If your shoulder pain keeps you from doing the things that you love to do, Ministry Medical Group’s Orthopedic Department can diagnose your problem and offer you surgical and non-surgical solutions to help you get your life back.
Rotator cuff injuries are the most common cause of shoulder pain.
Non-surgical procedures like cortisone injections, medication and physical therapy can help you build the strength of the rotator cuff muscles while reducing inflammation. This can relieve pain.
When non-surgical treatments do not bring relief, you can turn to the skills of orthopedic surgeon Marcus Haemmerle, MD for shoulder procedures, including reverse total shoulder replacement surgery.
You may be a candidate for minimally invasive surgery to repair a tendon which has torn away from the attachment site or you may need a complete reverse shoulder replacement, which allows the deltoid muscle to provide the force necessary to raise the arm in the absence of a rotator cuff.
Rotator Cuff Injury
The rotator cuff is a group of muscles and tendons deep within the shoulder that control the fine motions of the shoulder joint and are involved in all shoulder activities particularly reaching and lifting. Often times, rotator cuff injuries involve inflammation within or around the tendons resulting in tendonitis and/or bursitis. This type of injury can be treated successfully with a course of physical therapy and/or injection.
The tendons of the rotator cuff can sometimes tear off their attachment in the shoulder. This can be “acute” after an injury such as a fall, or “chronic” which occurs slowly over time. This may cause significant pain and weakness. A MRI is often obtained to visualize the tendons to determine if there is a tear and how extensive it may be.
Rotator cuff tears may become less painful and less limiting through rehabilitation with a physical therapist, but many times, they require surgery to reattach the tendon to the bone.
Surgery can be done either using minimally invasive arthroscopic technique or through an “open” incision. The orthopedic surgeons at Ministry Medical Group perform this procedure arthroscopically. The procedure is done as an outpatient. The patient is typically placed into a sling for 2-6 weeks. Therapy begins around week 2 and patients are taken through a step-wise rehab program that gives the tissues time to heal, regain range of motion, and ultimately strength and function. It may take up to a total of 4-6 months to completely recover.
Although not as common as arthritis of the lower extremity, shoulder arthritis does occur and can be very painful and debilitating Today, about 53,000 people in the U.S. have shoulder replacement surgery each year, according to the Agency for Healthcare Research and Quality. Shoulder arthritis can be easily diagnosed using examination techniques and x-rays. It is initially treated with activity modification, anti-inflammatories, gentle exercise, and possibly cortisone injection.
If non-surgical management fails, the patient may benefit from shoulder replacement surgery. Similar to hip and knee replacement, shoulder replacement surgery involves removing the arthritic portions of the joint and replacing them.
Some patients who have a significant rotator cuff tear in addition to the arthritis may benefit from a Reverse Shoulder Replacement that can improve motion and function in this select group of patients.
A patient who has shoulder replacement surgery can expect a short hospital stay, limited use of their arm in sling for specified period of time, and a gradual therapy program to regain motion and strength.
Sometimes, shoulder pain can be caused by impingement of the rotator cuff under the overlying bone. This can potentially result in recurrent irritation of the rotator cuff tendon. Often times, non-surgical treatment with a course of physical therapy and/or injection can resolve the symptoms. If this conservative care is unsuccessful, many patients find relief through decompression surgery in which more space is created for the tendon to avoid continual impingement. This surgery is done arthroscopically as an outpatient. There are very few restrictions after surgery and range of motion, strength, and function are allowed as pain tolerates.
The shoulder is designed to provide us with an extensive range of motion in order to position our hands. This mobility also makes the shoulder the most unstable joint of the body. Either shoulder instability can occur through a traumatic injury such as a dislocation or it can develop through repetitive activities in extreme positions (swimming, gymnastics, etc). Many times this causes pain and a feeling of the shoulder slipping out of place.
The treatment depends on the cause of the instability, but typically involves a focused therapy program to strengthen the muscular stabilizers of the shoulder. If this treatment fails, surgery to repair and/or tighten the ligament structures can be performed. This is done as an outpatient and often times using the arthroscope.