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Dr Taufiq
Dr Taufiq, Doctor
Category: Health
Satisfied Customers: 7
Experience:  MBChB (Class of 2000, Leeds, UK), Member of Royal College of Surgeons (Edinburgh, Scotland)
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If muscles are attrophied, and were relocated after surgery,

Resolved Question:

If muscles are attrophied, and were relocated after surgery, what can be done to stretch the muscles so they can re attached to their proper locations?
Submitted: 8 years ago.
Category: Health
Expert:  Dr Taufiq replied 8 years ago.
Hi. Thanks for looking up Justanswer. If you want to know whether muscles can be reattached, it can only be done through surgery. But if you are asking if muscles can be stretched, then any muscles can be stretched either through intense physical therapy (or physiotherapy) or through using a frame (eg. Taylor spatial Frame). But in your case, its mainly physiotherapy unless you want another surgery to correct the problem, but you have to understand that more surgery means more complications and scarring. If you want to know more, I am ready to answer your question.

Best Regards
Dr BinJemain
Customer: replied 8 years ago.
No real information was given. I work in the Medical field. My experience with physical therapy has been that the therapists know what to do for normal physical conditions, but not for complications such as old surgeries that have gone wrong due to poor surgery techniques. Of course reattachment involvement requires surgery. Just because I have seen and experienced energy work does not mean that ligament and tendons can be moved via energy. Maybe with miracles, but rarely in the medical field. Please elaborate on what can be done and what the process for this procedure entails. My knowledge indicates that two surgeries will be required, with a six month seperation between them. I want to know how to prepair for them. Gene
Expert:  Dr Taufiq replied 8 years ago.
Hello again. I am sorry to hear what has happened. I presume you had a shoulder hemiarthroplasty for osteoarthritis which went horribly wrong. I know it will be difficult to have physical therapy especially if the muscles have been reattached to differing locations. In this sort of circumstances, you will need an experienced physiotherapist who will need to be guided by the surgeon who relocated the particular muscle. That has to be done 6 weeks following such surgery, otherwise you may lose strength.

From what you are saying, you can elevate your arm over your head using a wheel (I assume without any pain?). But you can only elevate up to 20dgs by yourself. This may mean that there is no mechanical restriction to achieve that range of movement. So it means your muscle especially your deltoids is too weak to achieve that range of movement. If you want to avoid further surgery, you will have to work on the deltoids in order to elevate your arm above 20dgs. What has the physical therapist done to improve your deltoid strength?

Best Regards
Dr BinJemain
Customer: replied 8 years ago.
The shoulder was shattered in 12 pieces (humeral head). The last surgery was 2 years ago. The humeral head has since moved out of the glenoid fossa. Each successive surgery was an improvement. My alternative medicine practishiner asked for x-rays as the theraphy I was receiving was not acheiving the results expected. Upon review, the y-view X-ray and the inferior-superior view demonstrated that the humerous was out of socket. The internal & external views showed the surgical clips in the wrong areas. Soft tissue views showed the outline of the muscles and tendons going to different areas other than the normal areas of attachment. The treatment from Physical Theraphy helped some ,but was discontinued for lack of results. Therefore I sought out other venues of help. Massage has been very helpful especially Myal-facial release. Body engeniering was also helpful, but the recovery time was slow and scarr tissue reformed between sessions.
Expert:  Dr Taufiq replied 8 years ago.
I'm sorry about the accident. In such cases, having a shoulder hemiarthroplasty may be the only viable option (depending on the status of the humeral shaft). Considering your age (you are still young), ideally, you need to have the humeral head back in the glenoid fossa.

I think the best course of action is to seek a 3rd opinion and review the case with a qualified shoulder surgeon. You will also need a high resolution MRI scan possibly with an MRI arthrogram (if you haven't had one already) to assess exactly where the muscles have been attached to.

There are limitations to non-surgical intervention like physical therapy and massage when the situation needs surgery. Also, physical therapy in such cases have to be guided by the surgeon unless the physical therapist is present during the surgery. Otherwise, as you have found out, they wouldn't be able to help as all they know are someone with normal anatomy, and clearly in your case, your anatomy has been changed by the surgeries you've had.

I hope that helps.

Best Regards
Dr BinJemain
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