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Shoulder problems can develop from everyday wear and tear or overuse, or from a specific injury (also known as trauma).
Trauma injuries include:
- Fractures, ligament tears, tendon tears, joint dislocations and shoulder separation (partial or complete separation of the collarbone and the end of the shoulder blade)
- A much less common shoulder injury is the "SLAP tear," which stands for "superior labrum, anterior to posterior. " This refers to the part of the shoulder that is injured, and is usually caused by a fall or a direct blow to the shoulder.
Common overuse injuries include :
- Osteoarthritis (degenerative joint disease)
- Tendinitis (inflammation of the tendons)
- Frozen shoulder (adhesive capsulitis), a condition that limits shoulder movement and may also be the result of a previous injury
- Torn rotator cuff, which is damage to one or more of the tendons covering the shoulder joint
UCSD's board-certified orthopedic surgeons are specialists in treating shoulder injuries of all kinds. While some injuries can be treated with a sling, cast or other non-invasive treatments, more severe injuries can require surgery. Surgical solutions can range from minimally invasive arthroscopic procedures to total shoulder replacement.
Our orthopedic specialists are also experienced in treating the after-effects of previous injuries, including nonunions (fractures that do not heal) and malunions (fractures that do not heal in the correct alignment).
Diagnosis and Treatment Options
In addition to a thorough physical exam, including checking your range of motion and looking for bumps, bruises or deformities, your physician may perform an X-ray or use magnetic resonance imaging (MRI) to diagnose specific shoulder injuries.
If necessary, an arthroscopic procedure may be used to diagnose injuries. In this procedure, your surgeon uses tiny incisions to insert a special camera that is used to look at the inside of the joint and shoulder area.
Many mild shoulder injuries can be relieved simply by restricting activities and using anti-inflammatory medications. For example, frozen shoulder often resolves over time. However, severe injuries such as fracture or separation require surgery. So do less serious injuries that don't respond to initial treatments and are causing weakness, loss of function, and limited motion.
Types of surgery:
Many injuries can be repaired with this technique; for example, a torn rotator cuff can be treated by repairing the damaged tendons and removing any bone spurs.
Surgery to repair a torn rotator cuff tendon usually involves:
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Removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (debridement).
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Shaving bone or removing bone spurs from the point of the shoulder blade (known as subacromial smoothing)
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Sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone
Frozen shoulder can also be be treated with arthroscopy to release the tight portions of the joint capsule that are restricting movement.
In fact, the majority of shoulder disorders are treated with advanced arthroscopic procedures, including arthroscopic reconstruction for instability and labral disorders. The major advantages of arthroscopy over traditional surgery are significantly less pain and improved cosmetic appearance.
Some complex instability disorders and massive rotator cuff tears may be optimally treated by open conventional surgical methods.. Your orthopedic surgeon will work with you to determine the best course of treatment depending on your general health, the extent of your injury, your activity level, and other factors.
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Shoulder replacement: In the case of severe osteoarthritis and rheumatoid arthritis, or a serious fracture, shoulder replacement surgery can be very effective in relieving pain and restoring mobility. During shoulder replacement, the arthritic or damaged joint surfaces are replaced with a metal ball attached to a stem, and a plastic socket.
- Reverse shoulder replacement: This procedure is appropriate for patients with degenerative arthritis with an absent rotator cuff. The reverse shoulder replacement uses a ball-and-socket joint as well, but the ball is placed on the shoulder blade, and the socket is placed on top of the arm bone.
Any type of shoulder surgery will be followed by a thorough course of rehabilitation, such as physical therapy or exercises, to restore function and mobility.
To schedule an appointment
For more information, to schedule a consultation or refer a patient, please call:
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