Athletes and non-athletes alike use their shoulder joints on a regular basis. Throwing balls, lifting boxes, reaching out to shake hands, and opening doors all require you to engage your shoulder. When an injury, disease, or another concern affects this area it can have a significant impact on your quality of life. Our experienced orthopaedic surgeons are extensively trained in a comprehensive range of shoulder conditions and shoulder treatments, both surgical and non-surgical. We emphasize conservative approaches whenever possible, and we utilize advanced technology to achieve optimal results.
Please follow the links below to learn more about common shoulder conditions. If you have other questions, or wish to schedule a consultation, please contact us today.
Rotator Cuff Injuries
The rotator cuff is a group of muscles/tendons located in the shoulder, which commonly cause symptoms from either overuse and/or injury. Symptoms include pain, loss of motion and loss of strength. Not all rotator cuff conditions are the same, and there are differing levels of severity when it comes to describing rotator cuff pathology. The most mild condition occurs when the rotator cuff may be inflamed but intact, considered either tendinitis or bursitis. The next level of injury would show structural changes to the tissue, such as a partial tearing of the rotator cuff. The most severe type of injury would be a full–thickness tear of the rotator cuff. Rotator cuff tears are often present even in patients who do not have injury or painful symptoms. This is seen more commonly in patients who are older than 40 years of age. By the time, we reach the age of 65, most of us have at least some rotator cuff tearing, regardless of the presence of symptoms.
The rotator cuff’s function is to help stabilize the ball and socket of the shoulder and maintain the normal position of the joint as the arm is being lifted overhead. Most patients with rotator cuff disease have limitation of motion which involve bringing the arm overhead or away from the body, as well as reaching behind their back. Pain is often in the lateral upper arm and can radiate towards the elbow. Many times, the pain is associated with relative overuse (such as performing yard work), or activities which require overhead position of the arm for prolonged periods on a repetitive basis. Rotator cuff disease is rare in the patient under 40 without a major traumatic event.
Impingement syndrome is a condition where the patients have often pain related to inflammation around the rotator cuff tendon and bursa, which may be caused by poor shoulder mechanics or an abnormal anatomy, which puts them at risk for this condition. It is often treated with oral anti–inflammatories (Motrin, Aleve), steroid injections, physical therapy and/or arthroscopic surgery. Many times mechanics can be restored through a combination of inflammatory-relieving medications/injections and physical therapy. Shoulder surgery is reserved for those patients who do not respond to these conservative treatments.
Rotator Cuff Tears
Rotator cuff tears that are not full–thickness are often treated with conservative intervention such as described above for impingement syndrome. Even some full–thickness tears are treated in this manner, if , for instance the patient is considered poor candidate for surgical intervention.
If a patient does require surgery for a rotator cuff tear, it is often an arthroscopic procedure that can be performed as an outpatient. The rotator cuff may only require debridement (removing partially torn or dysfunctional tissue), or can require a repair of the rotator cuff. Repair of the rotator cuff is often performed with sutures and anchors to reattach the rotator cuff tendon to the bone of the upper arm (humerus). These procedures are typically performed in an outpatient setting without an overnight hospital stay. Rehabilitation however can require several months of physical therapy and requires a skilled physical therapist to help regain motion and strength without causing re–injury. Rotator cuff repairs heal slowly for a number of reasons, but poor blood supply at the area where the tendon attaches to the humerus is the main reason for this delay. Medical conditions such as diabetes or smoking can negatively effect blood flow, and also contribute to poor healing.
The labrum is a cartilage tissue which is responsible for providing stability to the ball and socket portion of the shoulder. It is the attachment point of the shoulder ligaments to the socket (glenoid). When a shoulder dislocates, usually due to a significant trauma, the labrum is often the site of injury. When the labrum remains detached, the shoulder becomes unstable and the ball can continue to slip out of the socket resulting in pain and disability.
Treatment of labrum tears involves rest, physical therapy, and arthroscopic surgery. The labrum is repaired to the socket with sutures, allowing patients to return to the activities they enjoy. If you have suffered a dislocation of your shoulder, recently, or many years ago, have your shoulder evaluated by one of our shoulder specialists.