Shoulders

Every bone in the human body is susceptible to a fracture. Strong and resilient, our bones can withstand most significant forces without injury. However, if the pressure applied to a bone is too strong or the bone is weak in health, a break or crack in the bone may occur.

Cases where a bone breaks but does not damage the tissue or skin surrounding the break are considered simple or “closed” fractures. Cases in which a broken bone causes a break in the skin are commonly referred to as “open” fractures. Higher energy injuries have a higher risk of complication and are considered “complex” fractures. Complex fractures may require specialized treatment.

A broken bone is an unfortunate and painful experience that impacts every aspect of a person’s life. From the first visit to Inland Orthopaedic Surgery and Sports Medicine Clinic, our goal is to provide maximum pain relief and to help our patients return to a normal life as soon as possible. Through a collaborative effort with the patient and their treating provider, we will formulate a treatment plan that achieves those goals.

Treatment for fractures ranges from immobilization of the broken bone with a cast or splint to reducing the fracture by manually realigning the broken bone without opening the skin. Sometimes, surgery may be required to restore normal alignment of the bone. These surgeries often involve the installation of plates, screws, pins or other forms of hardware.

Appropriate treatment is based upon the nature of the injury, as well as your expectations and needs. Safety, quality of life, and returning to work or sports all factor into the decision-making process. When surgical intervention is required, our providers are well-versed in the most up-to-date, minimally invasive surgical techniques, as well as the most appropriate post-operative rehabilitation protocols. Our goal is to get you back to living your normal life as soon as possible.

Muscle strains and tears are common soft tissue injuries that can vary in severity. Soft-tissue injuries fall into two basic categories: acute injuries and overuse injuries.

• Acute injuries are caused by a sudden trauma, such as a fall, twist, or blow to the body. Examples include sprains, strains, and contusions.
• Overuse injuries occur gradually over time when an athletic or other activity is repeated so often that areas of the body do not have enough time to heal between occurrences. Tendinitis and bursitis are common soft-tissue overuse injuries.

Osteoarthritis of the Shoulder is inflammation in your shoulder, causing pain and stiffness that can make it difficult to lift your arm. Osteoarthritis is a condition that destroys the smooth outer covering (articular cartilage) of the bone. As the articular cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. During movement, the bones of the joint rub against each other,  causing pain; this is often referred to as "bone on bone" arthritis.

There is no cure for arthritis of the shoulder, but there are many treatment options to help alleviate symptoms.

 

Rotator Cuff Injuries involve your rotator cuff, located in your shoulder. Your shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The shoulder is a ball-and-socket joint: The ball, or head, of the upper arm bone fits into a shallow socket in the shoulder blade. Your arm is kept in your shoulder socket by the rotator cuff. The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm.

There is a lubricating sac called a bursa between the rotator cuff and the bone on top of the shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

Rotator Cuff Tears occur when one or more of the rotator cuff tendons is torn, causing the tendon to become partially or completely detached from the head of the humerus. In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object.

The most common symptoms of a rotator cuff tear include:

• Pain at rest and at night, particularly if lying on the affected shoulder
• Pain when lifting and lowering your arm or with specific movements
• Weakness when lifting or rotating your arm
• Crepitus, or a crackling sensation, when moving your shoulder in certain positions

If you have a rotator cuff tear and keep using it despite increasing pain, you may cause further damage. A rotator cuff tear can get larger over time.

Shoulder Dislocations are relatively common. They can be complete or partial, and usually occur after a trauma, such as a fall or motor vehicle collision. 

• In a complete dislocation, the joint surfaces are completely separated.
• In a partial dislocation, the joint surfaces are only partially separated. A partial dislocation is also called a subluxation.

Symptoms of a dislocated shoulder include:

• Deformity
• Swelling
• Numbness
• Weakness
• Bruising
• Pain — you may experience muscle spasms from the dislocation, and this can make it hurt more

A shoulder dislocation should be considered an emergency injury.

Shoulder Impingement Syndrome happens when bones in your shoulder rub against or pinch your rotator cuff. It happens when swelling in your shoulder makes your rotator cuff too big to fit comfortably between your bones.

Shoulder pain is the most common symptom of shoulder impingement. The pain may:

• Make your shoulder feel tender to the touch
• Spread/radiate from the front of your shoulder to the side of your arm
  
• Worsen at night and affect your ability to fall or stay asleep

Shoulder impingement pain may get worse during certain movements/positions including:

• Laying on the injured side of your body
• Reaching behind your back
• Lifting and lowering your arm
• Extending your arm above your head

A SLAP Tear is an injury to part of the labrum of the shoulder. The labrum is the ring of cartilage that surrounds the socket of the shoulder joint. 

In a SLAP injury, the top (superior) part of the labrum is injured. This top area is also where the biceps tendon attaches to the labrum. A SLAP tear extends from the front (anterior) to the back (posterior) of this attachment point. The biceps tendon can be involved in the injury, as well.

An acute SLAP injury may result from:

• Wearing down of the labrum that occurs slowly over time
• A motor vehicle collision
• A fall onto an outstretched arm
• Forceful pulling on the arm, such as when trying to catch a heavy object
• Rapid or forceful movement of the arm when it is above the level of the shoulder
• Shoulder dislocation

In most cases, the initial treatment for a SLAP injury is nonsurgical. Your doctor may recommend surgery if your pain does not improve with nonsurgical methods.