Paul Ross
Giving Pain the Cold Shoulder

Paul Ross says he knows exactly what damaged his shoulders, eventually causing so much pain that he underwent two shoulder replacement surgeries last year at Palomar Medical Center Poway.

“I have always been a very active person,” Paul says. “In school I participated in wrestling, baseball, football, weightlifting and power lifting – and I really beat up my joints.”

A devoted weightlifter, Paul pursued the sport into his 40s, even as his shoulders protested and he had arthroscopic surgery on both knees. “My shoulder was popping in and out of the socket,” he recalls. “It got to the point where the pain was unbearable, especially at night.”

Paul had turned to board-certified orthopedic surgeon Brad Cohen, M.D., in 2005 for his knees and continued to confer with him about his shoulders. In April 2012, Dr. Cohen replaced Paul’s left shoulder and then performed a right shoulder replacement seven months later.

Paul is among 53,000 people a year who have shoulder replacement surgery each year in the United States. That compares to more than 900,000 knee and hip replacements done annually. 

“Shoulder replacement surgeries probably are less common because knees and hips are weight-bearing joints that are more likely to be damaged,” says Dr. Cohen, who is affiliated with Palomar Health’s Orthopedic and Spine Center. “Patients also may try to live with shoulder pain because it doesn’t affect their mobility. We don’t walk on our shoulders.”

Paul said he opted for shoulder replacement surgery to stop hurting and to regain his active lifestyle. “These were very successful procedures from start to finish,” Paul says. “I am so glad I’m back to doing what I love to do. I still go to the gym and do cardio and yoga. On the weekend I bike, play tennis and even golf – with a full range of motion. Probably the best part is that I can sleep again without tossing and turning from pain.”

Paul’s story is typical of many patients who choose shoulder replacement surgery, according to Dr. Cohen. “They definitely tend to be active,” he says. “And they come in with pain, pain, pain.”

Paul’s weightlifting had repeatedly stressed his shoulders and led to substantial osteoarthritis so that he could no longer lift his arms above his shoulders, Dr. Cohen says.

Osteoarthritis is often a culprit in painful shoulder damage that restricts joint mobility.

Osteoarthritis is more common as we age, but also can be brought on by joint injury, repetitive stress on the joint, bone deformity or some diseases. Rheumatoid arthritis and chronic steroid use also can be significant causes of joint damage, according to the American Academy of Orthopaedic Surgeons.

Surgery should be the last option after first trying more conservative treatments, Dr. Cohen says. “I usually have all my patients try treatments such as cortisone injections, physical therapy and anti-inflammatory medications first. If that doesn’t work, then we may consider surgery,” he says. “If x-rays show a high level of arthritis, the patient’s level of pain is most important and guides what we do for treatment.”

Shoulder replacement surgery takes about 90 minutes. The patient usually is hospitalized for at least a day, although a patient occasionally may leave the same day as the procedure. That was the case with Paul Ross.

“I did both of his surgeries and he left the hospital the same day both times,” Dr. Cohen says.

Physical therapy is important for strengthening the muscles around the new shoulder joint and typically starts about four days after surgery, continuing for one to two months.

“The goal is for the patient to regain a full range of motion and at least the same activity level as before,” Dr. Cohen says. “Paul had lost at least 50 percent of his range of motion and now it’s fully restored. It’s amazing, really.”

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