Dr. Mark Mighell, Glenohumeral Arthritis - Florida Orthopaedic Institute скачать в хорошем качестве

Dr. Mark Mighell, Glenohumeral Arthritis - Florida Orthopaedic Institute

You know arthritis is one of those things that we kind of talk about but there are lots of different types of arthritis and so I thought I'd kind of go through this a little bit. We'll talk about the anatomy of the joint and some non-Op and operative strategies. But remember once you go to an hour through a joint replacement you can't go back. So I think it's important to talk about things we can do to avoid getting there. And we kind of understand that the shoulders of ball and socket joint. But it's a very unstable ball and socket joint. So a hip socket stable shoulder. It's one of those joints it's almost more like you have a plate of bone. So it's a unstable joint because the glenoid or the socket of the shoulder is relatively flat. So this joint not only is unstable but it's also the most commonly dislocated joint. And Ioannis will talk about that a little bit later. But it's not really a true ball and socket joint. And the reason it becomes a ball and socket joint in a way is that the labrum adds about 50 percent of the depth of the socket. There's a negative pressure in the shoulder. There's this adhesion the fluid kind of holds it in and then you have this relatively wonderful kind of capsule and ligaments and muscles that all function around the shoulder. So for the shoulder we're talking soft tissues. It is a soft tissue joint and there four rotator cuff muscles. And I love that and clinic and you guys have heard it too and God bless our patients had have Rotary cup problems or you know you hear all this when they come in and I still get a kick out of it but there's four muscles that make up the rotator cuff and you don't tear muscles really in the shoulder it's more of a tendon injury you're gonna tear your tendons. That's because they're relatively avascular structure. You don't really get rotator cuff tears in people under the age of 40. That's kind of one of those misnomers. I mean you can but most of rotator cuff tears occur and people my age so a fifty-five year old and something occurs and I'm in this boot now to eat and crow because last year Jeff Stone fell and tore both of his calves so Mark Frankle has both of his shoulders replaced. I was feeling young and sprightly because I didn't have any orthopedic injuries. Here I am. So let's talk about function and then and I thought John. That was a wonderful lecture that he gave. This is look out for this girl Coco Gauff used at Wimbledon probably the star of the summer she followed the playbook of kind of the Williams sisters You know and she beat one. Thing that's interesting she started playing tennis and she was really little. On our shoulder. Of course, this year we've got a guy named Epstein who's coming to talk about range. I don't know if you guys knew this but Roger Federer didn't really start playing tennis until he was 18. So he was really good at sports but he didn't start when he's a little kid. So the question that always becomes you know how do you get good at a sport. And so if you come to our shoulder Of course you can listen to Epstein give his lecture so let's talk about elevation. You know when you lift your arm up. One third of the motion is from your shoulder blade. Not from my ball and socket joint. So even if you have arthritis you can still lift your arm up the ball and socket joint seizes up much like the car engine it stops working but you can use your shoulder blade to elevate your arm. I kind of like this get to the the barnyard or into the garage and kind of figure this out. But this is what the muscles do so you're kind of trying to figure the rotator cuff compresses a ball in the socket so your deltoid can work but all arthritis isn't the same. And so there's different ways to treat it but I think the biggest mistake people make is that you have an arthritic joint they go Hey don't use it. Mistake. It's actually quite the opposite. If you have an arthritic knee and arthritic hip and arthritic shoulder you want to exercise you want to stay active you want to keep moving the joint. It's really counterintuitive. There's a lot of supplements that are out there right now. You know I kind of my best friend growing up lives in Colorado you know and all these different kind of things he's he likes allopathic medicine. So tumeric it's this you know you can take it with pepper. It's a natural anti inflammatory glucosamine conduit and sulfate and we heard about that a little bit earlier. But I think that it's important to start these supplements early before the arthritis gets too bad. We can inject the shoulder and we've talked about that but the most important thing I tell my patients is keep exercising don't stop. Website: http://floridaortho.com Facebook:   / florida.orthopaedic.institute   LinkedIn: https://www.linkedin.com/company/flor...