One should always consider the “why.” Why does my shoulder hurt and need surgery? What makes you different from all those people around you who don’t need surgery? This line of questioning is important. The simple answer that you will likely hear from others, and even your MD, is that there is something anatomically wrong that needs fixing. Well, duh! But how did it get there, and why did my parts break down?

Answering this question is important to your recovery but also the longevity of the repair.

Imagine you go to the auto repair shop because your car has some major wobbling issues when you drive down the freeway and drifts severely to one side. The auto repair will tell you why this is happening and then fix it.Bad Alignment Wear.jpg Your alignment has been out, and by this point you have driven long enough that you need to replace the tires, as well as fix the alignment. The tire replacement is only part of the fix because the other part is the
underlying cause:  your alignment is out. If you only replace the tires, then in a few months you will be back to the same problem.

Shoulder surgery fixes the anatomical abnormality (the worn out tires), not the cause. If you only treat the symptom, you ensure that you will have to treat it again because you missed fixing the cause.

I’m not discouraging shoulder surgery; it is how you fix the anatomical parts that have worn out. I just see many patients that are under the under impression that the repair should fix all their problems and that they will quickly be pain free once their body heals.

Little emphasis is put on posture, strength of the rotator cuff, scapular stabilizers, and activities that brought the patient to the point of needing surgery.

What if you need a rotator cuff repair because you sit at a desk with your shoulders slumped in front of you all week and then you go play racquetball on the weekends? Or because you hit the gym lifting heavy weights building your pecs and deltoids but never build the smaller shoulder muscles? Posture and weakness play the same role in the shoulder like the alignment on a car affects the wear of your tires.The relatively small rotator cuff muscles guide the humerus from impinging inside the joint.

So if you’re considering surgery, make sure you understand that to fix the cause you will need therapy. The surgery is just putting on new tires.