The shoulder has the most mobility of any joint in the body. Even small injuries can result in significant loss of use the shoulder. One of the most common injuries to the shoulder is to the Rotator Cuff. The Rotator Cuff consists of 4 separate muscles and can be injured by overuse, repetitive smaller injuries, or a single larger injury. Most injuries will result in either weakness, stiffness, or instability of the joint. Because of the significant number of muscles around the joint, rehabilitation plays an extremely important role in getting back in the game. When surgery is needed to heal injury, minimally invasive techniques are utilized to reduce the length of disability and allow faster return to activities.
AC JOINT Injury (the separated shoulder)
The acromioclavicular (AC) joint is the meeting point of the acromion and clavicle bones in the shoulder area, often indicated with a visible bump in the area. AC joint injuries often occur as a result of a fall or other trauma, which may cause the acromion to move or separate from the clavicle, or cause the ligaments to be stretched or torn.
While conservative treatment is often used first for AC joint injuries, surgery may be required for injuries that are more severe or those that cause prolonged pain.
A labrum is a protective cuff of cartilage found in ball and socket joints like the hip and shoulder. They provide more stability, cushioning and a full range of motion for these shallow joints. A tear in the labrum, known as a labral tear or Bankart tear, is caused by injury or overuse and can lead to pain and “catching” of the joint while moving. A dislocation of the shoulder is a common cause of labral tears and can result in the shoulder feeling unstable or sliding out of joint.
After a shoulder dislocation, physical therapy is commonly used to help restore motion, reduce pain and regain strength. The labrum has a very poor ability to heal on its own. Labral repair surgery, or Arthrscopic Bankart Repair, aims to repair unstable shoulders with arthroscopic surgery.
Rotator Cuff Repair
The rotator cuff is the thick band of muscles and tendons that covers the top of the upper arm and holds in it place, providing stability and a full range of motion to the shoulder joint. It is made of four muscles and their associated tendons. These tendons can become partially or completely torn as a result of a rotator cuff tear. A rotator cuff tear most often occurs as a result of overuse of the muscles over a long period of time. As a result, this condition is most common in patients over the age of 40. It may also occur as a result of a traumatic injury, and involves pain when lifting or lowering their arm, muscle weakness and atrophy.
Many rotator cuff tears can be treated through nonsurgical methods that focus on relieving pain and restoring function to the shoulder. These may include:
- Use of a sling
- Anti-inflammatory medication
- Steroid injections
- Physical therapy
Surgery may be recommended for tears that cause severe pain or that do not respond to more conservative treatments. The type of surgery performed depends on the size and location of the tear, but often involves trimming torn edges or suturing the tendon back together.