Last fall Steve Ronken broke his arm walking down a flight of stairs at his home – a day after he had his shoulder replaced at Sanford Health.
He had just completed a successful reverse shoulder replacement surgery and was looking forward to following a rehab regimen that would have him back on the golf course by spring.
The tumble down the steps took care of that and sent Ronken back to surgery with Harvey Oliver, M.D., an orthopedic specialist at Sanford Health who had done the original procedure eight days earlier.
This would be his third surgery, if you count the initial exploratory surgery. This procedure would replace the shoulder implants that had just been set in place while also putting his upper arm (humerus) back in order. It would be a more complicated surgery than the first replacement and would have a slower recovery, but Dr. Oliver was there to sort through these new circumstances.
“Dr. Oliver and I talked on the (My Sanford Chart) app,” Ronken remembered from the hours after he realized he needed another surgery. “He said, ‘I will fix this.’ And then I didn’t worry about it.”
In Dr. Oliver’s words, Ronken’s fracture “threw a wrench into everything,” but as he assured Ronken, he was going to fix it.
“We had to come up with new ideas to actually get a secure implant all over again,” Dr. Oliver said. “Steve needed a special design for the implants. The standard parts were not going to work because the fixation of the implant was going to have go down the shaft of the arm to better bone.”
The surgery was successful – his broken humerus has healed – and Ronken is progressing. As such, the procedure serves as an example of how effective shoulder replacement surgeries can be, even if you break the bone between the affected shoulder and the elbow just hours after the original arthroplasty.
“I’m encouraged that I will be able to play golf again,” Ronken said. “There is every hope of that. From the first time I talked with Dr. Oliver and he told me we would have to run some tests, I knew he was my guy. He knew I had a unique history with my shoulder. He told me what was up, he explained all the possibilities. I didn’t have to make any decisions – it all just fell into place. It was that smooth.”
Surgery available at Sanford
Shoulder replacement procedures similar to the one Ronken received – and then received again – are an increasingly common way of addressing shoulder pain both at Sanford and throughout the United States.
The Journal of Shoulder and Elbow Surgery forecasts as many as 350,000 shoulder replacement surgeries like Ronken’s will be performed in the U.S. in 2025. This would represent a 235% increase since 2017.
Sanford orthopedic surgeons and specialists offer a variety of shoulder replacement options for patients of all ages.
The three types of shoulder replacements Sanford Health offers are:
- Total shoulder replacement. Also known as a total shoulder arthroplasty, this procedure replaces the end of your upper arm bone and the cup-shaped part of your scapula with artificial components, restoring proper function to the shoulder joint.
- Partial shoulder replacement. This procedure removes the damaged section of your shoulder joint and replaces it with an artificial component.
- Reverse total shoulder replacement. This procedure replaces both parts of your shoulder joint but reverses the natural location of them, meaning the ball end is attached to your scapula and the cup end is on your upper arm. This can be beneficial for patients who have a torn or damaged rotator cuff.
How his injuries started
Ronken was catching for the Augustana Vikings in a baseball game vs. Morningside in 1988 when his shoulder problems began in earnest.
In his dive for a foul ball, he collided with a fence post near the first-base dugout and dislocated his shoulder while also injuring his head and neck. The injury delayed the game by a half-hour as they prepped him for a ride to the hospital.
One Augustana teammate later told him they couldn’t believe he had survived the collision. Another told him they couldn’t believe the post he ran into survived the collision.
The joint quickly snapped back into place that day, though damage remained. Surgeries followed, involving nerve repair that permitted him to get decades of good use out of it.
He was able to return to baseball and golf and – get this – regularly did cartwheels and back handsprings in his role as Jake Blues in a touring Blues Brothers show that visited baseball parks and other sporting events all over the U.S.
In recent years, his shoulder began to act up again, however. As is often the main issue for those in need of shoulder replacement surgery, arthritis had become a problem that was not going away. Coupled with a bad rotator cuff, basic quality-of-life things like driving a car became uncomfortable.
Now in his 50s, Ronken knew it was time to consider a replacement procedure. Based on recommendations from a friend, he made an appointment with Dr. Oliver, Sanford Health’s medical director of shoulder arthroplasty.
They decided on a reverse shoulder replacement, which is often used when patients have rotator cuff damage or serious arthritis.
“They got it figured out,” Ronken said. “How blessed are we that they have the technology and the knowledge to have procedures like this? If this was 40 years ago, they might have had something that would help, but you knew your shoulder was never going to be the same.”
Right doctor, right attitude
Ronken’s post-surgery progression suggests his shoulder will be better than it was before arthritis and rotator cuff issues began to take over.
“Now it’s just about pushing through a recovery that was made a little more difficult by the broken arm,” Dr. Oliver said. “Steve is always positive when he comes in to see us. He’s always in a good mood, so he is a great patient to have. There is definitely more work ahead for him, but he’s coming along really well – as well as he can for the type of injury he had.”
Ronken’s physical therapy began shortly after surgery. It started with twice-a-week sessions but is now down to once a week with Jillissa Schnebel, a physical therapist at Sanford Physical Therapy Solutions who specializes in back and joint pain, as well as patients recovering from surgery.
“We are going to keep working together until we get it as strong as he wants it to be, or when he can do all the exercises independently,” said Schnebel, who has been helping Ronken since early 2025. “We’re still working on finding the right exercises because of the weakness in that shoulder. We’re making modifications regularly, but he’s doing great with our sessions and doing his own exercises at home.”
Schnebel often works with patients recovering from shoulder replacement. For the first month to six weeks, patients wear a sling when they are not exercising. Schnebel files reports with the patient’s surgeon. Together, they establish an individual timetable for the progression of exercises.
“Typically, the pain the patient was feeling before the surgery is completely gone,” Schnebel said. “That’s why it is sometimes difficult to keep people from using their arm too much early in the recovery. It’s very encouraging for many of my patients because they realize they are going to get back to racquetball or pickleball or golf – whatever it is they really like to do and weren’t able to do before their surgery.”
Checking in with Dr. Oliver
During a recent visit to Dr. Oliver’s office for a checkup, Ronken talked with the doctor about his progress on strength and flexibility. Essentially the conversation was aimed at reviewing what sort of discomfort is cause for concern and what is not. Ronken wanted to push himself but didn’t want to damage anything.
The visit included this exchange:
Ronken: I was out chipping and putting. Then I thought, “Well, you know, this feels pretty good,” so I started hitting shots from about 25 yards out. Then it felt different. It wasn’t like a pain, but I thought maybe I shouldn’t be doing this yet.
Dr. Oliver: To some degree, I actually would not be opposed to you pushing it a little bit. I don’t want it to hurt, but looking at your X-rays today, everything is healed perfectly. Things are solid in there. Sometimes as you’re getting back to doing things again, it’s going to be a little uncomfortable. Some of your muscles are not going to be happy about what you’re asking them to do, but it’s not going to be harmful. In a way, it will be part of your therapy.
Conversations like Ronken’s with Dr. Oliver can make a big difference in proceeding through rehab with confidence, even after a complex procedure. The communication element is crucial in a team healing effort for a patient who has endured a unique set of circumstances.
“Jillissa has been awesome,” Ronken said. “She has a lot of patience, and she is very encouraging. This is a different situation than she has ever seen or even that Dr. Oliver has encountered. They’re learning and I’m learning. I’m taking baby steps.”
These small steps have included a succession of victories fueled by resolve to make them happen. Golf and swimming are targets. As Ronken described it: “I will jump in and go after that puppy that is drowning in the river.”
“I got advice from people who have gone through this before and they’ve always said, ‘You have to remember you got a baby’s arm again, right?’” Ronken said. “So I just keep going and keep on. Just trudge through and you’ll come out the other end better.”
To learn more about shoulder replacement
If you suffer from shoulder pain or struggle with your joint function, shoulder replacement surgery may be the best way for you to get relief.
Sanford Health’s orthopedic surgeons and specialists offer a variety of shoulder replacement options for patients of all ages. They will be there to walk you through the entire treatment process so you can recover safely and effectively.
Read more
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Posted In Orthopedics, Rehabilitation & Therapy, Sioux Falls
