeon until April 22nd. He talked about surgical intervention at my last visit but I pleaded for more time. I'm guessing if things don't improve by then he may want to go in and take a look but I am petrified to have another surgery after waking up with a dead arm after the TSR.

I feel like I'm going nowhere fast. I'm barely able to move my shoulder due to the nerve injury and now I may be dealing with scar tissue as well. What do you think my odds are at avoiding another surgery? Even if my nerves decide to wake up, will the scar tissue still prevent any purposeful movement?

 02/11/2008 06:22 AM

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MB - let me stress I am not a surgeon, I have a lot of experience with shoulder problems but ultimately, you should consider I come from a practical approach, not clinical.

Now for your question, it is tight, but does it hurt a lot after stretching and exercise or is it just tight? Usually if you have scar tissue, it will hurt after exercise but it will calm down within 48 hours. And usually the pain is not the same as before surgery, you shoulder feels different. And finally, my pain has always been from scar tissue in the back of the shoulder, across the top, and down to the front. Now mine was always subacromial scarring with some subscap tightening and cuff interval contracture of the capsule which was brought on by surgery. Scar tissue forms the first 2-3 days post op, so if you were unable to move your arm then, it could be the case.

Does this sound like you? Before your TSR, your arm should have felt heavy, clunky, and sharp pain followed by dull aches. Now, it just has dull aches, localized pain (not down to your hand), tightness, correct?

Fill me in and I'll give you my thoughts, but it is important to maybe see your surgeon or a PT in your area to get their opinion.

Best regards,

 02/11/2008 05:54 AM

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I had a TSR in July '07. I sustained a pretty severe BPI which is affecting my axillary and suprascapular nerves. After initially having no use of my arm, I now have use of my biceps, triceps, hand and wrist muscles. My deltoid and upper back muscles, however, are being very stubborn.

My question to you is, when (I'm trying to stay positive!) I regain use of my shoulder muscles, will I be dealing with a lot of scar tissue, as I haven't been able to move or use the TSR? When I do my at-home PT (pulleys, stretches, etc.) my shoulder feels so tight. Is this just the BPI causing the sensation or scar tissue?

Thank you in advance for your opinion,
 02/10/2008 06:38 PM

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I meant Packfan... not Packman
 02/10/2008 06:33 PM

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Dear Packman,

I'm sorry to hear about this. However, 10% of Hemi's need a capsular release, so you are in company with lots of folks.

This is what the surgery looks like

You will feel instant pain relief. You also run a slight risk of being loosened too much causing instablility, but I don't see this being the case for you.

You can Email me directly at [email protected] if you want some more info, I've had this done to my shoulder... too.

Remember when I told you it could be the subscap... it's tricky to tell but you sounded just like me after my open reconstruction.

Best regards,

 02/10/2008 05:51 PM

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I had a Hemi in Oct. 07. Range of motion is still minimal after 4 months of continual therapy, with extreme stiffness/tightness in the joint. I also have not been able to progress to unassisted elevation or stengthening of any degree without a lot of pain in the anterior portion of the shoulder. This seems to to disallow more aggressive therapy measures after being aggrevated. I'm not sure if that is coming from the biceps tendon or subscapularis tendon, they are so close together, or if it could be something mechanically wrong within the joint causing this pain.

Recently, I was told by the surgeon that a capsular release my be needed if this doesn't resolve within 6-9 months of the index surgery. I'm not sure what is involved with this kind of procedure and what benefits it may render. I'm also not ready for another surgery and wonder if this all may resolve on its own any time soon. Has anyone had a capsular release? Any information would be much appreciated....


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