Posted 12/5/2016 5:20 PM (GMT -6)
Since your body has a propensity to produce scar tissue, perhaps discussion with your orthopedic surgeon options to mitigate scar tissue formation would be in order.
On thought would be to place you on low dose of corticosteroid in the weeks following your closed reduction. Ex. Prednisone or prednisolone or dexamethasone.
Be aware that there are risks with continued use of a corticosteroid, the most serious being pituitary suppression of the hormone ACTH that communicates with the adrenal glands to produce the life-essential hormone cortisol. You would want a physician (other than the orthopedic surgeon) to guide and monitor the titration process off of the corticosteroid (ex. a rheumatologist or an endocrinologist).
I doubt that your propensity to produce scar tissue/adhesions is all due to you.
A surgeon who is overly aggressive in the manipulation of the shoulder will set into motion an overly aggressive healing response - resulting in more scar tissue in the joint that was surgically mobilized. The surgeon must be sensitive to the fact that a closed manipulation is, in essence, an additional physical trauma to an already traumatized joint. Additional trauma with an overly egregious surgeon can and will set into motion excessive adhesion formation and possible reflex sympathetic dystrophy.
The take home message: Be critical of your surgeon and his technique.
At home, post-op, use gentle pendulum movement as your primary self-mobilization technique. Assume a gravity eliminated posture, with the affected arm/shoulder dangling at your side. Use your non-affected arm/hand, if necessary, to GENTLY guide the affected shoulder in a rotating rhythm. Start with a small circular circumference and increase gradually in circumference.
Knees have the benefit of continuous passive motion machines for the initial post-operative period. Continuous passive motion machines are a mainstay for post-op knees. Prior to the availability of the CPM, knees would adhere with generally less favorable outcomes. The key to using a CPM is to keep the rate of movement slow and gradual . . . the machine literally at a crawling speed.
There are CPMs available for the shoulder. I would inquire with your orthopedist about a rental CPM for the shoulder.
Also, there are rental cold therapy units for both knees and shoulders. These are water chilled thermal insulated units that are intended for hospital and in-home use. Easy to plug in. These cryotherapy units are popular with sports-medicine orthopedists and physical therapy clinics. They come with velcrow pads that contour to the knee or to the shoulder. Ice-cold water circulates through small capillaries that run through the pads, the water constantly recycling with the portable unit.