It started as a simple discomfort. The first thoughts are always the same: maybe it was caused by a sudden movement, maybe I slept on my arm, maybe I just strained it, and in a few days it will pass on its own. Whatever your assumption might be, one thing is for sure: you are certainly not going to see a doctor for something you consider to be nothing!
The problem, however, is that in this case, it actually was “something.” Something that, as time went by, kept getting worse.
How severe can tendinitis become?
Most people have faced tendinitis at some point in their lives. Most of the time, with a little rest, ice therapy, or muscle-relaxing creams, everything turns out fine. But what happens when they don’t?
My shoulder started bothering me in May 2023. Not daily and certainly not to a very intense degree. My activities continued normally with the hope that any discomfort would subside on its own. The condition, however, was getting worse and worse, a little more each day, until the moment came when the pain became unbearable. Mornings were always difficult, since as soon as I woke up, I couldn’t even lift my arm. Later on, though, the pain worsened to the point where I couldn’t perform simple daily movements, such as just lifting a bottle of water.
Why must we seek medical help immediately?
When we face such problems, many people might start suggesting rest, muscle relaxants, or an X-ray. If you want my opinion… don’t listen to them. I, of course, did listen to them. It is important to know that an X-ray shows problems related to bones, not tendons or muscles.
When the pain became unbearable, I looked for an orthopedic surgeon who specializes in the upper limbs. Dr. Ioannis Polyzois was my first choice, due to his specialization, but also because acquaintances of mine were very satisfied with their experience. From the very beginning, I not only realized that he possesses deep knowledge and experience in similar cases, but I also felt immediate comfort and security thanks to his approachable character.
After the clinical examination and checking the shoulder MRI that I had already done, Dr. Polyzois concluded that conservative treatment was not suitable for my case and that surgery using the arthroscopy method was the most ideal solution.
How did I experience the operation and the post-operative period as a patient?
My case was not a simple tendinitis. Due to past injuries and repeated inflammation in the shoulder area, the amount of calcium that had accumulated was large and made movement very difficult. Also, the exact site where the damage was located was unusual, as the calcium had not accumulated on the tendon, but between the tendon and the muscle.
Usually, shoulder arthroscopy is performed with regional anesthesia. Due to the severity of my specific case, the surgery was performed under sedation (twilight anesthesia). Dr. Polyzois was very supportive before I entered the operating room. He reassured me, explained the procedure in detail, and the empathy he showed—which is not taken for granted with many doctors, no matter how good and experienced they may be considered—really made a difference. Throughout the entire process, I felt that I was in very good hands, as was later proven by the result.
The surgery went very well, and after I recovered from the anesthesia, I returned home that very same day. Dr. Polyzois was always available to answer any of my questions or concerns during the recovery, which led me to the conclusion that he genuinely cares about each of his patients.
The post-operative course was not particularly difficult. Surely, the first few days after the surgery were a challenge, mainly due to the sutures, the prescribed painkillers, and the overall exhaustion. However, within the first week, I was already feeling much better, and the most fundamental thing of all is that although there was some discomfort—as is natural due to surgery—I no longer felt that awful pain I was facing daily in my shoulder before the arthroscopy! Almost immediately after the arthroscopy, I started physical therapy sessions, while my stitches were removed after two weeks.
What did I learn? After surgery, the patient also plays a fundamental role
It is important that after the surgery, the patient does not become afraid or feel insecure about moving their arm. Dr. Polyzois advised me to start physical therapy as soon as possible. I realized that this was truly good advice, as my arm began to become functional again.
Although weak due to the surgery, the pre-operative pain had subsided. The physical therapists, in fact, commented very positively on the unexpectedly good condition my arm was in, and they gave the credit for this to the correct judgment and excellent work that Dr. Polyzois did in the operating room.
To put it more “scientifically”… What is Dr. Polyzois’ perspective?
The patient was facing severe chronic calcific tendinitis at the myotendinous junction of the infraspinatus and supraspinatus tendons with the muscle. This occurred due to an old instability in the area, which prompted the patient to use her arm differently, resulting in overloading the subacromial space and the tendons at the top of the shoulder. Consequently, repeated tendinitis was caused by incorrect posture and faulty movement. Thus, calcium deposits were created in this unusual area.
So, we started with a lesion called a “SLAP tear”—that is, a tear of the superior labrum—which was created from an episode of minor but significant instability that she had in the past. We repaired this using two knotless all-suture anchors with specialized, strong tape-sutures, which are excellent and are absorbed by the body. Next, we moved to the subacromial space and decompressed all the calcium and calcium fragments from the myotendinous junction, concluding with an acromioplasty, minimally shaving the underside of the acromion to create more space in the shoulder.
Summarizing, therefore, we started from a shoulder instability. As a consequence of this instability remaining untreated all these years, repeated tendinitis occurred, causing severe chronic calcific tendinitis at the myotendinous junction of the Supraspinatus – Infraspinatus. Our treatment was arthroscopic, minimally invasive, with minimal to no pain and rapid rehabilitation. A repair of the SLAP tear of the superior labrum was performed with two knotless suture anchors using strong tape-sutures, along with a very thorough decompression/acromioplasty of the subacromial space, as well as the removal of all calcium deposits from the tendons.