Acromioclavicular (AC) Joint Separation | Bankart Tear Repair
Biceps Tendonitis | Glenoid Labrum Tear | Humeral Avulsion Glenohumeral Ligament
Proximal Biceps Tendon Rupture | Rotator Cuff Tear with or without Repair/Surgery
Rotator Cuff Strain | Shoulder Dislocation | Shoulder Impingement | Shoulder Instability
Common Shoulder Injury Symptoms & Treatment
Acromioclavicular (AC) Bone Spurs- SAD (Subacromial Decompression)
Bone spurs are bony projections that form along joints, and are often seen in conditions such as arthritis. Bone spurs are formed from the body's attempt to increase the surface area of the joint to better distribute weight across a damaged joint surface. The AC joint is located where the collarbone meets the highest point of the shoulder blade. Bone spurs in the AC joint may be removed by the surgical procedure of Subacromial Decompression (SAD). SAD may be performed arthroscopically or by using an open incision, and is considered to be a “minor” shoulder surgery. This surgery treats various sports injuries, such as shoulder impingement, and is used to increase subacromial space in the shoulder by removing the subacromial bursa.
Acromioclavicular (AC) Joint Osteoarthritis (Degenerative Joint Disease)
The AC joint is the joint where the collarbone and shoulder blade connect, and the joint which allows the shoulder to move freely. The shoulder is in constant use, resulting in osteoarthritis of the AC joint a common disorder. Symptoms of this condition may include pain and tenderness in the front of the shoulder and around the joint, a large bump over the joint on the affected shoulder, or a clicking noise as the shoulder moves. Treatment can include rest, anti-inflammatory medications, physical therapy, cortisone injections, or a resection arthroplasty for serious injuries.
Acromioclavicular (AC) Joint Separation (Shoulder Separation)
The AC joint is where the collarbone meets the highest point of the shoulder blade. The most common cause for separation of the AC joint is from a fall directly onto the shoulder. The fall injures the ligaments that surround and stabilize the AC joint, causing a separation of the collarbone and wingbone. This injury can range from a little change in configuration with mild pain, to deforming and very painful. Nonsurgical treatment used may include a sling, cold pack, and medication. Surgery may become an option if the pain persists and the injury is severe.
Bankart Tear Repair (Anterior/Posterior)
The Bankart lesion is a specific injury to a part of the shoulder joint called the labrum. The labrum is a cuff of cartilage that forms a cup for the end of the arm bone to move within. This cuff allows the shoulder joint to be much more stable and provides a range of shoulder movement. When the labrum of the shoulder joint is torn, the stability of the joint is compromised. A Bankart lesion occurs when an individual sustains a shoulder dislocation. As the shoulder pops out of the joint, it often tears the labrum. Symptoms usually include a sense of instability, repeat dislocations, catching sensations, and an aching of the shoulder. Treatment may include rest, use of a sling, physical therapy, or surgical repair.
Biceps tendonitis, also called bicipital tendonitis, is inflammation in the main tendon that attaches the top of the biceps muscle to the shoulder. The most common cause is overuse from certain types of work or sports activities. Symptoms usually include a feeling of a deep ache directly in the front and top of the shoulder, weakness in attempts to bend the elbow, or a catching/slipping sensation near the top of the biceps muscle. Treatment may include rest, anti-inflammatory medication, physical therapy, or cortisone injections. Surgery for a severe condition may include an acromioplasty or biceps tenodesis.
Glenoid Labrum Tear (Shoulder Joint Tear)
The arm bone rests in a shallow socket in the shoulder blade called the glenoid. Around the socket there is soft fibrous tissue called labrum to help stabilize the joint. Injuries to the tissue rim surrounding the socket is called a glenoid labrum tear, also known as a shoulder joint tear. This injury can occur from either acute trauma or repetitive shoulder motion. Symptoms may include pain with overhead activities, a “popping” of the shoulder, instability, loss of strength, or a decreased range of motion. Treatment options include anti-inflammatory medication, physical therapy and rest. If the tear is major, arthroscopic surgery may become an option.
Humeral Avulsion Glenohumeral Ligament (HAGL)
HAGL is a surgical method used to repair shoulder instability. Traumatic forces applied to the shoulder during sports activities are often the cause of this instability. The surgery may be either conducted through an open incision or an arthroscopic procedure. An anterior approach to the procedure is typically more common than a posterior approach.
Proximal Biceps Tendon Rupture
Tendons attach muscle to bone. The biceps muscle in the upper arm splits near the shoulder into a long head and a short head. Both attach to the shoulder in different places. These connections help the muscle stabilize the shoulder, rotate the lower arm, and accelerate or decelerate the arm during overhead motions. These tendons may become torn due to an unexpected force, a previous injury, or wear-and-tear from age. Symptoms may include a sharp pain in the upper arm, an audible snap, a bulge in the upper arm above the elbow, bruising from the middle of the upper arm down toward the elbow, or pain and tenderness at the shoulder. Treatment usually includes ice, nonsteroidal anti-inflammatory medication, rest, or strengthening exercises. For a complete tear, tenodesis surgery may be necessary to reattach the tendon.
Rotator Cuff Tear with or without Repair/Surgery
The rotator cuff is the network of four muscles that form a covering around the top of the upper arm bone (humerus). The rotator cuff holds the humerus in place in the shoulder joint and enables the arm to rotate. Most tears are the result of overuse of these muscles and tendons over a period of years. Symptoms of a torn rotator cuff may include thinning of muscles about the shoulder, pain when lifting the arm, pain when lowering the arm from a fully raised position, weakness, or a crackling sensation. Treatment options include rest, a sling, anti-inflammatory medication, steroid injection, physical therapy, or surgery. Surgical treatments include an arthroscopic repair, mini-open repair, or an open surgical repair.
Rotator Cuff Strain
The rotator cuff is the network of four muscles that form a covering around the top of the upper arm bone (humerus). The rotator cuff holds the humerus in place in the shoulder joint and enables the arm to rotate. A rotator cuff strain is when the arm cannot move freely in a wide range of motion without feeling pain because one or more tendons are strained. Symptoms may include pain at the top and front of the shoulder, pain that worsens at night, loss of movement, swelling, weakness, or pain while reaching and throwing. Treatment may include physical therapy, anti-inflammatory medication, cortisone injections, or surgery for a severe strain.
The shoulder joint is the body's most mobile joint, making it an easy target for dislocation. A partial dislocation is when the head of the upper arm bone is partially out of the socket, and a complete dislocation means it is all the way out of the socket. Symptoms of shoulder dislocation include swelling, numbness, weakness, and bruising. Treatment of this injury includes closed reduction, when a doctor will place the ball of the upper arm bone back into the joint socket. Severe pain stops almost immediately once the shoulder joint is back in place.
Shoulder Impingement (Thrower's Shoulder)
Shoulder impingement, also known as thrower's shoulder, is the most common cause of shoulder pain, and results from pressure on the rotator cuff. The pain may be due to inflammation of the bursa overlying the rotator cuff or a “tendonitis” of the cuff itself. Symptoms develop slowly and usually are not reported until an advanced stage is reached. These symptoms include pain radiating from the front of the shoulder to the side of the arm, sudden pain with lifting and reaching movements, or athletes having pain in overhead sports while throwing or serving a tennis ball. Treatment options include physical therapy, cortisone injections, nonsteroidal anti-inflammatory medication, subacromial decompression or anterior acromioplasty.
Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. A shoulder may become instable due to a shoulder dislocation, repetitive strain, or multidirectional instability. Symptoms can include pain caused by shoulder injury, repeated shoulder dislocations, repeated instances of shoulder giving out, or a persistent sensation of the shoulder feeling loose, slipping in and out of the joint, or just “hanging there”. Nonsurgical treatment may include activity modification, nonsteroidal anti-inflammatory medication, and physical therapy. Surgical treatment may include arthroscopic or open surgery to repair the torn or stretched ligament.