Shoulder Surgery for Paraplegics Needing a Wheelchair

The shoulder is the most frequent area of pain according to those who use wheelchairs. Over half of those with shoulders bearing weight (persons in wheelchairs and users of crutches) get shoulder pain [Gellman, 1988; Sie, 1992; Finley, 2004 ]. 

This often entails the subacromial area as well as the rotator cuff, with rotator cuff tears, degenerative alterations, along with other pathologies around the coracoacromial arch usually identified [Boninger, 2001; Escobedo, 1997].

The most frequent issues we have observed with shoulders that bear weight are subacromial impingement (48%), rotator cuff tears (34%), biceps pathology (28%)(linked to cuff tears generally) and acromioclavicular joint arthritis (12%).

The duration of weight-bearing together with wheelchair use correlates with the progression of pain in the shoulder (that is, the more time you were using a wheelchair the more inclined you will to get pain).

But yet, zero difference has been identified between non-athletes and athletes, therefore involvement in sporting activities is not going to make an individual more susceptible to shoulder troubles [Finley, 2004].

Shoulders Bearing Weight tend to be more susceptible to pathology due to:

  1. the repeated qualities of propelling a wheelchair
  2. the high-strength demands applied to the muscles in the shoulder
  3. putting weight on the shoulder joints at extremes of movement
  4. weak muscles or imbalance
  5. substantial inner joint stresses as well as excessive strains placed on the subacromial spot during weightbearing via the shoulder, propelling the wheelchair and transfers.

It is critical that paraplegics avoid a tear in the rotator cuff since it is vital for regular functions and for shoulder strength. Optimal power and operation is needed for both movability and hand functions.

A tear in the rotator cuff can be very debilitating. An ultrasound scan is used to detect a cuff tear. It will have to be repaired if it is damaged.

Shoulder Surgery in Shoulders Bearing Weight

It can be a very anxious time for someone who requires shoulder surgery, especially if they use their shoulders for mobility. A rotator cuff requires weeks of keeping your arm immobile in a sling for recovery.

Complications with the surgery is also another concern for those who rely heavily on their shoulders for mobility.

1. The surgery:

All surgeries have the risk of complications, but these complications are reduced with arthroscopic surgery. No muscles are damages to get access to the shoulder, this reduces chance of muscle damage and infections, but this kind of surgery should only be done by experienced surgeons.

2. Post surgery:

Knowledgeable occupational therapists can be quite beneficial to organize caretakers preoperatively and guidance on having to live with a sling.

 

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