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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 from 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.

INFLAMMATION AND TENDON HEALINGIf you’ve had a sore shoulder or elbow for weeks, it’s easy to worry that the tendon isn’...
13/10/2026

INFLAMMATION AND TENDON HEALING

If you’ve had a sore shoulder or elbow for weeks, it’s easy to worry that the tendon isn’t healing. The first thing to know is that inflammation isn’t the enemy. It’s the first stage of the body’s repair process.

Tendon healing generally runs in overlapping stages:

1. Inflammation: immune cells arrive to clear damaged tissue and send repair signals.

2. Repair: the body lays down new collagen to rebuild the tendon.

3. Remodelling: the new tissue slowly matures and strengthens over weeks to months.

A recent laboratory study in mice, looking at shoulder tendon irritation, supports this picture. Immune cells called macrophages switched on strongly in the first week, then the signals shifted towards settling down and repair. Calming that early surge reduced degenerative changes under the microscope, but the tendons weren’t any stronger when tested.

That is a useful reminder that less inflammation doesn’t automatically mean better healing. It’s early research in animals, so it can’t yet tell us what to do for patients.

If your tendon has been sore for more than a few weeks, please don’t ignore it. Rest alone, or an injection alone, isn’t always the answer. Get it assessed so the plan fits your tendon and your stage of healing.

Source: Covello et al., J Bone Joint Surg Am, October 2026. DOI (via PubMed)

Any questions? Please ask below 👇

09/10/2026

WHAT’S ON THE OP LIST TODAY?

ALL ABOUT THE LABRUM

The shoulder is a ball and socket joint, but the socket is very shallow. Think of a golf ball sitting on a tee. That’s what gives the shoulder its huge range of movement, but it also means the ball has very little to stop it slipping off.

The labrum helps with this - it is a rim of tough cartilage around the edge of the socket, like a soft lip around the top of the tee. It deepens the socket, cradles the ball, and gives the ligaments a secure anchor. The posterior labrum is the part at the back, and its job is to stop the ball slipping backwards.

When it tears, people often notice:

• A deep ache at the back of the shoulder, especially when pushing (press-ups, bench press, opening a heavy door)

• Clicking, catching or a feeling the shoulder is “slipping” or not quite sitting right

• Loss of strength or confidence with overhead or pushing activities, often in rugby players, weightlifters and racket-sport athletes

Many tears settle with a good physiotherapy programme that rebuilds the muscles around the shoulder, and that is usually where we start. If symptoms persist despite proper rehab, surgery can help.

Today’s operation is done by keyhole (arthroscopy). Through a few small cuts, I reattach the torn labrum to the edge of the socket using tiny suture anchors, rebuilding the lip of the tee and restoring stability. If the capsule at the back is stretched, I can tighten that at the same time.

After surgery, the shoulder is protected in a sling for a few weeks, followed by a structured physiotherapy programme. Most people take several months to build back to full strength and return to sport. It’s a gradual process, but the aim is a stable, pain-free shoulder you can trust again.

Any questions? Please ask below 👇

08/10/2026

LABRAL TEARS AND THE BICEPS

Many people who supper from a labral tear complain of biceps pain. It’s important to understand the anatomy so that we can understand why this is the case.

In SLAP (superior labrum anterior to posterior) tears, the tear is at the top part of the superior labrum, where the long head biceps tendon attaches. Because this tendon is directly attached the SLAP tear therefore causes biceps pain.

Patients will often experience some or all of the following symptoms:

- Pain in the front of the shoulder and down to the biceps muscle

- Pain that is often worse with lifting the arm in front of the body or above the shoulder

- Snapping of the biceps tendon with shoulder motion

- Pain that interferes functional activities

- Pain that prevents or disrupts sleep

Surgery is not always necessary but early accurate assessment is key.

Have you had a SLAP tear and if so what were your symptoms? If you’re a therapist how do you explain this condition to your patients? Please comment below 👇

ARTHRITIS IN A YOUNGER PERSON?Being told you have arthritis in a shoulder that’s young, active and not ready to slow dow...
06/10/2026

ARTHRITIS IN A YOUNGER PERSON?

Being told you have arthritis in a shoulder that’s young, active and not ready to slow down is genuinely worrying. It’s a fair concern but there are more options than most people expect.

I’ve been reading a useful review on how we manage shoulder arthritis in active adults. Here are the key takeaways:

1️⃣ It isn’t only an older person’s condition. Past injuries, dislocations, surgery and heavy overhead use can all wear the joint earlier. In one group of patients under 40 with shoulder instability, about 1 in 4 developed symptomatic arthritis around 15 years later.

2️⃣ We start with non-surgical care: activity changes, physiotherapy, pain relief and sometimes injections. These can ease pain and improve movement, but they don’t stop the arthritis progressing.

3️⃣ A joint replacement has a lifespan. Implants can loosen or wear over time, and a younger, active patient asks more of them for longer. So the aim of non-surgical care is to delay replacement for as long as possible and keep your own shoulder going for longer.

4️⃣ When replacement is truly needed, it can still do well. Studies in the review reported better pain, activity and mobility scores at around 13 years, though loosening and dislocation can happen.

The right plan depends on your age, activity level, scans and goals, so it’s worth talking it through before deciding anything.

References: Garvick S et al. JBJS JOPA 2022;10(1):e21.00029. See also Jain S et al. JBJS JOPA 2026;14(3):e26.00008.

Any questions? Please ask below 👇

02/10/2026

WHAT’S ON THE OP LIST TODAY? 🩻

Today’s main case is a patient who had a Latarjet procedure some time ago and now needs the screws taken out.

Over time, the bone around the screws has resorbed (thinned away). That leaves the screw heads sitting proud and rubbing on the structures around them, which understandably causes symptoms.

On paper, this sounds simple: remove some screws, and sometimes it is. But how deeply the screws are embedded isn’t always clear until we’re in there, so planning means preparing for everything:

1️⃣ Arthroscopic (keyhole) screw removal, if the screws are easy to reach
2️⃣ Diamond drilling, if bone has grown over or around the screw heads
3️⃣ Opening up the shoulder (an open approach rather than keyhole), if that’s what it takes to remove them safely
4️⃣ The right equipment in the room for every one of those scenarios

Having a plan for each possibility means that if things turn out harder than expected, we’re not improvising. We simply move to the next step, which is safer for the patient.

If you’re facing a similar operation, it’s completely normal to wonder what it will involve. Your surgeon should be able to explain the likely plan and the backup plans too.

Any questions? Please ask below 👇

BONE CANCER Bone cancer is rare, but the word alone is frightening, and it’s completely understandable to worry if you’v...
01/10/2026

BONE CANCER

Bone cancer is rare, but the word alone is frightening, and it’s completely understandable to worry if you’ve had a persistent ache or pain.

Primary bone cancer starts in the bone itself. Secondary bone cancer starts elsewhere in the body and spreads to the bone. As a shoulder surgeon, I most often see it as an incidental finding, because suspected cases picked up in primary care are usually referred straight to specialist bone tumour teams.

Most aches and pains are simply muscle strains, but these are the signs worth knowing:

1. Pain: a painful or tender area, sometimes present at rest and often worse at night. It can also travel along a nerve and be felt away from the tumour itself (referred pain).

2. Swelling: around a particular area.

3. Problems moving: it may feel harder to get around, or you may notice a limp.

If any of these persist, or you notice something unusual such as unexplained weight loss, please don’t wait and worry. Book an appointment with your GP or a healthcare specialist and get it checked. In most cases it will turn out to be something far less serious, but it’s always better to know.

Bone Cancer Research Trust is a great resource if you’d like to read more.

Any questions? Please ask below 👇

RECOVERY ISN’T LINEARIf you’re recovering from shoulder surgery or an injury and it feels like you’re going backwards, p...
29/09/2026

RECOVERY ISN’T LINEAR

If you’re recovering from shoulder surgery or an injury and it feels like you’re going backwards, please know you’re not alone. It’s one of the most common worries I hear in clinic, and it’s completely understandable to feel frustrated or anxious when progress stalls.

Recovery rarely runs in a straight line. Many patients have a bad week, a temporary setback or a plateau where nothing seems to change. This is often a normal part of the process, and the key is to keep going.

Staying in regular contact with your physiotherapist, your surgeon and your family gives you the best chance of a good recovery. Each of us sees a different part of the picture, and working together makes a real difference.

If things aren’t going to plan, don’t be afraid to say so. For some patients, a bit of reassurance is all that’s needed. For others, it gives us the chance to take stock and reassess.

So keep the dialogue open, however you’re doing. Good days and bad days are both worth telling us about, and you are never a bother by asking.

Any questions? Please ask below 👇

25/09/2026

WHAT’S ON THE OP LIST TODAY?

A lady who was referred to me after two steroid injections into her shoulder that didn’t fix the problem and in fact, we’ve now found she has a rotator cuff tear that needs repairing.

I understand why steroid injections feel like the obvious first step. They’re quick, non-surgical, and can genuinely ease pain in the short term, but it’s worth knowing what they don’t do… and what they can do if used repeatedly or in the wrong situation.

Steroids reduce inflammation, but they don’t heal a torn tendon and there’s good evidence that repeated injections can actually:

1️⃣ Weaken the tendon tissue itself, making it more prone to tearing
2️⃣ Mask pain without addressing the underlying problem, so damage can progress unnoticed
3️⃣ Inhibit the body’s own healing response if given too close together or too often

That’s exactly what seems to have happened here.

Today I’m repairing that tear, reattaching the tendon to the bone so it can heal properly and she can get back to full function.

If you’ve had an injection and the pain keeps coming back, that’s not something to just repeat, it’s a sign to get the shoulder properly assessed.

Any questions? Please ask below 👇

SMOKING AND CUFF REPAIR FAILUREThis isn’t always an easy conversation to have, and I know it can feel like one more thin...
24/09/2026

SMOKING AND CUFF REPAIR FAILURE

This isn’t always an easy conversation to have, and I know it can feel like one more thing to worry about before surgery, but it’s important, so I’d rather be upfront with patients.

A meta-analysis of over 1,600 shoulders has confirmed something we’ve long suspected: smoking significantly increases the risk that a repaired rotator cuff won’t heal properly.

1️⃣ Smokers had a 53% higher risk of the repair failing on follow-up scans
2️⃣ Function scores were only slightly lower in smokers. Pain relief was broadly similar
3️⃣ The effect held regardless of age, tear size, or how long patients were followed up
The tendon-to-bone healing process is what makes or breaks a cuff repair, and smoking impairs exactly that.

If you’re due for surgery and you smoke, cutting down or stopping beforehand is one of the few things genuinely within your control that improves your odds of a lasting repair.

Any questions? Please ask below 👇

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