When one or several anatomic structures of the shoulder are injured, a multitude of shoulder and upper extremity problems can occur. The different types of injuries or problems that can occur in the shoulder are fractures, separations, dislocations, adhesive capsulitis, rotator cuff tears, and arthritis.

Understanding the anatomy of the shoulder can help you understand why your shoulder is not functioning the way it should. It is easy to misdiagnose the condition, so you should be evaluated by a knowledgeable professional. To schedule an appointment with one of our specialty-trained shoulder doctors at Western Orthopaedics, please call 303-321-1333.

• Shoulder and Elbow Fractures

  • Common Shoulder Fractures

    The most common bones fractured are the clavicle (the collarbone) and the proximal humerus (the upper part of the arm bone). Most of these fractures can be treated conservatively with an arm sling, but some require surgery in order to provide the best chance of achieving normal function and limited pain. It is important to see a shoulder specialist soon after an injury in order to discuss these treatment options.

               
    Fracture of the distal 1/3 of the clavicle (collarbone)                       Proximal humerus fracture
    

• Shoulder Separation

  • Shoulder Separation

    Another type of injury to the shoulder is a “separation," which occurs at the junction of the clavicle and the acromion process of the scapula called the acromioclavicular joint (ACJ). An injury here can cause the ligaments of this joint to tear, making the clavicle appears to “pop up” as the rest of the arm droops away from it. Usually, more minor separations can be treated conservatively and do well without surgery. More severe injuries can be treated by reconstructing the torn ligaments and stabilizing the joint surgically.

              

    For more information go to >>> Shoulder Separation and AC Joint Athritis

• Shoulder Instability and Dislocation

  • Shoulder Instability and Dislocation

    Shoulder instability refers to dislocation or subluxation of the humeral head from the socket. This most commonly occurs anteriorly with the ball of the humerus dislocating in front and below the socket. A less common dislocation is the posterior type, where the ball dislocates to the back of the socket. Sometimes the shoulder may be very loose and unstable in several directions. These patients tend to be younger and are hyperflexible, commonly seen in young female dancers or gymnasts.

    Occasionally, dislocations may be associated with rotator cuff tears in patients over the age of 40. If patients complain of chronic instability or are found to have a rotator cuff tear, surgery may be required to repair the torn capsule attachment to the glenoid, the supporting labrum cartilage, and any torn rotator cuff tendons.

    For more detail go to >>>Shoulder Instability

• Frozen Shoulder

  • Frozen Shoulder

    On the other end of the spectrum is adhesive capsulitis, or “frozen shoulder.” This is a common condition that occurs when the capsule of the shoulder becomes tight and relatively thick, usually for unknown reasons, but is more common in diabetics and patients with thyroid problems. Usually conservative treatment with a stretching program, light pain medication and anti-inflammatory, and occasional cortisone injections can help speed up improvement with this condition. Rarely, surgery is required to “manipulate” the shoulder’s motion back to normal or to surgically release the tight tissue arthroscopically.

• Rotator Cuff Tear

  • Rotator Cuff Tear

    Another common problem with shoulders is rotator cuff disease. The rotator cuff is the critical set of muscles and tendons that are required to power the shoulder. Rotator cuff disease can range from simple irritation, or tendinitis, to small and intermediate sized repairable tears, to extensive tears that sometimes cannot be fixed. One of the two biceps tendons in the shoulder, the “long head," is located close to the most common location of rotator cuff tears, the supraspinatus insertion. As a result, sometimes the long head of the biceps is involved with the rotator cuff tear and requires treatment.

    For more information go to >>> Rotator Cuff Injuries

• Shoulder Arthritis

  • Shoulder Arthritis

    Certain shoulders may develop joint arthritis. When the word “arthritis” is mentioned, most people think of pain in a joint from “getting old." To an orthopaedic surgeon, arthritis is a very specific term. It refers to loss of cartilage. Joints, including shoulders, require moving surfaces that glide without friction. It is the cartilage and the joint fluid within joints that give that smooth motion. When a joint becomes arthritic, this cartilage is lost causing “bone on bone” grinding and pain. This usually progresses over time and can cause significant pain, stiffness, and disability. Joint replacements of the hip and knee are well known treatments for arthritic pain of those joints. Modern shoulder replacement has been shown to be just as effective as hip and knee replacement.

    For more detail go to >>> Arthritis

• Biceps Tendon Injuries

  • Biceps Tendon Injuries

    The biceps tendon is most commonly injured in patients who perform repetitive shoulder activities, such in carpenters who use their hands overhead daily or in athletes who routinely weight train.  The biceps tendon is either injured at its attachment site on top of the glenoid (biciptial-labral injuries), where the attachment of the tendon to the superior labrum is pulled off the bone (SLAP tear).  Additionally, the long head of the biceps tendon may be injured as it enters into the bicpital groove.  

    Some older patients with shoulder arthritis may also develop bone spurs within the bicpital groove itself causing injury to the biceps tendon. Finally, the biceps tendon may also dislocate out of the groove, which is usually seen in combination with a tear of the subscapularis tendon of the rotator cuff.

    For more information go to >>>> Biceps Tendon and Bicipital-Labral Injuries