Winning Edge Fitness Article 2007
Authors: Nick Grantham
References: Winning Edge Fitness Solutions Newsletter - No32, Jan 2007
I was recently invited to attend a shoulder surgery, now for the physio's I work with this is a pretty regular thing but it's not an invitation that is usually extended to S&C coaches. The surgeon making the offer was Lennard Funk, one of the countries leading shoulder specialists, I didn't need to be asked twice. the experience was fantastic (apart from the part where the operating theatre became very hot and I felt slightly dizzy....I think it was the drilling! I only missed 10 minutes and was able to make it back to see the rest of the surgery - I've even got copies I can watch on my DVD player!). Watching the surgery has really informed my rehab process and I was keen to get Lennard to share his thoughts on shoulder injuries, surgery and the role of S&C coaches in the rehab process. I asked and he was kind enough to agree to do a Q&A. Here it is, a slight change from the norm, but very interesting.
NG: Thank you for the interview Lennard, it's an honour to have one of the top shoulder surgeons in the country sharing his thoughts with our readers. Why don't you start by telling us a little bit about your current commitments?
LF: Nick, thank you for asking me to participate in your newsletter. I am a shoulder and elbow surgeon in Manchester. My NHS job is with Wrightington Orthopaedic Hospital, made famous by the inventor of the successful hip replacement, Sir John Charnley. My Private Practice is with the Manchester Sports Medicine Clinic, which is the first surgeon-run sports clinic in the UK. It is modelled on similar clinics in the USA and Europe. My time is divided equally between the two.
NG: Lennard, can you tell the reader your educational and previous career background and how you ended up specialising in shoulder surgery?
LF: I started my studies in Sports Physiology and then Physiotherapy. I always wanted to do Orthopaedic surgery and have been fortunate to achieve this. My Undergrad training was in South Africa and I came to the UK for Postgrad training. I did a Shoulder Fellowship in Reading and then in France.
NG: Can you describe a typical day in the life of Lennard Funk?
LF: Busy! I am a true workaholic and tend to start clinic at 7am, often working through to 9pm (surgery or clinics). Unfortunately, I am one of those people who haven’t learnt the word ‘no’, so am always taking on a lot. However, I am finally doing the job I always wanted to do and get to work with, treat and meet so many interesting people.
NG: What are your typical clients and what is the most common injury that you have to deal with? Can you give the readers an idea of how long it typically takes to recover from this type of injury?
LF: On the NHS I mainly see traumatic and degenerative problems of the shoulder and elbow. In the Private sector I deal with a lot of sports injuries in both professional and amateur athletes. I suppose the two most common problems are shoulder instability and rotator cuff tears. Generally following arthroscopic repair of these conditions most athletes are back playing by three to six months. Sedentary people do take longer.
NG: What can physio's and S&C coaches do to make your life as a surgeon easier (pre and post operation).
LF: Communicate with me. I am very keen that we work as a team in the best interests of the patient, therefore close collaboration is essential. I am always accessible to physio’s and S&C coaches, and like it when I get lots of feedback from them and their opinions.
NG: What makes your job as a shoulder surgeon really difficult?
LF: The increasing lack of autonomy and control within the NHS. Patients in the NHS often think the surgeon has control over their treatment process, and it is difficult to juggle between the patient and the politics of the NHS.
NG: I know you study the field a lot. What innovations are taking place in shoulder reconstruction at the moment.
LF: Arthroscopic and minimally invasive surgery has been a massive step forward in shoulder surgery. It has improved our understanding of the pathologies and improved our outcomes. The next two big innovations are the introduction of improved biomaterials and biological scaffolds which incorporate growth factors. These are vastly improving the healing of poor quality tissues. Another ‘innovation’ is the improved ability of surgeons, therapists and coaches to work together and learn from each other. This has probably improved outcomes more than any technological innovation.
NG: What are your top tips that will help my readers continue to have healthy shoulders and avoid the operating table?
LF: Good posture, abdominals and spine; avoid excessive overhead work; regular and balanced exercise; go and see a physio early (most people I see have often left their shoulder problem too long hoping it would go away itself).
NG: Are there any nutritional supplements that you think can help maintain healthy joint (glucosamine, chondrotin etc) do you think work?
LF: I am no expert on supplements, but do know there is some good evidence for glucosamine and chondroitin for early degenerative disease.
NG: Anything else you'd like to mention? What projects do you have in the pipeline?
LF: Just to say thanks for this opportunity. Also, to offer an invitation to any therapists and coaches that read this to visit us in Manchester. You are welcome to join us for a clinical visit or come to our monthly seminars. Please see the website www.sportsmedclinic.com or ring 0161 2270027.
NG: Where can people read more about your work?
NG: I'm asking all of our contributors for their top three books - the ones every S&C coach should have in their library? Now as a surgeon don't go too high brow! What books would an S&C coach benefit from reading.
LF: I think the following books, which I have seen and found useful:
1. Physical Therapy of the Shoulder by Donatelli
2. Textbook of Musculoskeletal Medicine by Hutson and Ellis
3. Clinical Sports Medicine by Peter Brukner
NG: Lennard, many thanks for taking the time out of your busy schedule to contribute to the newsletter.