Shoulder

What Hurts?

Shoulder

Frozen Shoulder Syndrome (Adhesive Capsulitis)

Summary:
Frozen shoulder syndrome results when the capsule surrounding the ball and socket joint becomes thickened and contracted by inflammation and/or scar formation. This condition may occur secondary to previous injury or surgery, may be related to underlying medical conditions such as diabetes or heart disease, or may occur for unknown reasons. Progressive shoulder stiffness results in pain and loss of function. The natural history of frozen shoulder is generally one of gradual recovery that may occur anywhere between 3 months to 3 years. The majority of cases resolve within 12-18 months.

Rotator Cuff Tear

Rotator Cuff Tear Anatomy:
The rotator cuff is comprised of four tendons that attach to the humeral head (ball). These tendons serve two functions. First, they move the shoulder so that the arm can be placed into a wide variety of positions. Second, they keep the ball centered in the socket so that the shoulder joint remains stable throughout the range of motion. Almost all activities that involve the arm require the rotator cuff to stabilize and position the shoulder. Thus, these tendon must be able to provide both strength and endurance.

Rotator Cuff Tear Arthropathy

Summary:
Rotator cuff tear arthropathy occurs in a small percentage of patients with massive, irreparable rotator cuff tears. Without a functioning rotator cuff, the humeral head (ball) migrates upward, out of the socket and comes to rest against the acromion bone which forms a roof over the joint. As arthritis develops between the ball and upper edge of the socket, patients experience pain and stiffness in addition to the weakness that stems from the absence of a rotator cuff. This is one of the most challenging problems that faces the shoulder specialist as there is no way to restore the function of the torn tendons. Treatment alternatives focus on restoring comfort and improving motion, recognizing that strength and ability may not be fully recoverable. The sections below will provide greater detail about the symptoms of cuff tear arthropathy and the options for both non-operative and operative treatment.

Rotator Cuff Tendinosis

Summary:
Rotator cuff tendinosis is a very common disorder that causes shoulder pain and loss of function, generally in people over age 40. While many cases are caused by overuse, there is often no clear reason why this condition occurs. Tendinosis refers to intrinsic tendon degeneration or failure of the tendon fibers at a microscopic level. The goal of treatment of this condition is to provide an opportunity for the tendon to repair itself through an adequate tissue healing response. This involves rest, activity and technique modification, correction of underlying mechanical abnormalities of the shoulder such as muscle weakness and fatigue and, finally, patience. Tendon healing is a slow process that takes many weeks to several months.

Shoulder Arthritis

Definition:
Arthritis is a condition in which the cartilage that forms the smooth gliding joint
surface becomes worn and roughened. Another name for arthritis is degenerative joint disease. In a normal joint, cartilage helps distribute weight to the neighboring bone and allows frictionless joint motion. When the cartilage surface wears out the joint is affected in several different ways that result pain and loss of function.

Total Shoulder Replacement Surgery for Osteoarthritis

Summary:
The shoulder is a ball and socket joint that allows the arm to be placed in an incredibly wide range of positions during every day activities. The ball is formed by the head of the humerus (arm bone), and the socket is formed by the scapula (shoulder blade). The socket is also referred to as the glenoid. The surfaces of the ball and socket are formed by cartilage, a tissue which allows joints to glide in a smooth and frictionless way.

Treatment for Rotator Cuff Tear Arthropathy

How is Cuff Tear Arthropathy Treated? The primary goal of treatment for cuff tear arthropathy is relief of pain. Because the rotator cuff cannot be repaired, restoration of strength is unlikely in the affected arm. The optimal treatment depends on several factors.
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