If you are like most Americans, you have a very high risk of having shoulder pain at some time in your life.

If you have a rotator cuff tear, shoulder instability, or labral tear, you may even be considering shoulder surgery. You probably know someone with a history of shoulder surgery. It is possible that they told you about their experience, what was performed during the surgery, the healing after the surgery, the rehabilitation process, or how they are feeling now.

Or perhaps they told you how painful it was!

If they did, and you are feeling nervous about having shoulder surgery or a shoulder operation, consider a visit with Dr. Johnny T. Nelson, MD, a Raleigh, North Carolina, shoulder specialist.

Dr. Nelson specializes in shoulder surgery. This means that he has special training and shoulder surgery and performs more shoulder procedures than most orthopedic surgeons. It also means that he devoted special time to improving the care of patients who have shoulder pain and shoulder problems. And one very important aspect of this care is making his patients more comfortable!

If you speak with one of Dr. Nelson’s patients or watch some of his online video testimonials, you will notice that patients mention how little pain they have after the operation. In addition to modern nerve blocks, Dr. Nelson recommends a special regimen of oral medicines before and after shoulder surgery that have been proven to reduce pain levels.

Many patients do not even need any pain medication at all!

For example, one patient had 3 prior operations on both shoulders, and reports that his fourth operation, the only operation performed by Dr. Nelson, was nearly painless compared to the others.

If you have shoulder pain or are considering shoulder surgery, call 919-872-5296 today to schedule your visit with Dr. Johnny T. Nelson, MD, Raleigh North Carolina shoulder specialis

How Much Pain Will I Have after Shoulder Surgery? Read More »

Why Is It Important for a Shoulder Specialist to Use Ultrasound?

Injections, Platelet Rich Plasma, Rotator Cuff, Shoulder, Shoulder Arthritis, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries, Ultrasound

Why Is It Important for a Shoulder Specialist to Use Ultrasound?

If you are reading this, it is likely that you or someone you know has shoulder pain. It is possible that you tried treatments to improve your shoulder pain without success and are considering a visit with an orthopedic shoulder specialist.

This is certainly a good place to start.

An orthopedic shoulder specialist is expert in the evaluation, diagnosis, and treatment of all shoulder problems including rotator cuff tears, bursitis, instability, and biceps problems. An orthopedic specialist can order and read x-rays, CT scans, MRI studies and has more in-depth knowledge of the shoulder and shoulder problems than any other healthcare provider, including primary care physicians, physical therapists, chiropractors, and nonsurgical sports medicine doctors. Not only can an orthopedic shoulder specialist evaluate your shoulder, but they also provide treatment. It is also important to know that a visit with an orthopedic shoulder specialist does not always mean you will have surgery.

But there are many options out there! It is important that you see a shoulder specialist that uses ultrasound as part of evaluation and treatment of shoulder pain.

If you live in North Carolina, you are in luck! Dr. Johnny T. Nelson, MD is one of those shoulder specialists!

At The Bone and Joint Surgery Clinic, Dr. Johnny Nelson has state-of-the-art ultrasound equipment that allows a high-resolution scan of the rotator cuff and other structures in the shoulder. Along with a physical exam, x-rays, and a short discussion, Dr. Nelson can give you important information about the cause of your shoulder pain.

Doctors that do not use ultrasound are not able to see or evaluate the rotator cuff at the time of evaluation. This often requires an MRI study, which insurance companies will often deny, are expensive, require complicated scheduling, and multiple other visits to obtain. As a result, patients with big rotator cuff tears may possibly be treated with physical therapy, injections, or observation when they should be undergoing rotator cuff repair.

Dr. Johnny T. Nelson is also able to use ultrasound to perform targeted injections that are not possible without ultrasound. These include biceps injections and suprascapular nerve injections, which can be very helpful and more effective than “traditional” blind injections performed without ultrasound.

Do you have shoulder pain? Are you worried that you have a rotator cuff tear? Call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD, Raleigh North Carolina shoulder specialist.

Why Is It Important for a Shoulder Specialist to Use Ultrasound? Read More »

How Long Do I Have to Wear A Sling After Rotator Cuff Repair?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries, Uncategorized

Screenshot 2024 02 27 at 11.22.26 AM How long do I have to wear a sling after rotator cuff repair?

You recently discussed rotator cuff repair with your orthopedic shoulder specialist and you are moving forward with repair. Hopefully you are seeing a talented specialist. A talented specialist will spend time with you and discuss the details of the after-surgery healing process.

One of these details is the use of an arm sling after your rotator cuff repair. After rotator cuff repair, your arm will be immobilized in an arm sling, sometimes called a “UltraSling.” It usually consists of a durable, high-quality, well-padded sling. It also has an extra “pillow” piece that will help keep your arm and elbow from moving too much.

For more information on use of your sling, see Dr. Nelson’s YouTube channel. You may also download and print this important document, Shoulder Arthroscopy: What You Need to Know. Or you may visit Dr. Nelson’s main rotator cuff repair page.

After surgery, the rotator cuff repair must be protected. If your arm hangs free, the movement in the early weeks after the surgery will be uncomfortable. However it also places too much stress and tension on the rotator cuff repair. If too much stress and tension is placed on the rotator cuff repair, there is a risk that the repair will come loose and fail.

The sling also serves as an important reminder. It reminds you as a patient that you should not be using the arm, and it reminds others around you that you had surgery and should not be expected to use the arm.

But how long do I have to wear the sling?

The answer to this question is different for different doctors. Dr. Johnny T. Nelson follows a very simple protocol. Rotator cuff repair patients will need to wear their sling full-time for 4 weeks after the procedure. Of course, Dr. Nelson will have you come out of the sling for simple hand, wrist, and elbow exercises and sometimes some very gentle movement exercises of the shoulder. However you will be wearing your sling 24 hours per day, including sleep. After 4 weeks, Dr. Nelson will permit you to remove the sling while at home only and use the arm for very gentle activities

Dr. Johnny T. Nelson will still have you wear the sling when you leave the house up until 6 weeks after surgery. This is because it is important that you do not use the arm to do things like open doors, drive a car, carry grocery bags, etc.

In the first 4 weeks, there are a few reasons to remove your sling.

For example, if you are taking a shower or getting dressed, it is necessary to remove your sling. In these situations, it is still important to be careful with the arm and not use it for grasping, pushing, or pulling, or lifting.

It is also okay to remove your sling if you are sitting or lying down, such as on a sofa or armchair. It is acceptable to remove the straps and remove the sling for comfort, allowing the arm to rest at your side. You may do this only if you are awake. Remember, the sling is a reminder above all else, which is most important when you are up and especially when you are out of the house.

If Dr. Nelson does not perform a rotator cuff repair, and shoulder surgery targets other problems (such as the biceps tendon or bone spurs), he may allow you to remove your sling earlier and begin using your arm earlier.

If you have shoulder pain, if you have a rotator cuff tear, if you are in need of an orthopedic shoulder doctor, call 919-872-5296 today to schedule your visit with Dr. Johnny T. Nelson, MD.

How Long Do I Have to Wear A Sling After Rotator Cuff Repair? Read More »

When Can I Get Back to Work After Rotator Cuff Repair?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries

Image 2 15 24 at 1.25 PM — A rotator cuff tear before repair

Return to work after rotator cuff repair.

You have a painful rotator cuff tear. You try oral medications and anti-inflammatories, physical therapy, chiropractic care, watchful waiting, massage therapy. You change your diet and lower your sugar intake. You try regenerative therapies like PRP injections.

You try everything, and yet still you have pain.

The answer is clear. While discussing with your orthopedic shoulder specialist, rotator cuff repair is your best and only option to get you back to living and loving your life.

Yes, a well-trained shoulder specialist such as Dr. Johnny T. Nelson, MD is able to repair your rotator cuff. But what does this mean for you? How will your life be affected?

One of the most frequent questions that patient’s ask while discussing rotator cuff repair is:

When can I get back to work?

This is not a simple question, and ultimately the answer is usually different for every patient. That is why it is very important to have a personal, one-on-one visit with your orthopedic shoulder specialist.

But if you are alone, searching for guidance and answers to this question, here are some pointers.

Rotator cuff repair procedure is always done as an outpatient, meaning you will go home the same day that the procedure is performed. No lengthy hospitalization is necessary. You will be back home, resting and healing in your home environment on the day of the procedure. More information about the healing process after shoulder arthroscopy can be found here.

But you cannot return to work after rotator cuff repair immediately.

You will need at least one week of strict rest, mostly spent lying down with ice on your shoulder allowing the swelling to subside. While this process under the guidance of Dr. Nelson’s protocol not very painful, it is important that you have at least one week devoted to rest of the shoulder and the entire body. During this time, of course it is okay to get up and walk, go from one room to the other, and go on simple short excursions outside the home. It is also important that you move your hand, wrist, and elbow.

But the first week after the procedure is certainly not a time to return to work, no matter what you do.

After 1 week, most patients are able to sit up comfortably. For some patients, they are comfortable enough to sit at a desk or a computer, answer phone calls, and talk for extended periods on the phone. Therefore, some patients may be able to return to work at 1 week or 2 weeks if they do mostly sitdown, desk type work.

But even in these situations, you may require a shortened shift or periods of rest. So it is very important that your employer is comfortable with you using such accommodations.

Depending on the shoulder procedure that you had done, some patients must keep their arm strictly without movement, such as a rotator cuff repair. For other surgeries on the shoulder where rotator cuff repair is not performed, patients return to using their hand for waist level and gentle activities as soon as they can tolerate it. However, this does not mean that the patient returns to repetitive use or any forceful gripping, pushing, or pulling.

Are you having a rotator cuff repair? Plan out enough time for healing. Many patients are able to return to desk work at 1 to 2 weeks while wearing their sling. But some other patients may not be comfortable enough to do so.

If you work heavy labor, you will not be able to return to full work for 4 to 6 months.

You can probably return to work wearing your sling and without use of the operated arm 4 weeks after surgery. However, the use of the operated arm to push, pull, or perform any heavy lifting or climbing is not allowed for 4 to 6 months. This can be a long time to stay out of work. But it is absolutely essential that you do not perform heavy work with a newly repaired rotator cuff.

Do you have a rotator cuff tear? You need to learn more about your options. You need to discuss the healing process with an experienced shoulder specialist. Dr. Johnny T. Nelson, MD is a shoulder surgeon serving patients in Raleigh, Durham, Chapel Hill, Garner, Knightdale, Cary, and all of North Carolina. Call 919-872-5296 today to schedule a consultation.

When Can I Get Back to Work After Rotator Cuff Repair? Read More »

I Injured my shoulder! Should I rest it?

Rotator Cuff, Shoulder, Shoulder Pain, Shoulder Surgeon, Sports Injuries

I injured my shoulder! Should I stop working out? Should I wear a sling? Should I see an orthopaedic doctor?

Depending on the circumstances surrounding your injury or pain, these questions may be swirling about in your head, and the answer to these questions could vary.

Of course, very mild aches and pains can be a normal part of life.

Illness, exercise, sports, aging…all of these can lead to soreness, mild temporary aches, and fatigue. It would be unusual to pass an entire lifetime without any trace of discomfort in our bones and joints. These types of pains can and should certainly be tolerated and should not cause alarm. When we do experience them, it is best to stay active and not allow these symptoms to affect our active lifestyle.

However, shoulder pain that is more severe, longer-lasting, or accompanied by significant weakness or loss of motion should not be “brushed off.”

An orthopedic shoulder specialist like Johnny T. Nelson, MD is specially trained in diagnosis and treatment of any and all causes of shoulder pain. Based on questions that he will ask you about the type of pain you have, location of the pain, how long the pain has been present, as well as findings on physical examination, x-rays, and possibly ultrasound of your shoulder, he will be able to give you direction on whether or not further treatment is necessary or if it is okay to continue with life as usual.

For example, if your pain began after a more serious accident, for example a car accident or a fall, it is very important to rule out serious problem such as broken bones or torn rotator cuff tendons. This is usually done with a combination of x-rays and physical examination. Dr. Nelson also uses in-office ultrasound to diagnose these conditions as well without having to resort to more costly and time-consuming MRIs.

There are other conditions, such as bursitis, rotator cuff tendinitis and inflammation, and arthritis that are okay to live with, and continuing to workout is usually okay and safe. Of course, some modifications of your workout regimen may be necessary to avoid inflaming or aggravating the shoulder further.

It is almost never necessary or advisable to wear an arm sling or shoulder immobilizer unless a physician recommends it.

Unnecessary sling use can lead to more stiffness and pain, and does not contribute much to healing. Slings are usually only used for short periods of time after either serious shoulder injuries (broken bones or dislocations) or after shoulder surgery.

Sometimes if the patient has very severe pain, it may be a good idea to stop working out for a short whi 6993b le to focus on more basic exercises to rebuild shoulder health, such as strengthening the rotator cuff muscles, stretching out the shoulder blades, and working on posture and core strengthening. This also allows for time for a proper workup to rule out more serious causes of pain (for example, rotator cuff tears).

Also, as we age, some types of exercising, such as very heavy weights and plyometrics, may not be suitable for our level of conditioning and physical activity, so it may be necessary to discontinue some exercises altogether. However, every exercise that is discontinued should be replaced by another because, as Dr. Nelson always says, if you don’t move it, you lose it!

Once a diagnosis is made, Dr. Nelson can then recommend treatment. Very rarely, this includes surgical treatment, but more often it may include watchful waiting, oral anti-inflammatories, physical therapy, injections, a home exercise program, chiropractic care, or possibly even referral to a different physician.

Do you have shoulder pain? Are you unsure of where to go next or who to listen to? Call 919-872-5296 to make a visit with Raleigh’s Shoulder Doctor, Johnny T. Nelson MD.

I Injured my shoulder! Should I rest it? Read More »

Do I Have to Have Surgery for a Rotator Cuff Tear?

Arthroscopy, Rotator Cuff, Shoulder, Shoulder Surgery

Do I have to have surgery for my rotator cuff tear?

You may have recently been given a diagnosis of rotator cuff tear. Often, this can be given by a surgeon based on physical exam, a physical therapist based on your symptoms, or even based on imaging studies such as x-rays or MRI.

This diagnosis may lead to many questions for you.

Some patients think that just because rotator cuff tear is present, there is an immediate need for surgery. This is not actually true, as rotator cuff tears come in many different “flavors.” That is why it is very important to allow a shoulder expert like Dr. Johnny Nelson to examine your shoulder and discuss your unique situation with you.

It is important and helpful to look at the rotator cuff like a rope made out of a bunch of fibers. Some ropes are extremely new and extremely healthy, completely intact without any tearing or fraying. Other ropes may have some tearing and fraying of the fibers but overall remained intact. Then again other ropes may be completely torn, cut, or snapped and unable to be used.

The rotator cuff tendon is the same way.

Some patients have completely intact rotator cuff, with no tearing or fraying or even inflammation. Some patients have mild tearing of a few of the muscle and tendon fibers, while some patients have complete tears where the muscle is not connected to the bone.

We do have some evidence that smaller rotator cuff tears are less likely to become large tears, possibly scarring in place and healing. We also have evidence that large rotator cuff tears are more likely to get larger over time, and are less likely to be repairable the longer they are left without repair.

As a general rule, younger more active patients with more severe tears are more likely to be offered surgery and are more likely to respond well to that surgery. Patients with small tears are less likely to be offered surgery because there is evidence that these patients will often heal without surgery. However, even for small tears surgery is sometimes offered when treatments such as physical therapy, anti-inflammatory medications, and injections do not bring lasting relief of their pain and weakness.

If you have been told that you have a rotator cuff tear, or if you have been told that you need surgery on your shoulder, do not hesitate to make a visit to see Dr. Johnny Nelson to discuss your shoulder.

Sometimes knowing is half the battle!

Do I Have to Have Surgery for a Rotator Cuff Tear? Read More »

How Much Pain Will I Have after Shoulder Surgery?

How Much Pain Will I Have after Shoulder Surgery?

Or perhaps they told you how painful it was!

Many patients do not even need any pain medication at all!

Why Is It Important for a Shoulder Specialist to Use Ultrasound?

Why Is It Important for a Shoulder Specialist to Use Ultrasound?

This is certainly a good place to start.

If you live in North Carolina, you are in luck! Dr. Johnny T. Nelson, MD is one of those shoulder specialists!

How Long Do I Have to Wear A Sling After Rotator Cuff Repair?

But how long do I have to wear the sling?

In the first 4 weeks, there are a few reasons to remove your sling.

When Can I Get Back to Work After Rotator Cuff Repair?

You try everything, and yet still you have pain.

Yes, a well-trained shoulder specialist such as Dr. Johnny T. Nelson, MD is able to repair your rotator cuff. But what does this mean for you? How will your life be affected?

When can I get back to work?

But if you are alone, searching for guidance and answers to this question, here are some pointers.

But you cannot return to work after rotator cuff repair immediately.

But the first week after the procedure is certainly not a time to return to work, no matter what you do.

If you work heavy labor, you will not be able to return to full work for 4 to 6 months.

I Injured my shoulder! Should I rest it?

I injured my shoulder! Should I stop working out? Should I wear a sling? Should I see an orthopaedic doctor?

Of course, very mild aches and pains can be a normal part of life.

However, shoulder pain that is more severe, longer-lasting, or accompanied by significant weakness or loss of motion should not be “brushed off.”

It is almost never necessary or advisable to wear an arm sling or shoulder immobilizer unless a physician recommends it.

Do I Have to Have Surgery for a Rotator Cuff Tear?

Do I have to have surgery for my rotator cuff tear?

This diagnosis may lead to many questions for you.

The rotator cuff tendon is the same way.

Sometimes knowing is half the battle!

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