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 »

My Shoulder MRI Is Normal. Could There Still Be Something Wrong?

Shoulder, Shoulder Pain, Shoulder Surgeon, Sports Injuries, Ultrasound, Uncategorized

My Shoulder MRI Is Normal. Could There Still Be Something Wrong?

No imaging study is perfect. This is very important to understand when it comes to “MRI” studies of the shoulder.

Many patients with shoulder pain will try many treatments to make their pain better, including changing their activities, physical therapy, anti-inflammatory and other medications, and chiropractic adjustment. Often, these treatments can be successful, but when they are not and the pain continues, an MRI study may be helpful to look for a cause of the shoulder pain.

But sometimes even though your shoulder hurts, the MRI looks normal. How can this be?

It is very important to understand that an MRI, much like a photograph, is only a single “glimpse” of one moment in time. It does not show what happens to the structures of the shoulder, such as the rotator cuff, biceps, and labrum, during actual movement of the shoulder.

In other words, an MRI is like a photograph while you actually need a video recording to see the problem!

This is another reason why ultrasound is very helpful. Ultrasound can evaluate the structures of the shoulder during movement. The shoulder can also be re-positioned and structures can be looked at more closely with a simple movement of the ultrasound probe. Dr. Johnny T. Nelson, MD is the only fellowship trained shoulder specialist in the Raleigh Durham North Carolina area that uses ultrasound during clinic visits to evaluate the rotator cuff and other structures in the shoulder.

Because MRI studies can miss tears and other problems in the shoulder, there are situations where patients decide to move forward with a shoulder scope procedure even though very little is found on the MRI. Often in these situations, sizable tears are found in the rotator cuff, even though the MRI was normal! This is well-documented in the medical literature.

If you have had an MRI study of your shoulder and would like to have Dr. Johnny T. Nelson, MD review the MRI and examine your shoulder, call 919-872-5296 today to schedule a visit with North Carolina’s rotator cuff repair specialist!

My Shoulder MRI Is Normal. Could There Still Be Something Wrong? 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 »

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 »

How Do I Know If I Have a Rotator Cuff Tear?

Shoulder, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Ultrasound

US shoulder How do I Know If I Have a Rotator Cuff Tear?

Shoulder pain is very common, and many of those with shoulder pain wonder and worried about why they have pain. They would also like to take steps to figure out the cause of their shoulder pain and ask themselves: how do I know if I have a rotator cuff tear? And most importantly, they want to know what it will take to make their shoulder stop hurting.

If you have shoulder pain, and you are trying to figure out why, seeing a shoulder specialist like Dr. Johnny T. Nelson MD is a great place to start.

Before you start working on trying to make your shoulder feel better, it is usually a good idea to be evaluated by a specialist and make sure that you have the correct “diagnosis” before you start treating the condition. If you do not have a correct diagnosis, sometimes you can be performing the wrong treatment. Think of it like driving a car: if you were trying to get somewhere, you need to know where you are starting, or else, the directions you are, following will not take you to the right place.

Typically it is a good idea to start with simple things like an x-ray, physical examination, and several questions about the history of your pain: When did it start? How bad is it? What movements make the pain worse? Do any movements make the pain better? Have any treatments you tried made it better?

With these pieces of information, a highly trained shoulder specialist like Johnny T. Nelson, MD is able to give you more information about your specific diagnosis, and most importantly, the best treatment for that diagnosis. From there, you might consider anti-inflammatory medicine, physical therapy or chiropractic care, anti-inflammatory injections, simple home exercises or watchful waiting.

Sometimes Dr. Nelson may recommend an MRI of your shoulder. This is if there is more concern for a more major problem, or if you have been having severe pain for a long time and other treatment methods have not helped.

However Dr. Nelson is one of the only orthopedic surgeons in the Raleigh Durham area to offer in-office ultrasound for the evaluation of the rotator cuff.

How is in-office ultrasound helpful?

In office ultrasound is a great way to determine the health of your rotator cuff. While x-rays can be very helpful to shows US RC tear the bones, x-rays do not show us the health of the rotator cuff. Sometimes a specialist can get information on the health of the rotator cuff with a physical exam, but still rotator cuff tears can be missed. In-office ultrasound helps shoulder specialist such as Dr. Johnny T. Nelson see rotator cuff tears quickly and easily. Furthermore, ultrasound gives you and Dr. Nelson peace of mind that you do not have a rotator cuff tear, and performing simple nonsurgical treatment is probably the best way to go.

Ultrasound to check for rotator cuff tears takes only a few minutes, and you are able to see the results as they happen in real-time. Dr. Johnny T. Nelson loves to point out the findings on ultrasound as he sees them, and teaches patients about the anatomy of the rotator cuff.

Sometimes if a rotator cuff tear is found, an MRI examination is ordered to get more information. Because ultrasound is not a perfect tool, if there are signs that there is a tear of the rotator cuff, an MRI is able to give us much more information and confirm the findings on ultrasound.

Do you have shoulder pain? Are you worried that you have a rotator cuff tear? Are you interested in ultrasound examination of your shoulder? Call 919-872-5296 today to schedule an appointment with Dr. Johnny T. Nelson, MD, Raleigh shoulder specialist!

How Do I Know If I Have a Rotator Cuff Tear? 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 »

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!

My Shoulder MRI Is Normal. Could There Still Be Something Wrong?

My Shoulder MRI Is Normal. Could There Still Be Something Wrong?

But sometimes even though your shoulder hurts, the MRI looks normal. How can this be?

In other words, an MRI is like a photograph while you actually need a video recording to see the problem!

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