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ShoulderDoctor

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ShoulderDoctor

Please do get in touch today to see how we can help you. All members of the team are highly skilled and are trained to an exceptional level.

Dr Tony Kochhar has brought together a team of highly experienced healthcare professionals to ensure that you get the best treatment at a time and place convenient to you. We are a specialist team of surgeons, physiotherapists, anaesthetists, and allied healthcare professionals dedicated to delivering the highest quality care for our patients. We understand that your condition may need treatment f

rom several fields - it's not just about surgery. We have therefore created a team of the best specialists in each field to ensure that you receive the most complete treatment from start to finish.

16/04/2025

WHEN SHOULD I WORRY ABOUT A LIPOMA?

This case is all about a lipoma. The video is of a lipoma I recently excised from a patient (shared with their permission). This appeared over the last couple of months and this patient rightly came along to get it checked out. We scanned it to assess what it was before discussing options and the patient opted to have this excised. It was of course sent off to pathology to get it checked post-op as we always do.

This condition is fairly common, affecting about 1% of the adult population. They are benign lumps of fat cells under the skin most commonly seen in adults between 40 and 60 years old. These lumps are usually soft and painless and if left are usually benign.

🚩 When to check them:

1️⃣ If they start hurting or limit movement.
2️⃣ If they grow rapidly.
3️⃣ If they’re very large (over 2 inches).
4️⃣ If new ones appear, especially after age 40.
5️⃣ If they’re deep within muscles or tissues.

While most lipomas are harmless, the signs above are worth a medical checkup.

14/03/2025

SLOW PROGRESS IS BETTER THAN NO PROGRESS

Recovering from shoulder surgery can feel like a long road, but every small step counts. Whether it’s regaining range of motion, building strength, or simply reducing pain, consistency is key.

Post-op physio isn’t about rushing—it’s about steady, controlled progress to protect your repair and achieve the best long-term outcome. Trust the process, stay patient, and celebrate the small wins. Your shoulder will thank you later!

If you’ve had shoulder surgery, please share your post op recovery experience 👇.

12/02/2025

PRP vs. Corticosteroid for Shoulder Pain: What Works Better?

This study compared Platelet-Rich Plasma (PRP) injections to corticosteroid injections for treating rotator cuff tendinopathy.

Here’s what they found:

✅ PRP provided better pain relief and improved shoulder function over 12 months.

✅ PRP patients reported higher satisfaction and better sleep quality compared to corticosteroid patients.

✅ The failure rate needing another injection) was lower in the PRP group (12% vs. 30%).

The study concludes: PRP injections are a superior, long-lasting solution for rotator cuff tendinopathy.

In my practice we use both steroid and PRP injections but it will be interesting to see how clinical practice evolves over time.

What has your experience been of PRP? Please share below 👇

07/02/2025

Best of luck to for the vacant British and Commonwealth titles this Saturday!

15/11/2024

VASCULAR RETURN - WHAT IS IT AND WHY IS IT IMPORTANT AFTER SURGERY?

This is a not-very-good picture of my hand after I had shoulder surgery. You can see the effect on my skin of being in a sling - even though I was moving regularly to maintain passive range of motion.

Vascular return is the process of blood flowing back to the heart. Strong vascular return helps deliver vital nutrients and oxygen to the skin and tissues, which aids in healing and recovery.

**How It Affects Skin Health:**

Post-surgery, the skin around the surgical site requires more oxygen and nutrients to repair itself. Proper vascular return helps ensure blood flows efficiently to these areas, promoting optimal healing, reducing swelling, and minimizing scarring.

**The Autonomic Nervous System:**

After surgery, the autonomic nervous system—responsible for managing involuntary functions like blood flow—may shift. This can sometimes lead to changes in blood circulation to the upper limbs, impacting skin healing. Supporting vascular return helps counterbalance these changes, ensuring the surgical site receives the oxygen and nutrients it needs for smooth recovery.

**Supporting Vascular Return:**

Following post-op guidelines like gentle movements and elevation (as directed by your rehab team) can improve blood flow, promoting better healing for the skin and tissues.

**Take Care of Your Recovery:**

Every small step—whether it’s movement, posture, or simply elevating your arm—plays a role in your skin’s healing journey after surgery.

If you’ve had surgery did you experience any of these skin changes? Please share your experience below 👇

12/11/2024

HOW MUCH PAIN WILL I BE IN?

One of the questions patients often have (but I wonder how many actually ask!) is how much pain they will be in post op.

Pain is of course subjective but having an operation is bound to be painful - not only have you had an incision, in most cases you have had invasive surgery. You should expect for it to be painful.

However, the job of a good surgical team is to minimise your post op pain and certainly complete pain relief in the immediate post op period is our aim.

The pain relief journey starts at the beginning of the surgery when you will be given an interscalene block. Just like an epidural, this works by numbing the nerves which allow you to feel pain around the shoulder. I’m lucky to work with anaesthetists who are experts in their field and will target this block to numb sensation but NOT movement - a dead hand is somewhat disconcerting even if it means you can’t feel pain!

The block lasts for the course of the surgery and for about 24 hours post-op. When that wears off, a patient can be hypersensitised to pain which can be quite severe. In the chart this is shown as the “cliff edge” decline in pain relief (dark blue line). The trick is to keep ahead of the pain. Post op pain medication is prescribed and given to you before you go home. The
best advice I was given when I had surgery was to take “home” painkillers (TTO) before I left the hospital even if I didn’t think I needed them.

People often think that taking some Ibuprofen or Paracetamol will not make any difference, but different painkillers work in different ways and basic pharmacology tells is that the sum of their effect is greater than the individual parts.

I was able to manage my post-op pain by:

1. Making sure I started take home medication before I left the hospital

2. Not skipping a dose

3. Reducing my dosage and discussing with my pharmacist what I could reduce and replace with different medication, and

4. Discussing my pain with my physiotherapist who was able to help reduce it by various other methods - it’s not always about pharmacology!

If you’ve had surgery what was your experience?

11/11/2024

TYPES OF CLAVICLE FRACTURE:

1️⃣ Midshaft Fractures: The most common type, usually occurring in the middle part of the clavicle.
2️⃣ Distal Fractures: Occur closer to the shoulder, sometimes affecting ligaments.
3️⃣ Medial Fractures: Least common, occurring near the center of the chest.

When Surgery is Needed:

In some cases, clavicle fractures heal well on their own. However, surgery may be recommended if:
* The bones are severely displaced or shortened.
* There’s a compound fracture (bone breaks through the skin).
* The fracture impacts nerve or blood vessel function.

Non-Surgical Treatment:

* Rest & Immobilisation: A sling or brace is used to keep the shoulder stable.
* Pain Management: Pain medications and ice help with initial discomfort.
* Physical Therapy: After initial healing, exercises help restore strength and motion.

Recovery Time:

* Non-Surgical: Typically, it takes 6-12 weeks to heal with rest and gradual movement.
* Surgical: Recovery may extend to 3-6 months, depending on the complexity and rehabilitation progress.

The journey to recovery can feel long, but with the right care, most patients regain full strength and mobility in their shoulder.

Any questions? Please ask below 👇

27/10/2024

What a pleasure to meet the . We might’ve been the only two supporters in the vicinity but the fight was real! What an impressive guy!

24/10/2024

Mrs K said my attempt at a snarl was unnerving. Not sure my smile is any better …
Anyway it was an absolute privilege seeing in clinic today for an MOT.

17/10/2024

I’ve been trying (badly) to perfect my snarl for boxing. Was an absolute pleasure meeting the brilliantly talented for an MOT.

10/10/2024

It was a privilege to catch up with for a shoulder and upper limb MOT today. He fought so hard a few weeks ago to win in London. Great things ahead for this lovely guy!

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London

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Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm

Telephone

+442033013750

Website

http://www.shoulderdoctor.co.uk/

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