Rotator Cuff Repairs, Why Bench Pressing is Awful for Your Shoulder, and Questioning the Arm Bike with Dr. Ken Kearns, M.D. [Part 2]
Season 3, Episode 6 | Podcast #42
Today we are joined by Dr. Ken Kearns, a Board Certified, fellowship-trained shoulder and elbow orthopedic surgeon who specializes in arthroscopic surgical procedures, joint replacements, minimally invasive procedures, as well as upper extremity fracture care from the clavicle to the elbow.
Originally from Ohio, Dr. Kearns completed his undergraduate studies at Colby College in Maine then onto medical school at The University of Toledo School of Medicine. Next stop, Orthopaedic Residency Program at Thomas Jefferson University Hospital. While a resident, Dr. Kearns was recognized by several orthopedic organizations for his research and leadership. Last stop, Dr. Kearns didn’t go far for his fellowship. He was accepted to the internationally renowned Thomas Jefferson University Hospital/Rothman Institute Shoulder & Elbow Orthopaedic Fellowship Program.
Dr. Kearns has been published in numerous specialty medical journals on topics specifically related to rotator cuff tears, shoulder instability, and shoulder replacement. He’s been with Philadelphia Hand to Shoulder since 2016.
In this episode we cover:
1:10: New research available about shoulder instability stating that shoulder injuries should be repaired after the first injury rather than the third, which was the previous recommendation.
“New research states that any teenager that plays a contact sport should have it fixed after first-time dislocation if they intend to continue playing that sport.”
3:15 The two things that keep your shoulder stable - static and dynamic stabilizers
5:00 Make a judgment call on if therapy is the way to go after 4-6 weeks, not 4-6 months
Stay long enough to see a minimal detectable change
6:00 How a labrum is repaired and normal-tension is recreated
6:50 Diagnostic scopes
7:50 What does typical recovery look like using Baker Mayfield from Cleveland as an example.
9:50 You have to take into consideration longer-term aspirations to plan ff and when to do a surgery.
10:55 The problem with Sully braces
11:55 The 6 grades of ligament separations
13:30 Grade 3 is the one that people go back and forth on whether surgery is necessary.
14:00 The surgical procedure for shoulder separation repair - arthroscopically assisted repair
19:50 The at-risk position for a shoulder separation is usually a throwing position where the top of the bone is parallel to the ground. Ie. going for a rebound, catching a ball, throwing a ball.
20:30 Typically rotator cuff tears are the gray hairs and wrinkles of the shoulder or traumatic cuff tears.
“If you get old enough you’re going to have a cuff tear. I always say it goes up by decade so pretty much by the time you get into your 50 and 60 you have a 50-60% chance of having some element of a cuff tear, you just don’t see it.”
21:50 Story from Dr.Kearns’ fellowship with a current hall of fame Hockey player
23:03 Very few professional athletes, besides Kobe Bryant, have come back to play after a cuff repair.
23:57 A case Dr.Kearns saw with a competitive weight lifter in her 40s. Her cuff tear was hanging on by a thread, Dr.Kearns repaired it and won her next international competition, was doing awesome and she is back after 4 years with a similar injury.
28:00 There are so many better exercises you could be doing for your upper body than the bench press.
28:21 There are two terrible things for your shoulders, shoulder press, and bench press
Any guy who bench presses probably has a posterior labral tear
29:10 People get intimidated about seeing a doctor - “My job is to get the person back”
29:40 There are very few things that I will ultimately say “you need to have them fixed” and its usually not a sports injury.
“If you’re 40 and over and you dislocate your shoulder, you have a cuff tear until proven otherwise.”
“If you have a cuff tear fix it and fix it immediately”
30:31 What happens if you don’t get a rotator cuff repaired immediately?
30:50 Your best chance of having a successful surgery is to have it within the first 6-12 weeks.
31:15 The small tears are often the hardest
35:50 Why see a surgeon rather than go to a sports medicine physician first?
36:50 People are ultimately more comfortable with the person who builds a relationship with them
37:45 Dr.Kearns asks “What is the point of the Arm bike”
38:00 Q is anti-machine as a physical therapist
38:30 Arm bikes don’t really make sense and cause more irritation than they help.
39:00 Patients often resist therapy and especially after one bad experience.
39:40 investing in the long-term benefits of therapy vs wanting instant gratification.
40:45 Even if you only go to the therapist once, you will be much better off for it.
Contact
Dr. Ken Kearns Philadelphia Hand To Shoulder Center
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