Responsible for the Department of Research on Shoulder Disorders
Dr. Di Giacomo, where does your interest in shoulder disorders come from?
Physician Responsible for ATP Tour Master Series Italian Open Rome
As the physician responsible for the athletes of the “Rome International Tennis Championships (ATP – Master Series) and by cooperating with US sports and arthroscopic surgical departments for over 20 years, I could personally observe the recent advance in the pain relieving shoulder techniques.
What has contributed to this advance?
The yearlong clinical experience has certainly made use of the most advanced technologies such as Nuclear Magnetic Resonance Imaging and arthroscopy.
What are magnetic resonance imaging and arthroscopy?
The first is a purely diagnostic test allowing to study the different tissues layer by layer (tendons, ligaments, cartilages, bones) without any exposure to ionizing radiation.
Whereas arthroscopy is a surgical procedure allowing to insert a 4mm scope into the shoulder so to detect on a monitor all the joint lesions repairable while operating. Anesthesia can be partial or total.
As for "the disorder" is it still correct to speak of "PERIARTHRITIS" in 2008?
The term scapulohumeral periarthritis means “inflammation around the shoulder”; therefore this diagnosis is understandably too generic. The physician must go further: the patient has the right to a more accurate diagnosis obtainable nowadays through radiographic tests, ecography and magnetic resonance imaging.
Which are the categories of people at risk?
People in the age group of 40-70 years, usually workers using this joint systematically, but also athletes and housewives.
Which are the patients’ complaints?
An often night shoulder pain, difficulty in making simple movements such as combing hair, fastening the bra and shaving.
Which are the causes of this frequent problem?
When speaking of "time passing", in biological terms we refer to "aging". So as we age our skin is subject to changes, tendons too lose their elasticity and by moving they become more susceptible to even minimal traumas.
What can we do?
Never undervalue the symptoms from the onset (pain and difficulty moving) and undergo an appropriate specialist check-up.
Which role do physiotherapy and surgery play?
Often based on an accurate diagnosis a rehabilitative treatment is sufficient, aiming at reinforcing and balancing the different muscle groups. Unfortunately the conservative treatment does not always represent the solution to the problem.
Arthroscopic surgery is required to detect and repair the shoulder lesions through small incisions.
Which are the benefits?
A simpler surgical intervention, faster and less demanding recovery time and minimum esthetic impairment.
Always and only "arthroscopy" in shoulder disorders?
No. Arthroscopy ha its own limits despite it represents a solution to tendon disorders, capsulitis and luxations. Sometimes the procedure with the standard open incision is required, for example in some forms of arthrosis or disorders with an arthroscopically irrepairable tissue damage.
It is important to rely on a specialist and follow a rational and specific rehabilitaton protocol. When necessary to rely on a surgeon expert in shoulder arthroscopy, a fascinating and promising technique but requiring particular instruments, training, continuous updating and dedication by the surgeon