Capsular Shrinkage

Arthroscopic Thermal Capsular Shrinkage

Nina Cooke, 2003

Since a young age I have been fanatical about swimming, competing in national events.  My shoulder problems first started following a fall, resulting in a right sided dislocation.  Although I received physiotherapy, I was experiencing recurrent dislocation during training whilst swimming butterfly - a challenging stroke.  The simple solution was to reduce the proportion of this stroke in my training schedule.

After coming to university in Manchester, I took up water polo and excelled because of my high standard of swimming.  This is when my shoulder problems re-occurred. During long distance throwing and physical tackles, both shoulders were repeatedly dislocating, causing much pain and limiting my abilities in the pool.

I am a Student Doctor at Hope Hospital, and following a shoulder dislocation in the hospital, I was referred to Mr. Funk.  The treatment plan involved further physiotherapy and the possibility of surgery.  During physio Kathleen Roney worked on both core-stability and shoulder muscles, to correct the imbalance.  She also tailored the treatment specifically to situations I would encounter in the pool.  I learnt to throw the ball with my shoulder set in the correct position; it was like learning from scratch again.  These exercises improved, but did not fully solve the dislocation problems.

I opted for surgery with a realistic outlook, and in conjunction with physio, may be more successful.  I had a form of keyhole surgery ( Arthroscopic Capsular Shrinkage ) which involves insertion of a tiny camera into the shoulder joint and internal heat treatment. This causes the joint capsule to shrink and results in a tighter joint less likely to dislocate.

After the operation it was difficult to move my shoulder, resulting in a small army of family slaves tending to my every need!!!  Unfortunately, this was quite short lived!  Simple daily tasks were difficult to carry out (for example brushing hair) due to the restriction in range of movement.  This sensation diminished gradually over time with physio exercises and gentle swimming (keeping my hair dry!).

Spotting the scars from the operation require a magnifying glass.  It has now been just over a year since the operation.  I am back to playing water polo, and although the surgery has helped immensely, the exercises still form a key role in maintaining my shoulder stability.


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