SHOULDER

Shoulder problems often occur when soft tissue breaks down from overuse, an acute injury, degenerative joint and bone diseases such as rheumatoid arthritis, rotator cuff disease, a compressed nerve or a frozen shoulder. Severe or constant pain, swelling, or numbness in your shoulder means it’s time to see a specialist.

Treatments can include non-surgical methods such as anti-inflammatory medication or minimally invasive surgical procedures like arthroscopy. Our team of specialists can address your shoulder condition and provide treatment options that help decrease your pain.

shoulder-x-ray | Dr. Robert Ference

Shoulder Physical Therapy

Shoulder Questions & Answers

AC Joint Separation

AC joint separation is also known as the “separated shoulder”. It occurs when the capsule of the AC joint is damaged.

It occurs in people who participate in sports. There are 6 types of classifications to the injury. The most common type of injury that causes the separation is a fall on the tip of the shoulder or outstretched hand.

Type I: Sprain

This is an AC separation that involves trauma to the ligaments that form the joint, but no severe tearing or fracture.

Type II:

This type is an AC separation that involves complete tearing of the acromioclavicular ligament, sprain or partial tear of the coracoclavicular ligaments. This often causes a noticeable bump on the shoulder. The bump is permanent.

Type III:

Both acromioclavicular and coracoclavicular ligaments are torn. The bump is formed.

Type IV:

This is a type III injury with avulsion of the coracoclavicular ligament from the clavicle, with the distal clavicle displaced posteriorly into or through the trapezius. This injury generally requires surgery.

Type V:

This is a type III injury with an exaggeration of the vertical displacement of the clavicle from the scapula. This injury generally requires surgery.

Type VI:

This is a type III with inferior dislocation of the lateral end of the clavicle below the coracoid. This type is extremely rare, and it’s generally only involved with motor vehicle collisions. This requires surgery.

Rotator Cuff Tears

Rotator cuff tears involve one or more inflamed rotator cuff tendons as the result of overusing, aging, falling on an outstretched hand, or a collision.

Labral Tears

Labral tears to the shoulder is when the thick tissue is torn due to trauma to the shoulder joint. The labrum itself can also become more brittle with age, and can tear as part of the aging process.

The common types of labral tears are:

1.- SLAP Tears: torn labrum on top of the shoulder socket where the bicep tendon attaches to the shoulder.
2.- Bankart Lesions: shoulder dislocation when the shoulder comes out of the joint and labrum tears which makes the shoulder vulnerable to future dislocations.
3.- Posterior Labral Tears: Less common injury, but seen in people with an internal impingement condition. The rotator cuff and labrum are pinched together in the back of the shoulder.

Sprains

Shoulder sprain is a tear of the shoulder ligaments.

A sprain that tears ligaments in the shoulder most often occurs at the joint between the acromion and collarbone, called the acromioclavicular joint.

Thoracic Outlet Syndrome

Thoracic outlet syndrome is a group of disorders that occur when the blood vessels or nerves in the thoracic outlet become compressed.

This causes pain in your shoulders and neck, also causes numbness in your fingers.

Causes of this syndrome are usually from trauma in a car accident, repetitive injuries from job or sports-related activities, and certain body defects. An old injury can lead to thoracic outlet syndrome as well.

Symptoms:

  • Pain, numbness, and tingling in the pinky, ring fingers, and the inner forearm
  • Pain and tingling in the neck and shoulders
  • Signs of poor circulation in the hand or forearm
  • Weakness of the muscles in the hand

Impingement/ Swimmer Shoulder/ Pitcher Shoulder

Impingement syndrome is caused by the excessive squeezing or rubbing of the rotator cuff and shoulder blade. The pain is a result of an inflamed bursa (lubricating sac) over the rotator cuff, inflammation of the rotator cuff tendons, and calcium deposits in tendons from wear and tear. Shoulder impingement syndrome can lead to a torn rotator cuff.

Impingement occurs when the space between the rotator cuff and the acromion bone become narrowed, preventing tendons from moving freely. Tendonitis may follow as a result of impingement.

Bursitis (Subacrominal)

Bursitis occurs when tendonitis and impingement syndrome cause inflammation of the bursa sacs that protect the shoulder.

General Shoulder Injury Symptoms:

  • Aching sensation in the shoulder joint
  • Catching of the shoulder with movement
  • Pain with specific activities
  • Limited to no range of motion in the shoulder
  • Weakness in the joint
  • Burning sensation due to movement or without movement of the shoulders
  • Swelling
  • Tenderness

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