Shoulder

Bursitis is the swelling and irritation of a bursa. A bursa is a fluid-filled sac that acts as a cushion between muscles, tendons, and joints. You may experience symptoms such as joint pain and tenderness when you press around the joint, stiffness and aching when you move the affected joint, swelling, warmth, and/or redness over the joint. The goal of treatment is to relieve pain and reduce inflammation.

Frozen shoulder is when your shoulder becomes painful and loses motion because of inflammation. The capsule of the shoulder joint contains ligaments that hold the shoulder bones together. When this capsule becomes inflamed, the shoulder bones are unable to move freely in the joint, causing a decreased range of motion of the shoulder, pain, and stiffness. Goals of treatment are to relieve pain and reduce inflammation.

Impingement syndrome is a common shoulder condition seen in adults. This condition is closely related to shoulder bursitis and rotator cuff tendinitis. These conditions may occur alone or in combination.

In most parts of the body, muscles surround bones. In the shoulder, however, the muscle is surrounded by bone. If you were to tap on your shoulder, you would feel bone. This bone is called the acromion. Under that bone lies your rotator cuff muscles that control rotational shoulder movements. Under the rotator cuff muscles is your upper arm bone (or proximal humerus). In other words, the rotator cuff muscles are sandwiched between the acromion shoulder bone and the upper arm bone. This arrangement of bone/muscle/bone at the shoulder joint leads to the condition of impingement syndrome (shoulder bursitis, rotator cuff tendinitis).

When an injury to the rotator cuff muscle occurs, the muscle responds by swelling much the way an ankle does when it is sprained. However, because the rotator cuff muscle is surrounded by bone, its swelling causes a number of events to occur. The pressure within the muscle increases, resulting in compression and loss of blood flow in the small blood vessels called capillaries. When the blood flow is diminished, the muscle tissue begins to fray much like a rope. As the muscle tissue swells, it results in the classic features of a pain characterized like a toothache. Pain is aggravated by actions such as reaching up behind the back and reaching up overhead. Night pain may also result from this shoulder condition and results in sleep interruption. Initial treatment of impingement syndrome consists of resting the shoulder muscles and reducing inflammation.

Shoulder instability means the shoulder joint is too loose and it is able to slide around too much in the socket. In some cases, the unstable shoulder actually slips out of the socket and dislocates. If not treated, the instability can lead to arthritis of the shoulder joint. Treatment goals for shoulder instability are to initially alleviate pain and reduce inflammation. A rehabilitation program helps with strengthening the shoulder and positioning techniques in order to regain stability of the joint.

The labrum is a thick piece of tissue that surrounds the shoulder’s socket joint. The shoulder joint is a ball and socket joint, but unlike your hip joint, the socket is very shallow. This allows for a larger range of motion, in fact, the range of movements your shoulder can make far exceeds any other joint in the body. The labrum helps to provide stability to this shallow socket by making the socket deeper for the ball to sit in.

When you have trauma to the shoulder, it is possible that you may have torn your labrum. The labrum becomes more brittle with age, and can therefore fray (like a rope) and tear with the aging process. Common symptoms of a labral tear consist of an aching sensation in the shoulder joint, a catching of the shoulder with movement, and/or pain with specific activities.

The treatment of a torn labrum depends on the type of tear that has occurred. Most labral tears do not require surgery; however, in patients who have persistent symptoms despite more conservative treatments, surgery may be necessary.

Proximal humerus fractures are a break of your upper arm bone. The upper arm bone, called the humerus, is part of the bones that make up the shoulder joint. Symptoms include severe pain and swelling, bruising, inability to move the shoulder, a grinding sensation with shoulder movement, and a deformity (“It does not look right”). The goal of treatment is to realign the bone into correct position for proper healing. Depending on the break alignment, surgery may or may not be recommended.

A rotator cuff tear is a common cause of pain and disability among adults. In 2016, close to 4 million people in the United States went to their doctors because of a rotator cuff problem. A torn rotator cuff will weaken your shoulder. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do.

The rotator cuff consists of a set of muscles that attach the shoulder blade (scapula) to the upper arm (humerus). A rotator cuff tear occurs when one or more of the rotator cuff tendons are torn (the tendon no longer fully attaches to the head of the humerus bone). In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object. Symptoms associated with rotator cuff tears include pain at rest and at night (particularly if lying on the affected shoulder), pain when lifting and lowering your arm or with specific movements, weakness when lifting or rotating your arm, and a cracking sensation when moving your shoulder in certain positions.

The goals of treatment for rotator cuff tears are to reduce pain and restore function. There are several treatment options for a rotator cuff tear, and the best option is different for every person. In planning your treatment, your doctor will consider your age, activity level, general health, and the type of tear your have.

The rotator cuff is a set of muscles that attach the shoulder blade (Scapula) to the upper arm (Humerus). Rotator cuff tendinitis is when the rotator cuff tendons (cords connecting muscle to bone) become irritated or damaged. This occurs in individuals who do repetitive lifting or overhead activities using their arm. These activities may include swimming, baseball, tennis, paper hanging, construction, or painting. Symptoms include minor pain that is present both with activity and at rest, pain radiating from the front of the shoulder to the side of the arm, and/or sudden pain with lifting and reaching movements. Athletes may experience pain with overhead sports when throwing or serving a tennis ball. The symptoms may begin initially as a mild pain, but may worsen if left untreated. The goal of treatment is to reduce pain and restore function. In planning your treatment, your doctor will consider your age, activity level, and general health.

The labrum is a thick piece of tissue that surrounds the shoulder’s socket joint. The shoulder joint is a ball and socket joint, but unlike your hip joint, the socket is very shallow. This allows for a larger range of motion, in fact, the range of movements your shoulder can make far exceeds any other joint in the body. The labrum helps to provide stability to this shallow socket by making the socket deeper for the ball to sit in.

When you have trauma to the shoulder, it is possible that you may have torn your labrum. The labrum becomes more brittle with age, and can therefore fray (like a rope) and tear with the aging process.

A SLAP tear is a type of labral tear most commonly seen in overhead throwing athletes such as baseball players and tennis players. The torn labrum seen in a SLAP tear is at the top of the shoulder socket where the biceps tendon attaches to the shoulder. Common symptoms of a labral tear consist of an aching sensation in the shoulder joint, a catching of the shoulder with movement, and/or pain with specific activities.

The treatment of a torn labrum depends on the type of tear that has occurred. Most labral tears do not require surgery; however, in patients who have persistent symptoms despite more conservative treatments, surgery may be necessary.