Frozen shoulder, or adhesive capsulitis, is a condition that begins with a gradual onset of pain and a limitation of shoulder motion. The discomfort and loss of movement can become so severe that even simple daily activities become difficult. Although much is known about this condition, there continues to be considerable controversy about its causes and the best ways to treat it.
Rotator Cuff / Impingement
Shoulder injuries are common in both young, athletic people and the aging population. In each of these age groups, there are numerous causes of shoulder pain. Two of the most common problems occur in the narrow space between the bones of the shoulder. Irritation in this area may lead to a pinching condition called impingement syndrome, or damage to the tendons known as a rotator cuff tear. These two problems can exist separately or together. It is likely that rotator cuff tears are the result of impingement syndrome and age related changes within the rotator cuff tendons.
Instability – Traumatic
Shoulder instability develops in two different ways: traumatic (injury related) onset or atraumatic onset. Understanding the differences is essential in choosing the best course of treatment. Generally speaking, traumatic onset instability begins when an injury causes a shoulder to develop recurrent (repeated) dislocations. The patient with atraumatic instability has general laxity (looseness) in the joint that eventually causes the shoulder to become unstable.
An acromioclavicular joint separation, or AC separation, is a very frequent injury among physically active people. In this injury the clavicle (collar bone) separates from the scapula(shoulder blade). It is commonly caused by a fall directly on the “point” of the shoulder or a direct blow received in a contact sport. Football players and cyclists who fall over the handlebars are often subject to AC separations.
Multidirectional Instability – Atraumatic
Shoulder instability develops in two different ways: traumatic onset (related to a sudden injury) or atraumatic onset (not related to a sudden injury). Understanding the differences is essential in choosing the best course of treatment. As a rule, the patient with atraumatic onset instability has general laxity (looseness) in the joint that eventually causes the shoulder to become unstable, whereas traumatic onset instability begins when an injury causes a shoulder to develop recurrent (repeated) dislocations.
Labral tears of the shoulder have been a particular focus of attention since the advent of the arthroscope, a small instrument that allows the orthopaedic surgeon to clearly see inside the shoulder joint and view the labrum, its environment, and any injuries that may have occurred. The arthroscope, in conjunction with anatomic dissections, history, physical examination, and symptoms has allowed orthopaedic surgeons to better understand and treat a variety of injuries to the labrum.
Glenohumeral (Shoulder) Arthritis
Glenohumeral (shoulder) arthritis is a common source of pain and disability that affects up to 20% of the older population. Damage to the cartilage surfaces of the glenohumeral joint (the shoulder’s “ball-and-socket” structure) is the primary cause of shoulder arthritis.