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Shoulder

Normal Anatomy of the Shoulder Joint

How does the Shoulder joint work?

Rotator Cuff Tear

Rotator cuff is the group of tendons in the shoulder joint providing support and enabling wider range of motion. Major injury to these tendons may result in tear of these tendons and the condition is called as rotator cuff tear.

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Shoulder Impingement

Shoulder impingement is also called as swimmer’s shoulder, tennis shoulder, or rotator cuff tendinitis. It is the condition of inflammation of the tendons of the shoulder joint caused by motor vehicle accidents, trauma, and while playing sports such as tennis, baseball, swimming and weight lifting.

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Shoulder Arthroscopy

Shoulder arthroscopy is a surgical procedure in which an arthroscope is inserted into the shoulder joint. The benefits of arthroscopy are smaller incisions, faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.

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Frozen Shoulder

Frozen shoulder is a condition of painful shoulder with limited movement because of pain and inflammation. It is also reffered as adhesive capsulitis and may progress to the state where an individual may feel very hard to move the shoulder.

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Shoulder Joint Replacement

Shoulder joint replacements are usually done to relieve pain and when all non-operative treatment to relieve pain have failed.

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Shoulder Instability

Shoulder instability is a chronic condition that causes frequent dislocations of the shoulder joint. A dislocation occurs when the end of the humerus (the ball portion) partially or completely dislocates from the glenoid (the socket portion) of the shoulder. A partial dislocation is referred as subluxation, whereas the complete separation is referred as dislocation.

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Thoracic Outlet Syndrome

The thoracic outlet is a small passageway leading from the base of the neck to the armpit and arm.This small area contains many blood vessels, nerves and muscle. When this passageway becomes compressed the condition is termed as thoracic outlet syndrome. This rare condition is characterized by burning pain in the neck and shoulder, numbness and tingling of the fingers, and a weak hand grip.

Dislocated Shoulder

Playing more overhead sports activities and repeated use of shoulder at workplace may lead to sliding of the upper arm bone, the ball portion, from the glenoid–the socket portion of the shoulder. The dislocation might be a partial dislocation (subluxation) or a complete dislocation causing pain and shoulder joint instability. Shoulder joint often dislocates in the forward direction (anterior instability) and it may also dislocate in backward or downward direction.

SLAP tears

The shoulder joint is a ball and socket joint. A ‘ball’ at the top of the upper arm bone (the humerus) fits neatly into a ‘socket’, called the glenoid, which is part of the shoulder blade (scapula). The term SLAP (superior –labrum anterior-posterior) lesion or SLAP tear refers to an injury of the superior labrum of the shoulder. The labrum is a ring of fibrous cartilage surrounding the glenoid for stabilization of the shoulder joint. The biceps tendon attaches inside the shoulder joint at the superior labrum of the shoulder joint. The biceps tendon is a long cord-like structure which attaches the biceps muscle to the shoulder and helps to stabilize the joint.

Arthritis of shoulder

The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Damage of the cartilage in the shoulder joint causes shoulder arthritis.

Shoulder separation

Acromioclavicular joint (AC joint) dislocation or shoulder separation is one of the most common injuries of the upper arm. It involves separation of the AC joint and injury to the ligaments that support the joint. The AC joint forms where the clavicle (collarbone) meets the shoulder blade (acromion).

Shoulder Joint Tear

The shoulder joint is a “ball and socket” joint that enables the smooth gliding and thereby the movements of arms. However it is inherently unstable because of the shallow socket. A soft rim of cartilage, the labrum lines the socket and deepens it so that it accommodates the head of the upper arm bone better.

Shoulder injuries in the throwing athlete

Shoulder injuries most commonly occur in athletes participating in sports such as swimming, tennis, pitching, and weightlifting. The injuries are caused due to the over usage or repetitive motion of the arms.

Shoulder injuries cause pain, stiffness, restricted movements, difficulty in performing routine activities, and popping sensation.

Some of the common shoulder injuries include sprains and strains, dislocations, tendinitis, bursitis, rotator cuff injury, fractures, and arthritis.

Biceps Tendon Tear at the elbow

Biceps tendon rupture is characterized by rupture of the biceps tendon from the elbow or shoulder joint.

The biceps muscle is the muscle in the anterior side of your upper arm that helps you bend your elbow and rotate your arm.

The biceps tendon is a tough band of connective fibrous tissue that attaches your biceps muscle to the bones at the shoulder and the elbow.

Distal Biceps Rupture

The biceps muscle is located in front of your upper arm. It helps in bending your elbow as well as in rotational movements of your forearm. Also, it helps to maintain stability in the shoulder joint. The biceps muscle has two tendons, one of which attaches it to the bone in the shoulder and the other attaches at the elbow. The biceps tendon at the elbow is called the distal biceps tendon and if there is a tear in this tendon, you will be unable to move your arm from the palm-down to palm-up position. Once the distal biceps tendon is torn, it cannot regrow back to the bone and heal by itself. Permanent weakness during rotatory movements of the forearm may occur if the tendon is not repaired surgically.

Burners and Stingers

Burners and stingers are common neck or shoulder injuries characterized by intense burning or stinging pain which can radiate from the neck to the hand. They are caused by sudden movement or a direct blow to the neck resulting in an injury to the brachial plexus. This injury is commonly seen in contact sports such as football, ice hockey, wrestling, and rugby.The brachial plexus is a group of nerves which pass from the neck to the arm that transmit the sensory and motor sensations of the arm. The compression or pinching of the brachial plexus results in pain. It usually lasts for a short period of time after which the symptoms resolve. It may also be associated with numbness or weakness of the affected arm. In a few cases it may last for a longer duration of time. People with a narrow spinal canal (spinal stenosis) are at an increased risk of recurrent burners and stingers.

Shoulder Trauma (Fractures)

A fracture is a break in the bone that commonly occurs as a result of injury, such as a fall or a direct blow to the shoulder. Shoulder joint is the most flexible joint of the body. It allows different motions of the hands making it possible for us to do a vast array of different activities. However its flexibility makes it more prone to injuries. The type of shoulder fracture depends of the age of the patients. Clavicle fractures are more common in children. A fracture of the upper part of the arm (proximal humerus) is more common in elderly individuals and its frequency increases with age.

Clavicle Fracture

A fracture is a break in the bone that commonly occurs as a result of injury, such as a fall or a direct blow to the shoulder. Shoulder joint is the most flexible joint of the body. It allows different motions of the hands making it possible for us to do a vast array of different activities. However its flexibility makes it more prone to injuries. The type of shoulder fracture depends of the age of the patients. Clavicle fractures are more common in children. A fracture of the upper part of the arm (proximal humerus) is more common in elderly individuals and its frequency increases with age.

Fracture of the Shoulder Blade (Scapula)

Scapular fractures are uncommon but do occur and require a large amount of force to fracture. They are usually the result of intense trauma, such as a high speed motor vehicle accident or a fall from height onto one’s back. They can also occur from a fall on an outstretched arm if the humeral head impacts on the glenoid cavity.

Adult Forearm Fractures

The forearm is made up of 2 bones namely the radius and ulna. The primary function of your forearm is rotation i.e., the ability to turn your palms up and down. The fracture of the forearm affects the ability to rotate your arm, as well as bend and straighten the wrist and elbow. The breaking of the radius or ulna in the middle of the bone requires a strong force and it is most commonly seen in adults. In most of the cases, both bones are broken during a forearm fracture.

Shoulder Joint Replacement

Shoulder joint replacement is a surgical procedure performed to replace the damaged shoulder joint with the artificial implants. Shoulder joint replacement is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, rotator cuff tear arthropathy, avascular necrosis and failed former shoulder replacement surgery.

Partial Shoulder Replacement

Partial shoulder replacement, also called shoulder hemiarthroplasty is a surgical procedure during which the upper bone in the arm (humerus) is replaced with a prosthetic metal implant, whereas the other half of the shoulder joint (glenoid or socket) is left intact. This surgical procedure is indicated in severe, persistent conditions of shoulder osteoarthritis in which the only the humeral head or ball of the joint is damaged. Osteoarthritis is a degenerative condition in which the cartilage that allows smooth movement in the joints wears away causing the adjacent bone to rub against each other resulting in pain and stiffness. In such conditions, replacement of the damaged portion of the humerus will reduce the friction as bone ends can no longer come in contact and thus relieve pain.

Conventional Shoulder Replacement

The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Damage of the cartilage in the shoulder joint causes shoulder arthritis. In an arthritic shoulder

Reverse Shoulder Replacement

Reverse Shoulder replacement is an alternative surgery for patients who have torn their rotator cuffs and have developed severe arthritis or who have had a previous total shoulder replacement that has failed to relieve their pain. Rotator cuff is the group of four tendons that join the head of the humerus (arm bone) to the deeper muscles and provides stability and mobility to the shoulder joint.

Shoulder Reconstruction

Shoulder reconstruction is a surgical procedure performed in patients with shoulder instability to improve stability, restore the function and prevent recurrent dislocations of the shoulder joint.

Click on the topics below to find out more from the Orthopaedic connection website of American Academy of Orthopaedic Surgeons.