Research Articles

Factors Affecting Rotator Cuff Healing

A review of current literature identified positive and negative factors regarding rotator cuff repair healing. Negative healing factors include larger tears, excessive fatty tissue in the repair, muscle atrophy (or lack of muscle mass), and older age due to a poor healing environment. Factors that do not affect healing outcomes are the type of surgical technique used or the use of platelet-rich plasma. Evidence is conflicting for the type of rehabilitative postoperative protocol used.Read more

Shoulder Pain in Spite of Treatment

Pain can be a good thing. For one thing, it is protective. It is a normal response of the body when there is an injury. The body uses pain to protect itself while it is healing. But in time, the healing processes are completed and the pain goes away. That is the normal healing response.Well, not always. In some people, a persistent pain response gets turned on in the central nervous system and it doesn’t get turned off. The result is chronic pain from this phenomenon we call central hypersensiti…Read more

Evaluation and Causes of Scapular Dyskinesia

The scapula (more often referred to as your “wing bone” or shoulder blade) is a key reason why your shoulder and arm move and glide smoothly and easily. Not only does the scapula give the shoulder muscles a base of operation, it also acts as a moving platform for the shoulder ball-and-socket joint to function properly.In short, the scapula is a silent partner with the shoulder in moving the arm in any and all directions. Any injury that affects the shoulder is going to also affect the scapula. T…Read more

Pain or Weakness After Rotator Cuff Repair

Sometimes patients don’t get the expected results after arthroscopic rotator cuff repair. Instead of pain relief, increased shoulder motion, and restored function, they experience persistent pain and/or weakness. Why does this happen and what can be done about it? These are the two questions surgeons from the New York University Hospital for Joint Diseases attempt to answer in this article.Arthroscopic repair of the rotator cuff is actually a very reliable technique. Most patients (more than 90 …Read more

Update on Hill-Sachs Shoulder Lesion

Traumatic injury to the shoulder with recurrent dislocation can be caused by a Hill-Sachs lesion or defect. This lesion is a fracture of the round head of bone at the top of the humerus (upper arm bone). Usually, this injury occurs when a person has his or her arm cocked back in a ball throwing motion. The shoulder is abducted (moved away from the body) and externally rotated.In this position, the head of the humerus moves forward. With enough force and/or load, the forward movement can overcome…Read more

Tissue Engineering in the Treatment of Massive Rotator Cuff Tears

Large, full-thickness tears of the rotator cuff can be very challenging for patient and surgeons alike. Loss of motion and loss of strength leads to loss of function for the patient. Finding a way to repair the problem without re-tears and surgical failure is a goal surgeons strive for.In this report, the successful use of a regenerative tissue matrix for 24 patients with massive irreparable rotator cuff tears is described. You may be wondering what is a regenerative tissue matrix. This is the u…Read more

Good Results with Joint Resurfacing for Shoulder Arthritis

Today’s patients with shoulder arthritis are fortunate to have several surgical options. If necessary, a total shoulder replacement can be done. But even better is a procedure called shoulder resurfacing that makes it possible to get a “new” shoulder without losing much bone and without replacing the whole thing. Instead the damaged surfaces of the joint are covered with a resurfacing prosthesis or implant.In addition to saving bone there are many other advantages to the resurfacing technique. F…Read more

Surprising Findings in 3633 Adults with Shoulder Dislocation

Injuries traumatic enough to dislocate the shoulder can also cause other additional damage to the surrounding soft tissues and bone. Recognizing how often this happens is important in making sure surgeons assess each shoulder carefully for other injuries.In order to find out how often associated injuries occur along with traumatic anterior (forward direction) shoulder dislocations, the records of over 3600 patients were reviewed. The researchers looking for this information relied on ultrasound …Read more

Report on a Rare But Devastating Problem After Arthroscopic Shoulder Surgery

Imagine you are in your late teens or a young adult in your 20s. You have a simple arthroscopic surgery on your shoulder for a rotator cuff tear or unstable shoulder joint. Three months later, the entire surface of your shoulder joint (called the articular cartilage) is destroyed. Deep shoulder pain with rapid loss of motion (and then function) are the main symptoms of this problem.You have a condition called postarthroscopic glenohumeral chondrolysis or PAGCL. Your shoulder has gone from your c…Read more

New Treatment Approach to Trigger Points

Star Trek lovers are familiar with the “Vulcan nerve pinch”, a technique used by Dr. Spock to cause someone to lose consciousness. The technique was to pinch a pressure point at the base of the victim’s neck but in fact, it’s likely the pinch was in fact a trigger point (TrP) of the upper trapezius muscle. The upper trapezius muscle is the muscle along the top of the shoulder at the base of the neck (where the neck and shoulder meet).Trigger points are defined as hyperirritable areas of tenderne…Read more

Low-Dose Steroid Injections Recommended for Shoulder Pain

In today’s medical world, physicians are moving more and more toward treatment that is evidence-based. For the patient, this means there is reasonable “proof” that the proposed treatment is going to work. Some treatment is easier to study and evaluate than others.For example, in this study, surgeons compared the results of using a low dose (20 mg) steroid injection versus high-dose (40 mg) injection for patients with shoulder pain. They included a third (control) group who received a placebo inj…Read more

Treating the Unstable Shoulder Successfully

Shoulder problems are common with a wide range of symptoms and treatments. One diagnosis that continues to challenge orthopedic surgeons is called multidirectional instability. This diagnosis is defined by instability of the shoulder in two (or more) directions. That sounds simple enough but there are shades of instability. And instability must be separated out from laxity (natural looseness of the ligaments).In this article, three surgeons from three separate educational programs combine their …Read more

Orthopedic Surgeon Compares Two Surgical Techniques for AC Joint Pain

Dr. William J. Robertson of Massachusetts General Hospital in Boston offers the results of his own study of surgery for acromioclavicular (AC) joint pain. Comparisons were made in terms of results (shoulder function, patient satisfaction, pain) between two groups. The first group had an open incision approach for this procedure. The second group had all all-arthroscopic approach with very small puncture holes to insert the arthroscope rather than full sized incisions.The acromioclavicular joint …Read more

Risk Factors for Recurrent Shoulder Dislocations

Having one shoulder dislocation is scary enough. But imagine having the shoulder pop out of the socket again — or again and again. Recurrent shoulder dislocations is the subject of this study. Orthopedic surgeons from the Netherlands add their efforts and expertise to many others looking for risk factors for recurrent shoulder dislocations.Previous studies have pointed to young age, male sex, and long delay between injury and surgery as the main risk factors for recurrent shoulder dislocations….Read more

Evidence Based Treatment for Shoulder Impingement

Can’t raise your arm up overhead without pain? Only able to go so far without that old familiar shoulder pain showing up? Only able to move the arm out to the side or forward up to a certain point and then it hurts? Move it a little further and the pain goes away? What about pain at night when you lie on that side? If you answered yes to any of these questions, you may have a problem referred to as subacromial impingement syndrome (SIS).In this condition, the soft tissues of the shoulder (e.g., …Read more

New Advances in the Treatment of AC Joint Injuries

The acromioclavicular (AC) joint has come back into sharp focus in recent days. Because of changes in surgical technology, new advances have been made in the surgical treatment of this problem. You might know this condition by its more commonly used name: shoulder separation.A shoulder separation is a fairly common injury, especially in certain sports. Most shoulder separations are actually injuries to the acromioclavicular (AC) joint. The AC joint is the connection between the scapula (shoulder…Read more

Using Size of a Rotator Cuff Tear to Determine Surgery

When is surgery indicated for a rotator cuff tear? Usually surgery is scheduled when the patient has completed a rehab program and is still experiencing significant pain and loss of motion. If loss of motion (and therefore function) depends on the size of the tear, what is the critical tear stage that just won’t respond to rehab and requires surgery?That is the focus of this cadaver study from the Orthopaedic Biomechanics Laboratory in California. They started with the hypothesis that there is a…Read more

What Do You Expect of a Shoulder Replacement

Every year more than 35,000 people in the United States have a total shoulder replacement (TSR) for painful, limiting osteoarthritis. What are these patients’ expectations? Are they satisfied after surgery? And are their expectations linked with their satisfaction? These are the questions surgeons at the Hospital for Special Surgery in New York City asked 98 of their total shoulder patients.It might seem obvious that expectations of a shoulder replacement would range from relief of pain, better …Read more

Deciding When Rotator Cuff Surgery Must Be Redone

Surgeons everywhere are grappling with the fact that rotator cuff repairs aren’t always successful. In this review article, surgeons from the well-known San Antonio Orthopaedic Group in Texas discuss the causes of arthroscopic rotator cuff repair failure and how to decide when revision surgery is advised.Using drawings, patient photos, written descriptions, and arthroscopic views, the authors cover a wide range of information about arthroscopic rotator cuff repair revision procedures. They inclu…Read more

Are Shoulder Bursitis and Rotator Cuff Problems Separate

The list of things that can cause mechanical shoulder pain is long and getting longer. By mechanical we mean anatomic factors such as compression or degeneration. The term mechanical shoulder pain leaves out problems like infection, tumors, or other systemic causes.One of the most common causes of mechanical shoulder pain is a problem labeled subacromial impingement syndrome or SIS. The term impingement tells us something is getting pinched. Subacromial impingement syndrome occurs when the rotat…Read more

Failure to Heal After Rotator Cuff Surgery

Austrian surgeons lend their expertise to the question of why there is such a high failure rate after rotator cuff surgery. In an analysis of 95 patients over an 11 year period of time, they found an overall failure rate of 33 per cent. Most of those weren’t really retears but rather a failure to heal. Their observations as reported in this article are very similar to what other surgeons are finding in other locations.Each one of the patients in this study was treated with a mini-open arthroscop…Read more

Effects of Platelet-Rich Plasma on Rotator Cuff Repairs

Tendon healing after rotator cuff repairs is a slow process. After surgery, patients are in a special abduction sling (looks like a square-shaped pillow under the arm). They have to wear this contraption for four to six weeks.Some passive movements are allowed while wearing the brace but not all. It isn’t until the patient is weaned off the sling that active motion can begin. Then it takes another four to six weeks before strengthening exercises can begin. And finally, for those who are engaged …Read more

Rotator Cuff Retears Remain High

Surgeons know that massive (very large) rotator cuff tears are at great risk of retears. Studies show a retear rate as high as 94 per cent. Not all of those retears are symptomatic but that is still not a very successful outcome. What can be done to improve the results of surgery for large rotator cuff tears?In this study, surgeons take a look at the timing of the tears. They hoped to see if the timing of the tears might offer some clues as to the reason for the tears. Tears that occur early aft…Read more

Reasons For Failed Rotator Cuff Tear Healing After Surgery

Surgeons around the world are trying to solve the mystery of rotator cuff tear failure after surgical repair. In this study, researchers at the Seoul National University College of Medicine in Korea join the search.Multiple studies have shown that the failure rate after rotator cuff repair ranges from 20 to 94 per cent. Although there are many potential risk factors, the authors of this study were looking for prognostic factors. Prognostic factors are patient characteristics that when present pr…Read more

Treatment for Deep Infections After Shoulder Replacement

Shoulder replacements (called shoulder arthroplasty) are not done as often as hip and knee replacements. But more and more older adults are taking advantage of this available surgery. As with any joint replacement, complications and problems can arise. One of those problems is deep joint infection. Treatment for this complication is the subject of a study at Massachusetts General Hospital in Boston.The authors (three highly experienced fellowship-trained orthopedic surgeons) took a look back at …Read more

Time To Stop Using the Term Shoulder Impingement Syndrome

Shoulder problems labeled shoulder impingement syndrome often make it difficult to raise the arm overhead. Patients are able to raise the arm forward or out to the side to a certain point. But then the arm won’t go any further without help from the other hand lifting it up.Another sign of shoulder impingement is pain that occurs when raising the arm from about 90 degrees until the person gets the arm up to around 120 degrees of motion. Then the arm continues on its merry way to the top, no probl…Read more

Current Concepts in the Treatment of Rotator Cuff Disease

More adults staying active and working longer before retiring can mean a greater risk of rotator cuff (RTC) disease and tears. Improved technology and surgical tools have led to an increased number of rotator cuff surgeries being done arthroscopically. This article was written in order to help surgeons keep up with all the changes.The four tendons of the rotator cuff attach to the deep rotator cuff muscles. This group of muscles lies just outside the shoulder joint. These muscles help raise the …Read more

Surgeons Shifting Toward Arthroscopic Shoulder Surgery

The debate over whether arthroscopic surgery is superior to open incision for the shoulder continues. In this fresh look, records from the American Board of Orthopaedic Surgery (ABOS) were used to look for trends in surgeon practice. Starting in 2003 and going through 2008, data was analyzed to compare these two approaches when doing a procedure called the Bankart Repair for shoulder instability.Shoulder instability means that the shoulder joint is too loose and is able to slide around too much …Read more

Should You Get a Steroid Injection for a Frozen Shoulder

Adhesive capsulitis, sometimes called a “frozen shoulder” still baffles physicians and scientists alike. No one knows what really causes it — or how to treat it. Women, age over 40, and shoulder injuries (trauma) head the list of possible risk factors.But adults of both sexes (male and female) who have serious health problems such as diabetes, heart disease, stroke, or thyroid conditions have a higher incidence of adhesive capsulitis than the general adult population.The problem comes on gradua…Read more

Uncommon Shoulder Dislocations

Shoulder dislocations are not uncommon. Most dislocate forward (called an anterior dislocation). Less often are the posterior shoulder dislocations. As the name suggests, a posterior shoulder dislocation occurs when the head of the humerus (upper arm bone) pops backwards out of the shoulder socket.What causes posterior shoulder dislocation and who is affected most often? How is it treated and what are the results? These are the questions answered by this study.Orthopedic surgeons from The Should…Read more

Scapular Winging: What Is It and How Is It Treated

Have you ever heard of scapular winging? If not, you might recognize it if you saw it — it’s the way the shoulder blade sticks out when it’s not where it’s supposed to be. And it’s supposed to lie flat against the back while gliding up and down/in and out with arm movements.Sometimes you see scapular winging in young children. They haven’t developed the full strength of the arms and upper back yet. If they are skinny and all arms and legs, you might not think twice about the scapulae (plural fo…Read more

Problems Unique To the Reverse Total Shoulder Replacement

Shoulder joint replacement surgery (also called shoulder arthroplasty) is a great treatment for many people with shoulder pain from arthritis. But patients who don’t have enough muscle function to stabilize the joint may not be able to benefit from the traditional implant design — one that mimics the normal anatomic shoulder.Instead, a different type of shoulder replacement, called reverse shoulder replacement has been developed. And it has worked so well, surgeons have expanded the number and …Read more

Bony Defects with Chronic Shoulder Dislocations

If the shoulder dislocates one time, it may be possible to rehab the muscles and regain normal motion and strength with no further problems. But a second or third (or more) dislocation leads to an unstable joint (also known as shoulder instability).At that point, there can be (and there often is) damage to the bone forming the joint. The defect may be in the head of the humerus (upper arm bone) or the glenoid (socket side of the joint). In traumatic dislocations, damage may occur in both places….Read more

A Different Look at Rotator Cuff Tears

In this study, orthopedic surgeons from Germany take a closer look at an unusual rotator cuff tear. The rotator cuff is formed by the tendons of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. Most of the time, the supraspinatus and/or infraspinatus are affected by a rotator cuff tear. Much less often, the teres minor and subscapularis are torn.An isolated tear of the subscapularis tendon in 21 patients treated with arthroscopic surgery is the focus of this report…Read more

Review of Posterior Shoulder Instability

In this article, a surgeon from the University of Michigan Medical School presents a review of a shoulder condition known as posterior instability. The term posterior instability tells us the shoulder has too much slide, glide, or movement backwards. Subluxation (partial dislocation) and even complete dislocation are often the end results of posterior instability.Another name for this condition is glenohumeral instability. Glenohumeral refers to the shoulder joint where the round head at the top…Read more

Popeye Deformity After Arthroscopic Shoulder Surgery

There are many different causes of shoulder pain. Any problem inside or around the joint can create pain. One of the more common sources of shoulder pain occurs when there is some type of pathology of the long head of the biceps tendon (LHBT).The biceps tendon attaches between the elbow and the shoulder. It helps you lift your arm straight up and bend the elbow. There are two parts: the short- and long-heads of the biceps. Each one attaches in a slightly different place on the arm. Pathology of …Read more

Can A Rotator Cuff Tear Repair Itself?

Trying to decide if you should have that rotator cuff surgery done? The findings from this study might help you. Many adults who have a rotator cuff tear consider waiting to see if the shoulder will heal on its own without surgery. The goal of this study was to observe over time what happens to full-thickness rotator cuff tears that are treated conservatively (nonoperative treatment).There has always been a question whether rotator cuff tears can heal without surgery. It is clear that painful sy…Read more

Coracoid Impingement

Some Information on the Rare Problem of Coracoid Impingement Raising your arm up over your head can be a piece of cake. Smooth, easy flow of motion is effortless. But to accomplish this movement, there is an entire shoulder and upper quadrant complex at work. The scapula (shoulder blade), clavicle (collar bone), and glenohumeral (shoulder joint) must slide and glide with just the right timing.Part of the shoulder complex includes the soft tissue structures surrounding and attaching to various p…Read more

Shoulder Joint Surface Destroyed with Injection of Local Anesthetic

Surgeons have found that reducing pain after shoulder surgery helps speed up recovery. As a result, more aggressive pain control measures are now in use. One of those methods is to inject a local anesthetic (marcaine, lidocaine, bupivacaine) directly into the joint after surgery.This study shows that the practice of postoperative infusion of marcaine actually contributes to the destruction of the joint surface. The result is a condition called chondrolysis. Chondrolysis is defined as a generaliz…Read more

Understanding Rotator Cuff Disease

Athletes who injure their shoulders aren’t the only ones to have rotator cuff tears (RCTs). Age-related degeneration is also a factor, especially for adults over age 60. Researchers are trying to understand the pathogenesis (process of disease) behind rotator cuff degeneration.In this report, orthopedic surgeons from the Philadelphia Hand Center use the case of a 63-year-old man with shoulder pain as a result of an injury to examine the current scientific evidence explaining shoulder rotator cuf…Read more

Athletes with Subscapularis Tendon Tear Can Return to Full Sports Activity

Normal shoulder movement and function requires that all parts of the rotator cuff are intact and working together. If even one of the four muscle/tendon units that make up the rotator cuff is damaged, there is an imbalance in the force and load placed on the joint. The result is abnormal joint biomechanics (movement).The largest muscle in the rotator cuff is the subscapularis. This muscle helps rotate the shoulder and arm inward (internal rotation). The subscapularis helps stabilize the shoulder…Read more

Rare But Serious Injuries of the Collarbone

The place where your collarbone meets the breast bone is called the sternoclavicular (SC) joint. Another name for the breast bone is the sternum. The anatomical term for the collarbone is clavicle, hence the name for the joint between these two bones: sternoclavicular or SC joint.Injuries to the SC joint are rare but when they do occur, the results can be very serious. The close proximity of structures such as the trachea, esophagus, lungs, blood vessels, and nerves to the arms makes this injury…Read more

Comparing Results of Shoulder Stabilization Surgery

When the shoulder dislocates repeatedly, it’s time to get some serious help. That’s when the surgeon steps in and provides a stabilization procedure. Special suture anchors are used to repair damage to the soft tissue. The surgeon can use either an open incision approach or an arthroscopic method to accomplish the task.Sometimes the stabilization doesn’t hold and the shoulder re-dislocates. Once again, the surgeon can go back in and use surgical means to restabilize the joint. Invariably, the qu…Read more

AAOS Publishes Clinical Practice Guidelines for Rotator Cuff Tears

It seems like everybody knows someone who has had a rotator cuff problem. With over half a million news rotator cuff injuries or tears each year, it’s highly likely you may find yourself in this same group. Older adults (65 years old and older) have the highest incidence of rotator cuff tears. Research shows that more than half of the adults in this age group have a rotator cuff tear — many without even knowing it!With the aging of the many Baby Boomers (folks born between 1946 and 1964), it’s …Read more

New Technology for the Surgical Treatment of Clavicle Fractures

Severe fractures of the clavicle (collar bone) can be tricky to treat. Advances in digital X-rays, surgical tools, and techniques have made it possible to now treat this problem surgically. Years ago patients would have been put in a sling and the body had to heal itself as best as possible. Deformity and loss of function were often the result with conservative care.Now, the use of a flexible intramedullary (IM) device has changed all that. Even collar bones that are broken into many pieces can …Read more

The Challenge of Shoulder Problems in Young Adults

Young, active adults with shoulder problems may not want a shoulder replacement as the solution to their pain and loss of motion. And, at the same time, they may not be a good candidate for such a procedure. The surgeon’s challenge is to find other ways to treat this problem called glenohumeral arthrosis.The glenohumeral joint is what the lay person would call the shoulder joint. Arthrosis means damage has occurred to the joint surface. The first step in managing glenohumeral arthrosis requires …Read more

New Information on the Reverse Shoulder Implant

Along with hip and knee joint replacements, shoulder replacement has become increasingly popular for people with pain and loss of motion from arthritis. But the shoulder is a bit different from the hip and knee. A tear in the muscles around the shoulder (called the rotator cuff) can complicate things.Replacing the joint without an intact, functioning rotator cuff may not improve the situation. Without the muscles to hold the joint in place and move the arm, the surgery may not be successful. Sur…Read more

A New Look At Rotator Cuff Tears

Why are some rotator cuff tears (RCTs) painful while others are not? And what makes them convert from a pain free (asymptomatic — without symptoms) to a symptomatic tear? If we knew the answers to these questions, we might be able to prevent rotator cuff tears from getting worse and becoming painful.Identifying factors linked with pain development in previously asymptomatic rotator cuff tears is the subject of this article. It’s actually an early report on the work being done by a group of orth…Read more

What Can Be Done About Adhesive Capsulitis?

Many adults (mostly women) between the ages of 40 and 60 years of age develop a strange case of shoulder pain and stiffness called adhesive capsulitis. You may be more familiar with the term frozen shoulder to describe this condition. But as we find out in this review article on the problem, frozen shoulder and adhesive capsulitis are actually two separate conditions.What separates these two diagnoses? Both show up looking like a painful, stiff shoulder. But adhesive capsulitis (as its name impl…Read more

Help with That Chronic Shoulder Pain?

In this article, a medical student, chief resident (orthopedic surgeon), and associate professor of orthopedic surgery at Brown University team up. Together, they review the current evidence about treatment for chronic shoulder pain. Whether it’s from a rotator cuff tear, arthritis, a frozen shoulder, or a labral tear, the information in this update will guide those looking for a little help for their ongoing shoulder pain.Read more

When Rotator Cuff Surgery Fails

What To Do When Your Rotator Cuff Surgery Fails Rotator cuff tears are a common cause of shoulder pain, stiffness, weakness, and loss of motion and function. Treatment starts with conservative (nonoperative) care in Physical Therapy and/or with steroid injections. But in some cases, conservative care fails to reduce the painful symptoms or restore normal motion. That’s when surgery may be needed.The rotator cuff is a group of four muscles with their tendons that surround the shoulder joint givi…Read more

Changes in Treatment of Collar Bone Fractures

In this report on clavicular fractures, surgeons from Tulane University in New Orleans review the various surgical options available and when to use them. Surgeons will find this information helpful given the rise in number of clavicular fractures in the last 10 years. Falls in older adults and high-impact sporting injuries (skiers, snowboarders) in young patients make this one of the most common shoulder injuries.What does the research show about why surgery is needed, when surgery is required,…Read more

Surgically Treat Complex Shoulder Fractures

When it comes to complex fractures of the humerus (upper arm) in older adults, surgeons really have their work cut out for them. There are so many things to keep in mind. A complex fracture usually means the bone is broken into three or four parts. Putting the pieces back together in a way that promotes recovery and return to full function can be a real challenge.The age of the person matters because people over age 70 often have low bone mass and slow healing. The way in which the bone has frac…Read more

Shoulder Surgery in the Development of Osteoarthritis

The Role of Shoulder Surgery in the Development of Osteoarthritis Many studies have been done in gaining understanding of shoulder dislocations. For example, surgeons have asked the question: can they get better without surgery? If surgery is done, will arthritis set in sooner than if there never had been an injury? Another area of investigation has been the role of surgery as the cause of arthritis after repeated anterior (forward) shoulder dislocation.In this study, a different approach was t…Read more

Surgery Helpful in Correcting Fractured Clavicle in Adolescents

Broken collarbones (fractured clavicles) are fairly common among adolescents. They make up about 15 percent of all fractures in this age group. Most of these fractures happen in the midshaft region and about half are displaced, or moved out of place. Most often, clavicle fractures are not treated with surgery, usually because doctors used to feel that it wasn’t too much of an issue if the bones didn’t heal exactly in place. However, the doctors did not perform studies to follow patients to see i…Read more

Can Shoulder Surgeries Be Combined in Middle-Aged Adults?

When it comes to middle-aged adults with shoulder injuries, surgeons are sometimes left scratching their heads puzzled over what to do. Should a full-thickness (complete rupture) of the rotator cuff be repaired at the same time a SLAP lesion is present? SLAP refers to the superior labral anterior-posterior structure around the shoulder joint. Superior anterior-posterior tells us the location of the damage: top of the shoulder socket from front to back. The structure that is torn is the labrum, a…Read more

Treating Patients with Multidirectional Shoulder Joint Laxity

Have you ever wondered how some people can put their leg behind their head or use their clasped hands together like a jump rope? How can anyone move like that without dislocating a joint? Most likely those individuals have something they are born with called joint hyperlaxity. The condition is considered congenital because it is present from birth throughout life.Joint hyperlaxity means the soft tissues around the joint that usually hold it in place are extra long and very elastic. Without those…Read more

Clinical Practice Guidelines for Shoulder Arthritis

Orthopedic surgeons continue to seek evidence to guide all aspects of patient care. In this document, the American Academy of Orthopaedic Surgeons (AAOS) offers 16 guidelines for clinical practice in the care of patients with shoulder osteoarthritis.There is a wide range of issues related to shoulder arthritis. The fact that the shoulder joint can be replaced with a joint replacement (implant) has changed the way patients are treated. Younger patients with shoulder arthritis has helped push the …Read more

New Advice For Patients After Rotator Cuff Surgery

Any time the rotator cuff is torn and surgery is required to repair or reconstruct the damage, patients are placed in a sling postoperatively to protect the healing tissue. Patients are then given a standard set of shoulder exercises called Codman’s or pendulum exercises to keep the shoulder joint from getting stiff or freezing up.Read more

Anatomy of Degenerative Rotator Cuff Tears

Thinning and tearing of the rotator cuff is a common problem with aging. Efforts to find out how and why this happens have not pinpointed the exact cause or location of these tears.In this study from Washington University in St. Louis, ultrasonograms are used to take pictures and measure the location, size, and extent of rotator cuff tears in 360 adults from 36 to 90 years old. They established some fairly narrow inclusion/exclusion criteria (who could be included, who could not).For example, no…Read more

What Is That Snapping and Grinding Under My Shoulder Blade?

Physical Therapy in Carbondale and Du Quoin for Shoulder Do you suffer from painful snapping of your shoulder blade, when you move your arm? This article discusses some of the causes of shoulder blade snapping or bursitis of the the shoulder blade. A Physical Therapist at Synergy Therapeutic Group in Carbondale and Du Quoin can examine your shoulder and may be able to help you with the relief of pain from shoulder girdle bursitis. Although most clients can benefit from conservative treatment fr…Read more

Failed Rotator Cuff Repair: Advance or Retreat?

Are you contemplating whether you should have surgery repeated for a rotator cuff tear? This article reviews the outcome of repeated surgery for rotator cuff tears. The effectiveness of the surgery seems to be more favourable if the injury is to a single tendon, as opposed to multiple tendons.Read more

Preventing and Treating Shoulder Injuries in Overhead Throwing Athletes

Are you an athlete who is required to throw something in an overhand motion? This article is concerned with the conditioning, rehab, and prevention of shoulder injury in athletes who throw overhand. Because of the vulnerability of these athletes to overuse injuries, it is recommended that they seek advice fro their Physical Therapist at “client_company” for specific training exercises designed to prevent and control overuse shoulder injuries.In this 15-page review of overhead throwing sports, Ph…Read more

Surgery May Be First-Line Option for First-Time Anterior Shoulder Dislocation

Have you suffered an anterior shoulder joint dislocation recently, or do you suffer from recurrent shoulder dislocation? This article, outlining the outcome of shoulder surgical repair versus conservative treatment may be of interest to you. According to statistics, the shoulder is the most commonly dislocated joint in the human body, possibly because of the wide range of motion the joint provides, reducing the stability that other joints have. The anterior dislocation is the most common type of…Read more

Diagnosis of Shoulder Pain in the Older Adult

Evaluating pain and problems in the shoulder is different when the patient is older. The underlying causes aren’t the same as in active, younger adults. Older adults have more degenerative disease or injuries from falls. Younger adults experience more injuries from sports or athletic participation.Although the basic interview, patient history, and physical exam are similar for these two age groups, there are some important differences. The authors of this article provide a review of the recommen…Read more

Beware Rotator Cuff Tear After Direct Blow to Shoulder

Have you suffered a direct blow to your shoulder in football? If so, you may find this article of interest. It is a case report of a football player who sustained a serious shoulder injury, and stresses the importance of early diagnosis, and surgical repair of a rotator cuff tear in a “young” athlete. Check with your Physical Therapist at “client_company” for expert diagnosis of your injuries.Read more

Review and Update on SLAP Shoulder Injuries

The focus of this review article is a specific shoulder injury known as a SLAP tear. SLAP stands for superior labral anterior-posterior. It refers to an injury affecting the labrum, a fibrous rim of cartilage around the edge of the shoulder joint. Because the shoulder has such a wide range of motion, the shoulder socket can’t be too deep. But if it’s too shallow, there is an increased risk of shoulder dislocation. The labrum gives a little lip to the socket to help balance out the need for mobil…Read more

Three of Five Positive Tests Good Indication of Subacromial Impingement

The shoulder is a joint that takes on a big burden. It needs to be able to take on a heavy load and still be able to move around freely as we need it to. When pain strikes the shoulder, however, it can become difficult to do some of the most minor of tasks. And shoulder pain is common. Slightly more than 33 percent of visits to doctors for complaints of muscle, joint, or bone pain are because of shoulder problems. The most common problem is subacromial impingement syndrome, a condition where a p…Read more

How To Improve Results with Steroid Injection for Shoulder Pain

Do steroid injections help with shoulder pain or not? This question has been debated and studied for quite some time. There is some evidence that certain soft tissue disorders respond well to steroid injections. There is also some proof that injecting the correct site makes a difference in results. The outcome of this study supports the importance of accurate needle placement and injection for best results.Read more

Risk Factors for Repeat Shoulder Dislocation Following Arthroscopic Surgery

Arthroscopic surgery, surgery where the doctor makes a few tiny incisions and uses long, narrow instruments to perform the surgery, is an increasingly popular option when it is possible. Shoulder surgery is one area where arthroscopic technique is frequently used. It is used often when a shoulder has been dislocated, leaving the joint unstable. Unfortunately, the surgery isn’t always successful over the long-term and the shoulder may dislocate again. In fact, with young adults, arthroscopic surg…Read more

Diagnosis and Treatment of Uncommon Nerve Injury of the Shoulder

The suprascapular nerve along the back of the shoulder can get stretched or compressed enough to cause serious damage. This condition is called suprascapular neuropathy. The result can be shoulder pain and loss of function. For athletes who depend on the muscles supplied by that nerve, such a problem can be very disabling. Overhead athletes with traumatic shoulder injuries, especially severe rotator cuff tears seem to be affected most often.In this review article, orthopedic surgeons from Rush U…Read more

Diagnosis and Treatment of Snapping Scapula Syndrome

The scapula (shoulder blade) is an amazing anatomical structure. It is suspended over the ribs between the spine and the arm by only two ligaments. There isn’t a real joint between the scapula and the trunk. Three layers of muscle and bursae (plural for bursa) support this structure. The bursae are small fluid-filled sacs designed to reduce friction between muscle or tendon and bone. These layers (superficial, intermediate, and deep) form a smooth surface for the scapula to move, glide, and rota…Read more

Physical Therapy Treatment for Subacromial Impingement Syndrome

Many people at all ages and stages of life can and do develop shoulder pain. A common condition causing significant shoulder pain seen in patients across the lifespan is called subacromial impingement syndrome. Impingement means something is getting pinched. Subacromial tells us that the something in question is located under the acromion. The acromion is a piece of bone that comes around from behind where it starts in the shoulder blade and curves over the top of the shoulder.At first (stage I)…Read more

What’s the Latest on AC Joint Injuries?

A fall onto the tip of the shoulder can disrupt the ligaments and capsule holding the acromioclavicular (AC) joint together. The result can be a dislocation of the AC joint. Sometimes this injury is referred to as a shoulder separation. The AC joint is located where the end of the clavicle (collar bone) meets the acromion. The acromion is a curved bone that comes from the shoulder blade across the top of the shoulder.Read more

Physicians Keep Up With Athlete Shoulder Problems

Despite all the focus on childhood obesity, there are still a large number of teens involved in physical activity and exercise. For example, last year, more than seven million high school students participated in some kind of sports activity. That’s more than half of all high school students. And records show the trend is on the rise. That’s the good news. The downside of this good news is that along with increased involvement in sports (especially high-demand activities) comes an increase in in…Read more

Frozen Shoulder: What Is It? What Causes It? And What Can Be Done About It?

Frozen shoulder is the layperson’s term for a medical condition called adhesive capsulitis. What is it? Well, the answer to that question is not entirely clear. There’s inflammation of the tissues in and around the shoulder joint that leads to fibrosis (scarring). The result is the joint gets stuck and can’t move smoothly anymore. Painful and limited shoulder motion are the two main characteristics of this condition.Read more

What the Experts Have to Say About SLAP Lesions

If you want to know how experts with years of experience treat SLAP lesions, this is the article for you. SLAP stands for superior labrum, anterior and posterior. It refers to a torn rim of fibrous cartilage (the labrum) that edges the shoulder socket. The tear is at the top of the socket (that’s what superior means) and goes from the front (anterior) to the back (posterior) of the socket.Read more

Effect of Workers’ Compensation on Outcome of Rotator Cuff Repair

Many studies have shown that patients hurt on-the-job and covered under Workers’ Compensation (WC) have worse results after rotator cuff repair compared to those who do not have WC claims. The reasons for this difference still aren’t clear.Read more

New Understanding of the Frozen Shoulder

There are some new studies on the condition commonly known as frozen shoulder. They have added information to what we know about how this condition develops and how to treat it. In this report, surgeons from the Hand and Upper Limb Centre in Ontario, Canada bring us up-to-date on this topic.Read more

Patients Respond Well to Either Surgical or Conservative Treatment of Shoulder Nerve Compression Syndrome

The shoulder is a well-used and important joint. It allows you to move your arm at will and then bears the weight of objects you pick up, as well as the weight of your arm if you are reaching up or beyond your immediate reach. Because of the way the shoulder joint performs, if a nerve is compressed, it can cause significant pain and weakness in your shoulder and/or arm. The area where the nerve is also affects how your arm will react, so it’s important that nerve compression of the shoulder be p…Read more

Treating Subscapularis Tendon: What’s the Latest?

In this report, orthopedic surgeons for The San Antonio Orthopaedic Group in San Antonio, Texas review the latest research on subscapularis tendon tears. They provide background on anatomy, etiology (causes), diagnosis, and treatment of this condition. Both conservative (nonoperative) care and surgical treatment are included.Read more

Disorders of the Superior Labrum: Assessment and Treatment

There’s a common belief that research published today is already outdated before it goes to press. To combat that problem and help keep us up-to-date, frequent, short-term reviews of published research are conducted and summarized in this journal. The topic of this article is disorders of the superior labrum in the shoulder.Read more Injuries & Conditions Ankle Arthritis Upper Back and Neck Mid Back Lower Back Cumulative Trauma Elbow Fibromyalgia Foot Hamstring Hand Head Hip Knee Muscle Injury Osteoporosis Pediatric Shoulder Shoulder Anatomy Shoulder Issues FAQs Research Articles Exercises Tendonitis Wrist Sports Activities Lifestyle Activities Work Activities Injury Care Women’s Health Issues Newsletters MAKE AN APPOINTMENT Yes, I would like to receive newsletters from Synergy Therapeutic Group.