Orthopaedic Surgery and Sports Medicine services for the shoulder joint
Shoulder Instability
Instability of the shoulder (glenohumeral) joint can be a source of significant shoulder dysfunction and pain. Typically, instability occurs anteriorly, though in some cases posterior or multi-directional instability may occur. Depending on severity, both operative and nonoperative treatment may be recommended.
Superior Labral Tears
Superior labral tears occur when the cartilage at the top of the shoulder joint tears away from the joint surface. This can cause inflammation and pain, particularly with a throwing motion. When rest, activity modification, anti-inflammatories, and therapy fail to provide relief, arthroscopic surgery with removal or fixation of the tear can a be very effective treatment.
Biceps Injury
The long head of the biceps tendon attaches to the top of the shoulder joint and runs in front of the arm to the muscle belly. This tendon is particularly susceptible to injury since it crosses both the shoulder and elbow joint. It can become inflamed, torn, or unstable, resulting in significant anterior shoulder pain. Treatment options may include anti-inflammatories, injections, and surgery.
Rotator Cuff Tears
Rotator cuff injury is among the most common causes of shoulder pain and inflammation. The injury spectrum can vary from temporary information to permanent tears, with treatment specifically directed toward the underlying issue. Surgical fixation of tears can be performed in a minimally-invasive fashion with arthroscopic surgery, providing pain relief and functional improvement.
Pectoralis Major Tears
Tears of the pectoralis (pec) major tendon are a relatively uncommon but debilitating injury that occurs from a direct traumatic injury. Typically bruising of the arm and chest wall occur with severe pain and weakness. Surgical repair is recommended in most cases and usually should be performed as early as possible.
Adhesive Capsulitis (Frozen Shoulder)
Adhesive capsulitis, otherwise known as frozen shoulder, can cause both pain and stiffness. It can happen with or without direct injury. Most cases resolve without surgery, but early diagnosis and treatment with focused physical therapy can help speed the recovery. In cases that do not respond to therapy, arthroscopic surgery with releases and manipulation can be performed.
Shoulder Arthritis
Shoulder arthritis may be due to a variety of causes and can result in significant shoulder pain and stiffness that limits routine activity. While initial management is typically nonoperative, shoulder replacement can offer substantial pain relief and mobility in persistent cases.
Scapulothoracic Disorders
The scapula (shoulder blade) forms the foundation of the shoulder joint. Problems with the shoulder blade can cause downstream dysfunction of the shoulder (scapular winging or dyskinesia) and the arm. Inflammation of the bursa between the shoulder blade and chest wall along with muscle imbalance is often improperly diagnosed and may be corrected with anti-inflammatory oral or injection therapy along with specialized physical therapy. Surgical options are also available in rare cases of bone overgrowth or persistent symptoms.
Nerve Compression
Excessive compression of the peripheral nerves around the shoulder can cause motor and sensory disturbance, affecting shoulder function. Depending on the site and severity, injections or surgery may be recommended to prevent permanent damage.
Acromioclavicular (AC) Joint
The acromioclavicular (AC) joint is located between the clavicle (collar bone) and scapular (shoulder blade). While it is a relatively small joint, it plays an integral role in shoulder motion. Excessive inflammation can cause targeted pain located directly over the joint as well as pain with impingement. Temporary relief can be provided with injections while arthroscopic surgery can provide permanent correction of impingement.
Sternoclavicular (SC) Joint
The sternoclavicular (SC) joint is located between the sternum and collar bone. Direct trauma (dislocation or fracture) as well as other causes can result in joint injury and pain. Depending on the source, both operative and nonoperative treatment may provide significant symptomatic improvement.
Thoracic Outlet Syndrome
Thoracic outlet syndrome is a disorder of the upper extremity as a result of compression on the neurovascular structures supplying the arm. Symptoms can vary in presentation but most commonly involve numbness and tinging of the arm that is position-dependent. Management options are specific to the underlying cause and can include both operative and nonoperative options.