Shoulder

The shoulder is made up of three bones, the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle). The shoulder is a ball and socket joint where the ball of the upper arm bones fits into the socket in the shoulder blade. The arm is kept in the socket by the rotator cuff, a network of muscles that come together as tendons. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate the arm.

SHOULDER

A torn rotator cuff weakens the shoulder, making daily activities painful and difficult. When one or more of the rotator cuff tendons are partially or completely torn, the tendon is no longer fully attached to the humerus. An acute tear can be caused by a fall or lifting something too heavy. A degenerative tear is the result of wear and tear over time caused by repeating the same motion.

Symptoms

  • Pain at night, particularly if lying on the affected shoulder
  • Pain when lifting or lowering arm
  • Weakness when lifting or rotating arm
  • Crackling (crepitus) sensation when moving the shoulder

Diagnostic procedures

If symptoms suggest a rotator cuff injury, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, range of motion and strength tests, X-rays, an MRI, and an ultrasound in order to determine proper non-operative or operative treatment.
Dislocations of the shoulder occur when the bones on opposite sides of a joint do not line up properly. Dislocations can involve three different joints.
  • Dislocation of the collarbone joint is a “separated shoulder.”
  • Dislocation of the sternoclavicular joint interrupts the connection between the clavicle and the breastbone (sternum).
  • Dislocation of the ball and socket joint of the shoulder can be toward the front (anterior) or the back (posterior) of the shoulder.

Symptoms

  • Pain over the top of the shoulder
  • Bump at the top or front of the shoulder
  • Inability to move the arm
  • Sensation of a “dead arm”

Diagnostic procedures

If symptoms suggest shoulder dislocation, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include reducing the dislocation and diagnostic procedure(s) such as X-rays to confirm realignment of shoulder joints.
Fractures of the shoulder commonly involve the clavicle (collar bone), proximal humerus (top of the upper arm bone) and scapula (shoulder blade). Fractures are broken bones usually caused by a direct blow from a fall or a collision.

Clavicle fracture:

Symptoms

  • Swelling in the middle of collar bone area. A prominent “bump” under the skin of the collarbone area Limited range of motion

Proximal humerus fracture:

Symptoms

  • Severely swollen shoulder Very limited movement Severe pain

Scapular fracture:

Symptoms

  • Pain Swelling Severe bruising around the shoulder blade

Diagnostic procedures

If symptoms suggest a shoulder fracture, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as X-rays, an MRI and a CT scan in order to determine proper non-operative or operative treatment.
The biceps tendons attach the biceps muscle to the bones in the shoulder and the elbow. Biceps tendons can begin as a partial tear, but as the damage progresses may become a complete tear. A complete tear can also damage other parts of the shoulder such as the rotator cuff. Injury and overuse generally cause biceps tendonitis.

Symptoms

  • Sudden, sharp pain in the upper arm
  • An audible pop
  • Cramping of the biceps muscle with strenuous use of the arm
  • Bruising on the upper arm Pain or tenderness at the shoulder and elbow
  • Weakness in the shoulder and elbow Difficulty turning the arm palm up or down
  • Bulge in the upper arm

Diagnostic procedures

If symptoms suggest tendonitis, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, X-rays and an MRI in order to determine proper non-operative or operative treatment.
Shoulder pain can result from arthritis. The most common type of arthritis in the shoulder is osteoarthritis, or wear and tear arthritis. Osteoarthritis develops slowly, eventually causing swelling, stiffness and pain. Other types of arthritis can be related to joint lining inflammation, rotator cuff tears or infection.

Symptoms

  • Pain aggravated by activity
  • Limited range of motion
  • A grating sensation (crepitus) with movement
  • Weakness Difficulty sleeping

Diagnostic procedures

If symptoms suggest arthritis, seek qualified orthopedic medical treatment.  Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, X-rays and an MRI in order to determine proper non-operative or operative treatment.

Shoulder Treatment Testimonials

ice climbing shoulder injury Shannon’s right shoulder snapped, crackled and popped with any weight-bearing exercise, when ice climbing in the mountains, and as the condition worsened, even putting on a shirt. The range of motion and the pain with motion was debilitating. Fortunately the shoulder is the most movable joint of the body, and unfortunately, one of the most unstable joints. The shoulder helps to lift the arm, to rotate it and to reach up overhead. The shoulder is made up of three bones, upper arm bone, humerus, shoulder blade, scapula, and collarbone, clavicle. The head of the upper arm bone fits into a shallow socket in the shoulder blade. The shoulder relies on strong tendons and muscles to keep the shoulder stable. If any of the shoulder structures are injured, the smoothly functioning shoulder can snap or pop. Injuries can be a result of aging, everyday use, chronic repetitive stress, sports, or significant trauma. Shannon’s injury was a combination of aging and every-other-day repetitive use of weights in a muscle madness aerobics class. Shoulder injuries characterized by popping, crackling and snapping include: Shoulder tear: If the cartilage in the shoulder is torn, it may be separating from the bone or becoming caught in the shoulder and causing a clicking sound. Shoulder dislocation: The ball of the shoulder can slide up or over the edge of the socket and popping may be heard when the ball then falls back into place. Torn rotator cuff: Overuse, aging or trauma strains the rotator cuff tendons, resulting in inflammation and tearing, characterized by weakness and noisy movement. Shoulder arthritis: The shoulder cartilage or cushioning on the ends of bones becomes depleted and snapping can occur if the cartilage is rough, thinning or absent. Shannon tried suggested nonsurgical relief options:
  • Ice
  • Anti-inflammatory medications such as ibuprofen
  • Rest
  • Activity modification
  • Physiotherapy to strengthen the muscles
The pain, limited motion and noisy shoulder persisted. So she went to Direct Orthopedic Care for help. After discussing her symptoms and medical history, the DOC physician examined Shannon’s shoulder and performed a series of range of motion tests to assess shoulder instability. Her orthopedic surgeon reviewed X-rays of the shoulder joint. Diagnosis: osteoarthritis or wear-and-tear arthritis. Treatment: cortisone injection. Cortisone injections do not cure the condition, but provide a window of symptom relief via inflammation reduction. This allows for improved joint motion and muscle strength and less snapping, crackling and popping. Shannon is happy to be able to reach for the stars without help or pain.
shoulder injury treatmentJerrod and his dad are motocross sports enthusiasts. Jerrod races competitive motocross and cross-country races on his 2013 kx450f. Jerrod cased a jump hard on a track in Fort Worth and the bike jutted forward, resulting in a bad crash.

Jerrod has insurance with a high deductible so was hesitant to go to the ER for care. Instead, he went to Direct Orthopedic Care and was seen immediately by Mike Nicholas, PA-C. After X-rays and a thorough examination, Mike diagnosed a shoulder dislocation and a non-displaced greater tuberosity fracture. The ball or head of the humerus, upper arm bone, fits into a shallow socket called a glenoid. The greater tuberosity is the prominent area of bone at the top of the humerus and is the attachment for the two large, powerful rotator cuff muscles.

Mike explained the treatment for this injury: “We had to reduce, or put the shoulder back in the joint. Jerrod was placed into a shoulder immobilizer for recovery. He understood the importance of protecting the shoulder and completing a physical therapy regimen.”

Coincidentally, Jerrod, the patient guest, and Mike, the orthopedic PA specialist, had a common passion . . . motocross. Mike raced motocross competitively as a teenager and did well in regional races. As he progressed in the motocross ranks so did his injuries, which eventually ended his racing career. Mike learned a great deal about the body and its ability to heal itself with proper care. His history in motocross inspired him to pursue a career in medicine and healthcare. Now Mike’s experience as an injured athlete and orthopedic provider gives him a unique perspective, which enables him to effectively communicate with athletes like Jerrod and to educate them about their injuries and recovery.

Jerrod recommends DOC: “If people need orthopedic care, they should go to DOC. They are open nights and weekends so I did not have to take off work for my appointments. They are good people and affordable.”

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