I saw both the surgeon and the physiotherapist this morning and the general felling is that there seems to be several things going on, all of which are effecting each other to some degree or other.
Firstly, the shoulder glenohumeral joint has some wear and tear (from the years of moving about without tendons properly in place to control it) so these surfaces are rough. Due to the surgery much of the shoulders natural lubricant is missing and so the plan is to inject some synthetic lubricant directly into the glenohumeral joint.
The shoulder is also not moving correctly, and even though the subacromial space has now been made much bigger there is still some impingement.The impingement is causing the tendons to be inflamed and painful so another shot of cortisone is needed to calm things down.
The reason for the incorrect movement of the shoulder could be either because of pain from the glenohumeral joint, or (and this seems more likely) from some post operative adhesive capsulitis I have which is restricting the external rotation. Or possibly both problems are contributing. So the plan is to (under a general anesthetic) to place some die into the joint, take a series of x-rays with the joint in various positions and then if the cause is the capsulitis then to break up the scar tissue and stretch it out whilst still under the general anesthetic.
So I’m booked in to have all three procedures done at the same time Monday week (29th March).