The shoulder is the most movable joint in the body and is made up of three joints, many muscles, and ligaments.
The shoulder must be mobile enough for the wide range actions of the arms and hands, but also stable enough to allow for actions such as lifting, pushing and pulling. The compromise between mobility and stability results in a large number of shoulder problems not faced by other joints such as the hip.
“Really had a great experience at the Merrillville office. The staff was very friendly and helpful. The doctor was very patient with all my questions and I got the answers I needed, but hoping physical therapy will help elevate my symptoms. Overall the staff was great and the doctor was very helpful and patient. I was so nervous too and he was very kind.”
– Hillary Podke
What is a Shoulder Injury?
The complexity of the shoulder joint is unmatched by any other joint structure in the body. A shoulder injury may involve the tendons, cartilage, ligaments, or muscles that provide stability and mobility to the shoulder joint. Shoulder injuries may relate to a traumatic event such as a sports or auto accident. Injury may also be due to normal wear and tear or overuse.
What Are the Symptoms of a Shoulder Injury?
A shoulder injury may cause a variety of symptoms depending on the type and severity of the condition or trauma. Some of the common symptoms that may develop include: Deformity of the shoulder and upper arm
- Pain in the shoulder or shoulder blade
- Pain that radiates down the arm
- Obvious malformation due to dislocation
- Weakness or tingling in the arm
- A popping or clicking sensation in the shoulder joint
- Shoulder pain when lying down or sleeping
- Limited range of motion, a difficulty raising the arm overhead
The initial point of contact for shoulder pain may be a primary healthcare provider or an urgent care physician. Depending on the findings of the consultation and examination or response to conservative treatment, a specialist may need to be consulted. Our physicians have extensive training and experience treating shoulder injuries and can offer the caring and comprehensive attention you need.
What Are the Most Common Shoulder Injuries?
What are the most common shoulder injuries? We provide diagnostic and therapeutic services for several types of shoulder injuries. Some of the common conditions that occur include:
Rotator Cuff Tears
The shoulder is supported by a group of tendons and muscles that we call the rotator cuff. This group of tissues holds the ball of the upper arm in the socket of the shoulder. Rotator cuff tears may occur as a sports injury or as a result of repetitive overhead motions. Often, a rotator cuff tear is only partial and may respond to nonsurgical treatment. Arthroscopic shoulder surgery may be advisable if symptoms do not resolve with conservative therapies such as ice, medication, rest, and physical therapy. Severe rotator cuff tears may need surgery as the primary treatment.
Shoulder Impingement/rotator Cuff Tendinitis
Tendinitis, also referred to as tendinosis, is an inflammatory condition affecting the muscles and tendons that make up the rotator cuff. Also called impingement syndrome, tendonitis tends to occur gradually and worsen progressively over time. It may stem from repetitive overhead lifting or side sleeping often, which places pressure on the shoulder joint. In most cases, rotator cuff tendinitis responds well to conservative therapies, and patients are able to regain the painless function of the shoulder.
Dislocated Shoulder/shoulder Instability
A shoulder dislocation involves the separation of the upper arm bone from the shoulder socket. Typically, the rounded end of the humerus sits firmly in the C-shaped shoulder socket, stabilized by the rotator cuff. A dislocation may happen due to a fall on an outstretched hand or to a traumatic blow or twist to the upper arm or shoulder. The dislocation may be corrected with what shoulder reduction, a manual technique that repositions the humerus bone back into the shoulder socket. This is typically done under some type of sedation or anesthesia. Depending on the degree of instability in the shoulder socket, surgery may be needed to prevent further dislocation.
The socket of the shoulder joint is naturally quite shallow. To compensate, there is a circular rim of cartilage that creates a cup within the shoulder joint for the humerus to sit. This piece of cartilage is called the labrum. The labrum connects to the tendon of the bicep muscle, adding stability to the shoulder. SLAP, or Superior Labrum from Anterior to Posterior, is the term that describes a tear at this intersection of the bicep muscle and the labrum. Like other shoulder injuries, a SLAP tear may occur due to trauma to the arm, a fall on an outstretched hand, or overuse. Nonsurgical treatments that reduce pain and restore strength are the initial approach taken for SLAP tears. Surgery may be necessary for severe tears or cases that do not respond to treatments.
Frozen Shoulder (Adhesive Capsulitis)
This painful condition occurs when the connective tissue around the shoulder joint becomes stiff. The more stiffness that occurs, the more pain that develops. The more pain that exists, the less the shoulder is used. This is why the condition is referred to as frozen shoulder. There are stages to this shoulder injury, ending with the likely recovery of motion and comfort. In the interim, remedies such as exercise, hot and cold therapy, and Transcutaneous electrical nerve stimulation (TENS) therapy may be used to manage comfort. If improvement does not occur, shoulder arthroscopy may be performed.
Shoulder Arthritis (Shoulder Osteoarthritis)
Osteoarthritis may affect just about any joint in the body. In the shoulder, the articular cartilage that forms a smooth outer covering over bone tissue can wear down. Shoulder osteoarthritis is a degenerative condition related to use and age. Over time, the cartilage becomes rough and frayed, decreasing the protective space between bones and other structures in the shoulder joint. Severe osteoarthritis may eliminate that space altogether, allowing bones to rub against one another.
When is Shoulder Injury Surgery Needed?
Treatment should be conducted right away in instances of severe, noticeable injury such as a dislocated shoulder or frozen shoulder. In addition to these situations, patients who are good candidates for shoulder injury treatment include those whose pain keeps them up at night or prevents them from comfortably performing normal daily activities.
How to Prevent Shoulder Injuries
Fortunately, shoulder injuries often respond well to nonsurgical remedies. With certain strategies, irritation to the shoulder joint can be prevented or minimized. Experts suggest:
- Always warm-up before exercise and sports. A proper warm-up takes only about 5 minutes and prepares the muscles and joints for full engagement in an activity.
- Keep lifting at a tolerable level. This is important for those who engage in weight training as they seek increases.
- Maintain muscle tone. Weight training, even using bodyweight, engages the muscles and tendons that support the joints of the body.
- Stop early in instances of discomfort. If shoulder pain occurs, it is important to stop the activity and rest the joint.
- Use good standing and sitting posture.
- Lift objects safely, with a straight back and using the leg muscles.
- Use tools such as a step-stool when reaching for objects in high locations.
Who is at Risk?
Shoulder injuries may occur at any age. Each type of shoulder injury may have unique risks, but most are more common among athletes and older individuals.
What Can I Expect at the Consultation?
If special care is needed for a shoulder injury, patients can expect to discuss much of the same points that they have with their primary healthcare provider. Our orthopedic specialists may ask about general health, existing conditions, and family history. Of particular interest are conditions such as anemia, diabetes, osteoporosis, arthritis, and hypertension, because these health problems may influence treatment options. Following the discussion of existing pain and medical history, the orthopedic specialist will conduct a physical examination of the shoulder. This aspect of the visit assesses swelling, skin condition, reflexes, and swelling. Our specialist may observe your ability to perform various motions such as lifting the arms in front of you, reaching behind the back, or lifting arms to the sides. An additional aspect of the orthopedic assessment is imaging. X-rays may be performed to observe details of the shoulder joint. X-rays may detect abnormalities in the position, shape, or size of the joint.