Shoulder Arthritis

A degeneration of the joint at the top of the shoulder which most often affects middle-aged people and is caused by overuse of the shoulder.

Symptoms: Pain in the front of the shoulder or over the joint, limited range of motion, and clicking or popping sounds when the arm is moved.

Treatment Options: Cortisone injections, anti-inflammatory medications, use of a splint or brace, exercise, and modification of daily activities. In severe cases, surgery may be necessary to remove damaged portions of the joint.

Bursitis or Tendonitis

Bursitis or Tendonitis can occur with overuse from repetitive activities, such as swimming, painting, or weight lifting.

Symptoms: Decreased range of motion, night pain, weakness

Treatment Options: Typically by modifying the activity which causes the symptoms of pain and a course of physical therapy for the shoulder.

Instability of the Shoulder (dislocations)

Instability of the shoulder occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of sudden injury, sports, or from overuse of the shoulder ligaments.

Symptoms: Instability

Treatment Options: Many dislocations require one of two surgeries. An open surgical repair, which may require a short stay in the hospital; or an outpatient arthroscopic surgical repair. After surgery, an extensive physical therapy program is prescribed for optimal healing and rehabilitation.

Rotator Cuff Tears

This group of muscles and tendons in the shoulder helps maintain joint stability while allowing the arm to lift and rotate. A tear can be painful and interfere with shoulder movement and can be caused by traumatic injuries, such as a dislocation of the shoulder. But they are most commonly caused by repetitive motions, especially from sports such as baseball or tennis.

Symptoms: Pain and weakness when lifting or lowering the arm, degeneration of the shoulder muscles, and a crackling sensation when the shoulder is moved.

Treatment Options: Rest, anti-inflammatory medications, steroid injections, strengthening exercises and use of a sling. If those methods do not relieve symptoms, surgery may be necessary.

Cortisone Injection

Cortisone is a powerful anti-inflammatory medicine that can be injected directly into your shoulder to relieve pain. This generally takes effect in 2-5 days.

Recovery: May resume normal activities as tolerated

Source: orthoinfo.org

Arthroscopy Procedures

Arthroscopy procedures are a minimally invasive surgical procedure orthopedic surgeons use to visualize, diagnose, and treat problems inside a joint. Small incisions are made to allow pencil-sized instruments to magnify, view and possibly repair the area.

Slap Repair

An arthroscopic procedure, this repairs a tear of the biceps tendon. A tear at this point is called a SLAP (Superior Labrum Anterior-Posterior) tear. SLAP repair is performed under general and regional anesthesia, and patients usually leave the hospital the same day. Patients generally require a sling for two to four weeks after.

Post-operative treatment: Physical therapy will be required to strengthen the joint.
Recovery: Most patients can regain normal activities within three to six months.

Mini-Open or Arthroscopic Rotator Cuff Repair

This surgical procedure inspects and reattaches torn tendons in the shoulder’s rotator cuff. After surgery, the arm is usually placed in a sling.

Post-operative treatment: Physical therapy is needed to regain full range of motion and increased shoulder strength.
Recovery: Most patients return to normal activities within three to six months.

Joint Replacement

Though less common than knee or hip replacement, it is just as successful in relieving joint pain if nonsurgical treatments like medications and activity changes are no longer helpful in relieving pain.

Total Joint Replacement

The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. These parts may be either cemented or “press fit” into the bone, depending on bone quality. The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid). Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.

Post-operative treatment: Your arm will be in a sling to support and protect your shoulder for the first two to four weeks after surgery. Pain management is an important part of recovery, as is physical therapy soon after surgery. When you feel less pain, you can start moving sooner and get your strength back more quickly.
Recovery: Patients usually spend one to two nights in the hospital and most resume normal activity after three months.

Reverse Total Shoulder Replacement

Reverse total shoulder replacement is used for people who have completely torn rotator cuffs with severe arm weakness, severe arthritis and rotator cuff tearing (cuff tear arthropathy), or had a previous shoulder replacement that failed. In reverse total shoulder replacement, the socket and metal ball are switched. That means a metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.

Post-operative treatment: Your arm will be in a sling to support and protect your shoulder for the first two to four weeks after surgery. Pain management is an important part of recovery, as is physical therapy soon after surgery. When you feel less pain, you can start moving sooner and get your strength back more quickly.
Recovery: Patients usually spend one to two nights in the hospital and most resume normal activity after three months.

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Shoulder pain is a common problem that can be caused by a variety of factors including a tear in a tendon of the rotator cuff, a tear of the labrum, arthritis of the glenohumeral joint (ball and socket), arthritis of the acromioclavicular, inflammation of the tendon or bursa and frozen shoulder. Cortisone injections are a common treatment option for shoulder pain.

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Motion is Lotion! Immediate Mobilization After Stable Rotator Cuff Repairs

The videos below demonstrate a typical rotator cuff tear before (vid1) and after (vid2) a repair. The key features of these videos are that the repair takes advantage of the native bone’s ability to provide growth factors and other blood-born, glue-like properties to firmly cement the repair in place. In addition, the repair construct has strong fixation medially, which establishes the anatomy of the repair which is strengthened by lateral anchors which drape the sutures over the repair - like bungie cords on a roof rack. This produces a strong repair, with a large surface area for robust healing and early motion.

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Rotator Cuff Tears

Some patients have tears in their RTC that have been there for years but they are still able to reach above their head as their body has compensated for the mobility usually using the deltoid. These patients may be able to reach above their shoulders and head but will have very little strength. Not all rotator cuff tears....

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Over the years of helping people recover from shoulder surgery and injuries, I’ve noticed an under emphasis on regaining symmetric internal rotation of the shoulder joint, which is key to achieving healthy balanced shoulder mechanics. On a very basic level, this is measured by our ability to raise our thumb behind our back up to our shoulder blade (scapula). Most of what we do with....

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I Need a Reverse Shoulder Replacement, What Should I Expect?

The reverse shoulder replacement allows your shoulder to work by modifying the physics of the shoulder. It moves the shoulder’s center of rotation down and allows your deltoid muscle (the large muscle that you feel on your shoulder) to do the work that your small rotator cuff muscles and tendons used to do. This gives you a painless and functioning shoulder despite having a rotator cuff tear! Over the past...

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Adhesive Capsulitis (Frozen Shoulder)

Adhesive capsulitis, also known as “Frozen Shoulder”, is a condition that causes pain, stiffness and eventual loss of range of motion in the shoulder. Secondary to pain, our natural response is to use the shoulder less and less to avoid discomfort. Over time, due to...

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Services

Shoulder

Shoulder Arthritis

Bursitis or Tendonitis

Instability of the Shoulder (dislocations)

Rotator Cuff Tears

Cortisone Injection

Arthroscopy Procedures

Joint Replacement

Shoulder Specialists

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