The shoulder is a complex joint formed from a variety of bones, muscles, ligaments, tendons, and nerves. Offering a wide range of motion and significant flexibility, we use our shoulders for a myriad of day-to-day activities. For active individuals, like baseball, tennis, or volleyball players, shoulders are utilized even more, making the intricate structures within the joint susceptible to injury. Some prominent structures within the joint include:
The shoulder is a ball-and-socket joint, with the top the humerus or “ball” fitting into the scapula or “socket.”
The labrum is a cup-shaped ring of cartilage that keeps the ball of the shoulder in place. This structure contributes to shoulder stability, so when torn, it can lead to a partial or complete shoulder dislocation and a considerable amount of pain. Along with dislocation, a torn shoulder labrum may result in a catching or locking sensation when moving. There are two different kinds of labral tears:
Labral tears often occur due to repetitive overhead motions during sports such as volleyball or tennis, but they may also develop as a result of the natural aging process. Oftentimes, surgical intervention is required to restore previous function and mobility.
The rotator cuff is a group of muscles and tendons that cover the head of the humerus, forming a cuff to keep the arm in its socket. Enabling a wide range of mobility, the rotator cuff allows you to rotate your shoulder and lift your arm. In a rotator cuff tear, the muscles and tendons can be torn in two ways:
These tears may result from a sudden movement, such as lifting something too heavy, or they may occur gradually over time, either due to old age, repetitive stress, or lack of blood supply. Although partial-thickness tears may be healed with physical therapy, more severe tears may require surgery. Your orthopedic specialist at FASSST Sports Medicine may recommend surgery if your symptoms have persisted for over six months, if the tear is larger than three centimeters, if you are a competitive athlete, or if there is a significant loss of shoulder function.
Tendonitis occurs when the tendons in the shoulder become inflamed or irritated. This condition may arise from repetitive use, a sports injury, or sudden trauma. Sometimes, tendonitis may occur from being pinched by nearby structures. The primary symptom of tendonitis is pain at the site of the injured tendon, either chronic or bouts of acute pain. Other symptoms may include:
Typically, shoulder tendonitis can be treated with physical therapy and RICE: rest, ice, elevation, and compression. In severe cases, surgery is able to realign tendons or remove bone spurs that may be rubbing against the tendons.
A frozen shoulder, also known as adhesive capsulitis, occurs when the connective tissues in your shoulder thicken around the joint. As a result of the swelling, scar tissue often forms, which causes pain and restricts movement in the shoulder. This condition usually develops due to the joint’s immobilization for an extended period of time, and it has three stages:
Frozen shoulders are typically treated with physical therapy and NSAID pain medications to relieve inflammation and restore joint flexibility. If nonsurgical intervention is unsuccessful, your orthopedic specialist may suggest surgical treatment.
A shoulder dislocation occurs when the head of the humerus slips out of its normal position in the shoulder blade; essentially, the ball falls out of its socket. A dislocation can occur in two different ways:
This type of condition can cause considerable pain, swelling, weakness, bruising, and a shoulder deformity. To treat a shoulder dislocation, your team at FASSST Sports Medicine will move the joint back into its place. Following this procedure, also known as a reduction, you will need to immobilize your shoulder with a sling and complete rehabilitation exercises to restrengthen the joint.
There are two main types of arthritis that affect the shoulder:
Shoulder pain due to arthritis sometimes may call for a shoulder replacement to restore strength, mobility, and function. In a shoulder replacement procedure, the arthritic parts of the shoulder are replaced with artificial implants.
There are numerous nonsurgical treatment options to alleviate the above shoulder conditions. Among the most common treatments are:
Only when these conservative options have not been successful at relieving your pain will your team at FASSST Sports Medicine then recommend surgical intervention. What type of surgery you receive will greatly depend on the severity of your condition, the presence of other injuries, and the location of your pain. Some shoulder surgeries that you may undergo for your shoulder condition are:
