Total Shoulder replacement versus cortisone shots

Hi, asking for a fellow swimmer who has been struggling with a shoulder injury and was diagnosed as having a frozen shoulder this fall. Her first consult suggested a complete replacement, while the second opinion suggested cortisone shots and put off surgery for a while. She has not been swimming since summer, and believes a fall let to a tear which got worse as she stopped using it due to pain. She knows her stroke needs work, when I last swam with her a few years ago I noticed her stroke crosses her center too much, which will put too much stress on the joint and cause impingement. She could have had both going on, impingement and an injury. Does anyone have experience or articles you have read you could share to help her make a decision on what to do? She wants to get back in the water when all is well, but does not know what her future will look like after a total shoulder re-due? Any advice is welcome. Thank you
  • The only shoulder injury I've had was a torn rotator cuff (result of throwing and NOT swimming)...which I had surgically repaired and came back 100%...if not better (swimming-wise) than I was prior to the injury. So the only thing that I have to add is that it's my understanding that cortisone shots will only be effective for so long. That is...the length of time each shot provides relief will get shorter and shorter until they essentially don't work anymore. So, depending on your friend's age...I'd opt for the shoulder replacement. Dan
  • Thank you for your reply, that sounds on par with what I have been reading. Thanks Just wanted to add that the cortisone shot(s) I got when I had my torn rotator cuff did work very well. I got two, and each lasted about three months. When the tears were diagnosed, it was early spring and I had just paid registration for several triathlons during the upcoming summer. The doc wanted to do the surgery sooner rather than later...but I convinced the him to let me put it off so the non-refundable entry fees wouldn't go to waste. He agree but said ABSOLUTELY NO LONGER!...for fear of too much scar tissue forming. The shots gave me enough relief to keep up with my swimming through the summer. The surgery was done in the fall. Dan
  • Thank you for your reply, that sounds on par with what I have been reading. Thanks
  • I work as a physical therapist, but work with inpatients rather than outpatients so haven't done much shoulder rehab in years. From what I have seen though, return to swimming after shoulder replacement might be really tough -- perhaps not even possible. Shoulder replacements are not nearly as routine as hip or knee replacements and the results are more modest. Your friend should definitely be asking some very pointed questions about what results are expected and what long term restrictions there will be (activity limitations as well as range of motion limitations). Keep in mind that shoulder replacement is very major surgery and very invasive. It is usually only done if the cartilage is worn down and the joint is bone on bone. Rotator cuff surgery is an entirely different procedure and much less invasive so return to swimming after appropriate rehab is very feasible. "Frozen shoulder" is a bit of a catch all term, but if your friend has adhesive capsulitis she might want to ask about PT to go with those injections. In my region, people who have had knee or hip replacements are told to avoid high impact exercise such as running and jumping forever. I've never met a shoulder replacement patient who wanted to swim laps, although I do know one who SCUBA dives.