If you observe Vikki Gagnon working out today, you would be extremely impressed with her athleticism. But she doesn’t consider herself an athlete.
“I really didn’t start doing anything athletic until I was 42 years old,” she says.
In the past, Vikki has participated in triathlons, marathons and, most recently, in demanding Crossfit strength training programs. And at age 67, she is currently the oldest participant in her Burn Boot Camp. But the most impressive feat is how far she has come. A year ago, Vikki could barely use her left arm for everyday activities, much less in her beloved workouts.
She doesn’t remember when her shoulder pain began. In her 20s, Vikki had shoulder instability resulting in dislocations on several occasions. The standard treatment at the time was muscle stapling, which is now considered an archaic technique. This surgical solution pulled her arm tighter, which stabilized her shoulder. But over the years, it caused bone spurs to grow and a painful case of osteoarthritis.
By the time she met Dr. John Hill five years ago, she couldn’t raise her arms up over her head to wash her hair, grab her coffee off her living room side table or easily put her dishes away on her kitchen shelf. She had also given up on many of her favorite sports. Because she had spent so many years with her shoulder out of position, she had developed some arthritis in her neck as well.
Hill, an orthopedic surgeon and shoulder specialist at Atrium Health Musculoskeletal Institute, educated Vikki on her condition and her surgical and nonsurgical options. He told her that based on her symptoms and imaging, surgery was an option. But the pain and discomfort had increased gradually, and she had learned to compensate by using her other arm, so Vikki decided to postpone the surgery.
“I generally tell patients that when you get to the point where the pain is so severe that it is diminishing your everyday quality of life, disturbing your sleep or preventing you from doing the things that you love, then it’s the right time to consider surgery,” says Hill.
That time came and Vikki finally decided that she had had enough of the pain and weakness in her shoulder.
The Best Approach for Vikki
The next step was to decide what type of surgery Vikki would need. Due to her severe shoulder arthritis, she needed a shoulder replacement. Hill says that surgeons often offer older patients a one-size-fits-all standard reverse shoulder replacement because these older patients may have a rotator cuff that is worn out. The technique offered does not rely on the function of the rotator cuff. The reverse total shoulder replacement reverses the position of the ball and the socket in a way that allows the shoulder to function in the face of a damaged or torn rotator cuff. An option for younger patients with intact rotator cuffs is an anatomic shoulder replacement, which replaces the shoulder as it was, in its original anatomical position.
However, Hill emphasizes that age alone should not dictate the treatment.
“I do my best to individualize the treatment to each patient,” he says. “I consider each clinical scenario in terms of the patient’s unique life variables such as work, recreational activities and pain patterns, in addition to the information provided by the physician examination and imaging.”
In Vikki’s case, shoulder stiffness from the tightening surgery in her 20s worked to her advantage. Because the tightening had limited her mobility and the use of her shoulder, a work-up revealed her rotator cuff was in good shape. So even though her age made her a typical candidate for reverse shoulder surgery, Hill opted for the anatomic shoulder replacement surgery. He knew that her healthy rotator cuff meant that this type of surgery was a great option for Vikki, and that it would give her the potential for a greater range of motion and more natural function.
“I think it’s key to get a physician who bases your treatment plan on your individual condition. That is what Dr. Hill did,” says Vikki. “And he listened to me. If I asked him a question, he answered with complete concentration and passion. He is a really good doctor.”
Hill was equally impressed with Vikki as a patient. Her years of diligently working out helped in the success of her surgery. Just like all of the sports that Vikki had always enjoyed, she was the model patient, particularly when it came to her post-surgery physical therapy.
“Vikki had a great result because she was so compliant with her post-operative therapy,” says Hill. “She was extremely motivated. Regarding pain control, the results show total replacement shoulder surgery has a very high success rate. But the patients who do the very best are the ones that absolutely throw themselves into therapy.”
Back in the Gym
Six months after her physical therapy began, Vikki was back in the gym. After the first few months of working out, she had someone take videos of her to send to Hill.
“I wasn’t sure if the exercises were safe,” she said.
Hill recalls his response to her with a laugh. “I told her to cool it a little bit because we didn’t want to work on it more than once. But she is having great results.”
Vikki is excited about what the future holds for her new shoulder.
“I have never been able to push this body before because of my shoulder hampering me,” says Vikki. “Now I want to be healthy. I want to be as strong as I can.”
If you have shoulder pain or need orthopedic care, learn more about Atrium Health Musculoskeletal Institute or call 704-863-HURT (4878).
