Slippery slope to shoulder problems

The ski season may be popular but it also creates and aggravates many shoulder injuries, making the later months of every year a busy time for orthopaedic surgeons. Here, Spire Washington Hospital’s consultant Mr Allan Stirrat talks through options for those suffering from shoulder pain.

Mr Allan Stirrat

Tell us a little bit about yourself?

Born and educated in Scotland, I trained and practised throughout the UK and USA before taking up a consulting post at Sunderland Royal Hospital where I have been for the past 23 years. I specialise in upper limb surgery with particular interest in the shoulder including treatment of trauma, instability, rotator cuff disease and arthritis. I hold out-patient clinics every Friday morning at Spire Washington Hospital and have a weekly theatre list on a Tuesday.

As a keen skier yourself when would you recommend that a patient should come and see you?

I have skied since childhood and continue to do so at the age of 57 which pretty much matches the age range of patients who present with symptoms related to skiing. High velocity impacts may cause fractures, dislocations and tendon ruptures which require immediate treatment at the resort. Lesser injuries may require no immediate intervention but cause persisting symptoms which require advice. Many patients I see come to me with longstanding conditions which have either been aggravated by skiing or are simply seeking advice before going on holiday. Broadly speaking the young (under 40!) are troubled by instability of the shoulder perhaps after a dislocation whereas the ‘mature’ suffer from rotator cuff problems, for example, a worn rotator cuff may become a torn cuff due to impact.

What would the next step be after an initial consultation?

If the injury seems to be minor then clinical assessment may be all that is needed before referral to a physiotherapist. Most cases with a clear history of trauma will require a scan, starting with a plain X-ray and progressing to ultrasound or MRI for suspected cuff injury or perhaps an MRI arthrogram if instability is suspected. Scanning and physiotherapy facilities are available on site so patients can either be seen during their initial visit or within a matter of days after their consultation.

How do you treat the different symptoms that you see?

Management ranges from reassurance alone through to non-operative measures such as physiotherapy or injection and in a small proportion of cases surgery is required. The type of surgery will depend upon the clinical features supported by the patient’s scans and is commonly performed by arthroscopic (keyhole) technique which keeps scarring and discomfort to a minimum. The majority of the procedures I perform are carried out as a daycase meaning that the patients do not have to stay overnight. Following a patient’s surgery they may require physiotherapy to aid recovery and regain strength in order to get them back on the slopes for the following ski season!

What are the benefits of someone coming to see you at Spire Washington Hospital?

One of the main benefits of coming to Spire Washington Hospital is the speed at which a patient can see a consultant, this can be important for minimising further damage and preventing frustration when a patient’s activity is limited.  I believe that the continuity of care that we are able to offer at the hospital is key when treating patients as this ensures they have a good understanding and are actively involved in their own treatment.

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