About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

7 comments on “Surgical Complications : The Role of Care Before Surgery

  • Thank you for your previous answer!

    I am now 6 wks post op from a Capsular release. Unfortunately, I have a small full thickness tear that hasn’t been repaired. My Surgeon thinks that it may heal on its own. I am having difficulty with reaching across my chest, pushing myself up and holding my arm level to be able to do the belly press test. What is the likeliness that this is a result of adhesive capsulitis and not the result of a Subscapularis tendon tear, even if it’s a small full thickness tear. If it’s not repaired, what does my future hold and being able to return to my physical job or working our as I previously did?

    Thanks for your help!

    • Too early to tell.. It will take a number of months for you to recover from a capsular repair. I can’t comment on the subscapularis since I can’t see you or your studies to examine.

      Howard Luks

  • Generally, a patient is afraid of surgery. They think of a surgeon and hospitals as competent. This post shows the things that worry the patient and shows that most problems, if they do occur, aren’t going to be from surgery. Very informative and helpful for someone worried about surgery.

  • Dear Dr. Luks

    I’m 22 and have bad shoulder pains it all started about 4 months ago at work. I get this hard grinding in the back side of my shoulder with a loud pop that kills me when it does it and it really only happens when I lift my arms straight over my head or kinda out in front of me. They get to the point that they hurt so bad I can’t sleep for a couple days and work won’t do anything about it besides tell me to stretch it and I have tried that and it hurts even worse when I’m at work can u please help me just a little bit?? Like what can I do to take the pain down? Do need to do something that I don’t know about ?? Thank u so much
    zach

    • Hi Zach … You need to be seen by a shoulder doc to get a diagnosis. It might be a labral tear, you could have instability — but unless you’re examined by a good doc and have a diagnosis, then treatment options aren’t reasonable to discuss yet.
      Good Luck

      Howard Luks

  • Dr. Luks,
    I have been diagnosed with a “large grade to full thickness tear of the distal supraspinatus tendon measuring 1.2 cm in anterior and posterior dimensions.” The localized retraction is 0.9 cm. No muscle atrophy is noted. I don’t know how I tore it but it might have been lifting some heavy boxes.

    My doctor says I need surgery now. Is it possible to avoid surgery with physical therapy? Is there a time frame in which it must be done?

    Thank you very much,
    Pam

    • Hi Pam… There are many issues to be considered. We, as a sports community favor fixing traumatic tears with a known cause. Many tears are degenerative, where the tissue simply wore out. We’re not in such a rush to fix those. A 1cm tear is not very large. Right now you have very little retraction and no atrophy. That can change if the tear becomes larger. Some tears do become larger, and yet some do not. It is not always an easy decision to determine who needs a cuff repair and who doesn’t. What we do know is that those who choose non-surgical care – PT, etc should be re-evaluated every so often to be sure that the tear is not getting larger.

      Good Luck..

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