Does Sen. John McCain have shoulder osteoarthritis?

Health Professional

Does John McCain have shoulder osteoarthritis? Is that why he has trouble elevating his arms above his head?

Whatever your political views may be, hopefully we can all agree that we owe a profound debt of gratitude to Sen. John McCain for his honorable service during the Vietnam War. I do not provide medical care for Sen. McCain and I do not know his personal medical history, but a patient with shoulder pain asked me "What's wrong with McCain's shoulders and why can't he raise his hands above his head?"

There are many reasons why a person may not be able to raise his hands high above his head. Many of them deal with shoulder problems. With the disclaimer once more that I don't know Sen. McCain's medical history or the extent of the injuries he incurred as a prisoner of war in Vietnam, there are certain reasonable hypotheses one could make.

While shoulders are not common joints to develop significant osteoarthritis, they are much more prone to developing osteoarthritis if they have had a significant injury in the past. When Sen. McCain was held captive and tortured in Vietnam, his arms were likely injured. As a result, these injuries would have predisposed him to developing significant osteoarthritis in the future. Shoulder osteoarthritis alone, unless severe, would be unlikely to make it impossible to raise the arms high above the head. However, shoulder osteoarthritis in conjunction with other injuries could. Repeated shoulder dislocations, severe tearing of the rotator cuff muscles, and fractures to the shoulder bones can lead to significantly restricted range of motion.

A shoulder injury may also lead to something called adhesive capsulitis (a.k.a. frozen shoulder). In adhesive capsulitis, the capsule of the shoulder becomes very tight, restricting motion, sometimes to a severe degree. Frozen shoulder can happen out of the blue, without warning, or it can happen after a shoulder injury. Left untreated, isolated frozen shoulder usually takes about two years to recover full function. When treated, frozen shoulder can take anywhere from one month to as long as six months or longer to fully recover.

If a frozen shoulder occurs in response to an injury, such as a torn rotator cuff and/or shoulder dislocation, and those underlying shoulder problems are not addressed, then the frozen shoulder can take much, much longer to improve.

Why does Sen. McCain have difficulty lifting his arms high above his head? I really don't know. But a good educated guess is that multiple shoulder injuries in the past that were untreated led to restricted motion, frozen shoulders, and worsening early and severe osteoarthritis. At a certain point, even with treatment, the function of the shoulders may not be fully recoverable.

A take home point for all of us is that the longer injuries to joints are left untreated, the more potential there is for subsequent development of osteoarthritis. If you have joint pain, please go to your doctor to have it evaluated.