The shoulder has the greatest range of motion of all joints in the body, making it susceptible to injury. Overhead activities like painting a ceiling or cleaning a cupboard can trigger pain, particularly in people who already have arthritis. High-impact, high-speed sports like football, rugby and skiing are often responsible for rotator cuff tears and shoulder separations. Tennis, swimming and baseball can all cause overuse injuries. It takes many muscles, tendons and ligaments to hold the joint together. This unique joint construction gives your shoulder wide range of motion, but also makes it more prone to injury than other joints.
Orthopedic and sports medicine doctors at Mills-Peninsula Medical Center treat a wide range of conditions including:
- Arthritis
- Rotator cuff injuries
- Shoulder impingement
- Fractures
- Frozen shoulder
- Shoulder labral tears
Our specialists offer a full spectrum of care to get you back in the game, from physical therapy and joint injections to rotator cuff repair and shoulder replacement.
Our goal is to reduce pain and help you regain the full range of motion you enjoyed before your shoulder problem developed. We are skilled in minimally invasive arthroscopic surgery that reduces scarring, as well as in effective, time-tested approaches and other treatments that don’t require surgery. Our shoulder specialists work closely with you to help you make the best decision for your particular medical needs. We want to get you back to the life you love.
Shoulder Problems and Treatments
Here, briefly, are the types of shoulder problems our orthopedic specialists treat.
Arthritis
Shoulder arthritis is caused by wear and tear of the cartilage in the joint, and is most common in people over age 50. The early symptoms include pain and progressive stiffness of the shoulder. Early treatment includes anti-inflammatory medications, icing or physical therapy. As in other joints with arthritis, injections with medications like cortisone can help relieve pain temporarily.
When shoulder pain becomes severe, shoulder replacement surgery is often the best way to ease pain and improve function. During shoulder replacement surgery, the doctor removes the damaged portions of your joint and replaces them with artificial materials, usually metal and special medical plastics. The new joint will be held together and moved by the same muscles and ligaments that normally move the shoulder.
Depending on the pattern of arthritis in your shoulder, your surgeon may recommend a partial, complete or “reverse” shoulder replacement. The new joint ball is attached to your upper arm bone in standard joint replacements. It’s attached to the collarbone—reverse position—in reverse shoulder replacements, which are often better for people with torn rotator cuffs.
Dislocated Shoulder
Of all the large joints in the body, the shoulder is dislocated most often. Dislocation of the shoulder typically happens when a strong force pulls the shoulder outward, or there’s extreme rotation of the joint. Dislocation can injure the ligaments that stabilize the joint, and sometimes even damage bones around the joint. Doctors can usually put the ball of the humerus bone back into the joint easily. If the shoulder repeatedly dislocates, the condition is called "shoulder instability" and may require surgery. Also, bone loss or damage to the humerus can occur following dislocation. This is called a Hill-Sachs lesion, and it may also require surgery.
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder can occur after a painful shoulder injury, or it can happen spontaneously for no obvious reason. Typically, people with frozen shoulder feel severe pain and stiffness—and stop using the shoulder naturally as a result. Adhesions can grow between the joint surfaces, which limit range of motion. People with rheumatoid arthritis, diabetes, lung disease, heart disease or stroke are at higher risk for frozen shoulder. Treatment begins with anti-inflammatory medications, heat and gentle stretches. Careful and regular stretching—sometimes with the help of a physical therapist—helps most people. The doctor may also give a cortisone injection to help speed recovery. In rare cases when those treatments don’t help, the surgeon can remove any remaining lesions through arthroscopic surgery.
Rotator Cuff Tear
Rotator cuff tendons can become inflamed from normal aging, overuse or an injury such as a fall. In younger people, rotator cuff injuries are most common in athletes and people who must do heavy lifting at work. Treatment begins with anti-inflammatory medications or cortisone injections, rest and physical therapy. If those treatments do not help, or if the tear is large, doctors suggest surgical repair of the tendon.
Separated Shoulder
Shoulder separation happens when the ligaments that connect the collarbone to the shoulder blade are torn, usually by a blow to the shoulder or a fall. The collarbone, which fits next to the shoulder blade, slips out of place. A separated shoulder may heal naturally in a few months if the person rests and wears a sling. Surgery may be required to hold the collarbone in place if the ligaments are severely torn.
Shoulder Joint Tear (Glenoid Labrum Tear)
The labrum is the rim of tissue that surrounds the shoulder joint socket. Many activities can cause a tear, including when you fall on an outstretched arm, receive a blow to the shoulder, lift a heavy object or try to stop a fall. Some labrum tears heal themselves with rest, anti-inflammatory medicine and rehabilitation exercises. Sometimes surgery is required to repair and reattach the labral cartilage with small bone anchors and sutures.
For more information on considering or preparing for a joint replacement surgery, or to find out more about the Joint Center at Mills-Peninsula, please call the patient navigator at (650) 696-5522.
