The shoulder is a complex network of structures that provide a wider range of motion and mobility than any other joint in the body. However, this mobility creates a risk for joint instability and injury.

Shoulder anatomy

The shoulder is a ball and socket joint where the head of upper arm bone (the “humerus”) fits into the glenoid (the “glenoid), the shallow socket in the shoulder blade (the “scapula”). This is called the glenohumeral joint. The glenoid is deepened by a rubbery ring called the glenoid labrum which strengthens shoulder stability. The glenoid capsule contains a group of ligaments that hold all the parts together and keeps the shoulder within its range of motion. The ball fits securely into the socket and is held in position by the rotator cuff. The rotator cuff is a group of four muscles and their tendons that wrap around the joint which holds the ball in its socket and allows us to lift and rotate the arm. There is another joint in the shoulder called the Acromioclavicular joint (the “AC Joint”) which is where the collarbone (the “Clavicle”) meets the shoulder blade (the “acromion”).

Conditions and treatments

• Rotator cuff tears are a common cause of shoulder pain and disability. Often the tendon is torn off the bone when caused by injury. However, a degenerative tear can result from the slow wearing down of the tendon over time. Degenerative tears are common as we age, caused by repetitive motions and overuse. Bone spurs can develop causing shoulder impingement. The bone spurs rub against the tendon causing it to fray and eventually tear. Arthroscopic rotator cuff repair can fix the tear.
• Frozen shoulder is common, causing pain, stiffness, and impaired range of motion. It is caused by inflammation which causes thickening and stiffening of the shoulder joint capsule. Risks include menopause, diabetes, and thyroid problems. Nonsurgical management can help improve mobility, but when ineffective, arthroscopic surgery will release the scar tissue, followed by physical therapy.
• Shoulder dislocation is an injury that causes the ball to partially or completely pop out of the socket. When the shoulder is dislocated the glenoid labrum and ligaments can be torn, and in some cases can fracture the glenoid. These tears are called Bankart lesions that cause instability and pain; as well as an increased risk of repeated dislocations. Untreated a Bankart lesion can lead to chronic shoulder instability, which can lead to repeated dislocations. Initial treatment is reduction or putting the ball back in its socket. Nonsurgical treatment can help to relieve symptoms. However, when there is pain, instability and limited range of motion after reduction, a Bankart lesion will be suspected. If found, surgery may be indicated.
• SLAP tears are the result of an injury to the shoulder labrum, the ring of cartilage that surrounds and supports the joint. A SLAP tear is caused either by trauma, shoulder dislocation, a fall or accident or overuse from repetitive motion. Throwing athletes and weightlifters are at risk of labrum tears. Initially, nonsurgical treatment is focused on reducing pain and swelling. When the pain fails to improve, arthroscopic surgery will be recommended.
• Shoulder separation is the result of an injury to the acromioclavicular joint (AC Joint) where the collarbone meets the shoulder blade. It is caused by trauma, an accident or a fall on the shoulder that damages the ligaments that stabilize the joint. A ligament tear causes the separation of the collarbone from the shoulder blade. Nonsurgical treatment can help to restore function and manage pain. Most people can manage without surgery. However, when pain persists arthroscopic surgery will be recommended.
• Broken collarbone is a break in the clavicle. It is common and is usually the result of a fall on the shoulder or an outstretched arm. A collarbone fracture is painful and limits range of motion. When the bones remain in the correct position, a fracture can be treated with a sling while healing. When the bones move out of place surgery will be needed to realign the bones.
• Shoulder arthritis it the result of wear and tear and causes inflammation, pain and stiffness which reduces range of motion. Arthritis typical affects the AC joint or the glenohumeral joint. The location of the pain indicates which joint is affected. Arthritis of the AC joint produces pain on the top of the shoulder. Arthritis of the glenohumeral joint is centered in the back of the shoulder. Nonsurgical treatment can help. when pain persists and disability increases arthroscopy can clean out the joint for pain relief. However, arthritis is a progressive disease and advanced disease is a good indication of the need for a shoulder joint replacement.

When you have shoulder pain contact Grossmont Orthopedics in San Diego, CA. Schedule a consultation to receive the correct diagnosis and treatment so that you can get back to the things that make life enjoyable.