A countless number of people live with shoulder pain every day. If you are one of those people experiencing weakness or have trouble lifting above shoulder level, you should consult one of our surgeons.
This problem can usually be corrected with a simple non-operative treatment. Some tears may require surgery to correct.
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ABOUT THE SHOULDER
Shoulder injuries are very common — especially in athletes who use repetitive motions in their sport—think swimmers, tennis players, pitchers and weightlifters. While common in athletes, injuries can occur during everyday activities — a simple reach into a cabinet can cause a strain.
Most shoulder injuries are a result of issues with the ligaments, tendons and muscles. Injuries can develop over time as the result of repetitive use and/or ignoring the warning signs of a problem. Occasionally, an injury will occur during or after an accident.
Orthopedic surgeons categorize shoulder injuries into many categories, primarily traumatic or overuse. The two most common shoulder problems seen by orthopedic surgeons are rotator cuff injuries and instability. The shoulder has more mobility than any other joint in the body, leading to more injuries.
Shoulder tendinitis typically occurs from a repetitive motion while playing a sport. Occasionally, a more sudden, unexpected injury can cause the issue. It’s common in athletes, especially those who may inadvertently use incorrect form, putting additional stress on the tissues and tendons in the shoulder.
Treatment for shoulder tendinitis focuses on regaining mobility and reducing the discomfort caused by pain and swelling. Rest and ice on the shoulder is a great start — it will help reduce the swelling. Physical therapy can help relieve the symptoms and help regain strength in the shoulder. Surgery is typically only needed if the tendon has been torn — either partially or completely.
Shoulder bursitis is caused when the small fluid-filled sacs (bursae) that cushion and protect bones, tendons and muscles become inflamed. The shoulder is one of the most common locations for bursitis, which often presents itself in joints that perform repetitive motions.
Bursitis can cause stiffness and swelling in addition to a general ache in the shoulder. It may be irritated when you apply pressure to the shoulder or move it. Generally, bursitis will subside with rest and extra care to protect the shoulder and limit use. If pain is persistent, you should see a doctor to develop an effective course of treatment. Your doctor may recommend medication to reduce inflammation, therapy to strengthen the muscles in the shoulder, injections to reduce more severe inflammation or surgery. Surgery is rarely needed in the treatment of bursitis.
ROTATOR CUFF TEAR
Rotator cuff tears are common — especially in people who are middle-aged or perform repetitive overhead motions at their job or while playing a sport. Tears can occur over time as a result of wear and tear or from a sudden accident or injury.
Most people describe the pain from a rotator cuff tear to feel like a dull ache, that worsens if you sleep on the affected shoulder. The tear can make it difficult to reach behind your back to do daily tasks like brushing your hair. It may also make your arm feel weak.
Rotator cuff tears are more common in people over the age of 40, people who work in the construction industry, those with family members who have had rotator cuff tears and athletes who play sports like baseball or tennis.
If you suspect a rotator cuff tear or other serious shoulder injury, it’s advised that you make an appointment to see an orthopedic doctor. There are many options for treatment, but they are generally more effective if the injury is diagnosed early.
At your appointment, your doctor will talk to you about your symptoms. Additional testing, such as an X-ray, ultrasound or MRI may be used to confirm the diagnosis and assess the severity of the tear. Your doctor may recommend physical therapy to improve the strength in your shoulder. Injections are an option to help reduce the pain, although it’s important to remember that even though the pain may be gone, the underlying issue is not. Surgery can help repair the tendon and, if necessary, replace the shoulder joint.
Frozen shoulder doesn’t occur suddenly — it gradually worsens, causing pain and stiffness in the shoulder joint. There are three main stages: the freezing stage, where you feel pain when you move the shoulder and your range of motion becomes limited; the frozen stage, where the shoulder is stiff and difficult to use (pain can reduce during this stage); and the thawing stage, where your shoulder slowly begins to return to normal.
Frozen shoulder usually gets better on its own within 12 to 18 months; however, physical therapy can be helpful to help maintain and recover mobility within the shoulder. Corticosteroid injections can help manage pain, although these injections are generally more helpful in the early stages of frozen shoulder. Surgical options for frozen shoulder aren’t common, but there are options should this be the course of treatment best for you.
When the humorous (upper arm bone) is forced out of the shoulder socket, shoulder instability occurs. Sometimes this is a result of overuse, while some cases are a result of sudden accident or injury. Unfortunately, once a shoulder has dislocated, it’s likely to happen again — when the shoulder repeatedly dislocates, the condition is referred to as chronic shoulder instability.
Shoulder dislocations can be partial or complete, meaning the ball comes either partially out of the socket or all the way out of the socket. The condition can also be caused when patients have loose ligaments in their shoulders — whether the looseness is simply their anatomy or a result of repetitive overhead motion. Those who play volleyball, tennis or swim sometimes have stretched shoulder ligaments. It’s also common in those who have an occupation that requires overhead work regularly.
Shoulder separation is a condition caused solely by loose ligaments — the bones remain in place, but the loose ligaments create a feeling of instability and weakness in the shoulder. Some specific sports and occupations can increase the risk of problems with the ligaments in the shoulder.
Physical therapy and modifications to your activities can help minimize the symptoms. Physical therapy can also help strengthen the shoulder to improve stability. Anti-inflammatory medications and injects can also help to relieve the swelling and pain. Surgery is sometimes necessary to repair damaged ligaments, allowing them to hold the shoulder in place again. At MOA, we see consistently positive outcomes for shoulder surgeries.
The ball joint of the humerus (upper arm) is held in place by the labrum — a rubber tissue attached to the shoulder socket to help keep the joint stable. A SLAP lesion (superior labrum, anterior to posterior) is a tear above the middle of the shoulder socket. Tears to the labrum can occur from a sudden injury or can wear and tear as we age.
Injuries that can cause a labrum tear include falling on the shoulder or arm, a direct hit to the shoulder, reaching overhead rapidly or a sudden pull. Some athletes, like weightlifters or throwing athletes, can see these types of injuries as a result of a repetitive motion that wears down the labrum.
A labrum tear causes pain, especially when reaching overhead. It may cause a feeling of instability and loss of strength, in addition to a decrease in your range of motion. Some people also experience a grinding sensation or popping and locking in the joint.
Physical therapy may help strengthen the muscles in the rotator cuff, while anti-inflammatory medications can help relieve the symptoms. Surgery may be necessary if there isn’t improvement with more conservative treatments. For a labrum tear, surgery is minimally invasive. While therapy is always needed after surgery to regain your range of motion and strength, there is minimal downtime.
Shoulder replacement surgery is not as common as hip or knee replacements. However, it is an effective way to treat severe pain, swelling, weakness and loss of range of motion if these symptoms have not responded to more conservative treatments. People who have arthritis, rotator cuff tears, severe fractures and more may benefit from shoulder replacement surgery.
If you’re interested in the procedure, you’ll first go through an extensive evaluation with your orthopedic surgeon, where you’ll discuss your medical history and have a full physical examination. Likely, you’ll also have imaging tests like an X-ray or MRI. As there are several different procedures for a shoulder replacement, it’s crucial that you and your doctor work together to ensure you understand your options.
For some patients, who have had a previous shoulder replacement that failed, have an incredibly severe rotator cuff tear or debilitating arthritis, a reverse shoulder replacement may be an option. In a reverse shoulder replacement, the ball and socket are switched — a plastic socket is attached to the humerus and a metal ball is attached to the shoulder bone. The reverse shoulder replacement means the patient can lift the arm with their deltoid muscle, not the torn rotator cuff.
HOW WE CAN HELP
Mountainstate Orthopedic Associates is one of the region’s leading orthopedic practices. We take pride in the education and experience that each of our doctors holds.
From your initial appointment to the conclusion of your treatment, we strive to keep you informed and active in the decision-making process. It’s always our policy to be conservative with our course of treatment, only recommending surgery if it is truly needed.
We also seek to be minimally invasive in our treatments, reducing the amount of time a patient is in the hospital. With many of our surgical treatments, patients are home the same day of surgery.
In our all new free guide, "Guide to Shoulder Pain" you will learn about: