The mobility of the shoulder makes it vulnerable to dislocation. Dislocated shoulders are common sports injuries. Patients typically experience pain, bruising, swelling and weakness.
Treatment: The surgeon will manipulate the ball of the shoulder joint back into the socket causing pain levels to reduce. The shoulder will be immobilised in a sling for a few weeks then treated with physiotherapy. If the shoulder dislocates on more than one occasion, it may need to be stabilised with keyhole surgery.
Frozen Shoulder (Adhesive Capsulitis)
This occurs when inflammation develops in the shoulder causing pain and stiffness. Shoulder function can be severely limited. This condition is associated with trauma, some surgeries and diabetes. It rarely affects people under the age of 40.
Treatment: Treatment is almost always non-operative. We normally use a combination of two hydrodilation injections and physiotherapy. Patients whose symptoms are not relieved by this treatment may need to have keyhole surgery.
Separated Shoulder (Acromio Clavicular Joint Injury)
AC joint injuries, also known as ‘separated shoulders’, typically occur when patients fall directly on their shoulder. They typically feel pain and a sensation that things are shifting. In mild cases, a patient may sprain the AC ligament but the collarbone stays in its natural position. Heavier falls may tear the AC ligament and the adjacent coracoclavicular (CC) ligament tugging the collarbone out of alignment. In the most severe cases, both the AC and CC ligaments tear dislocating the shoulder from the collarbone. This is known as an acromio-clavicular dislocation and is a different injury to a dislocated shoulder, which occurs when the ball and socket separate.
Treatment: Treatment for acromioclavicular joint injuries is normally non-operative. More serious ligament tears may need to be stabilised with keyhole or open surgery.
Acromio Clavicular Joint (ACJ) Osteoarthritis
As people grow older the cartilage in their AC joint can start to degenerate. This can cause the bones to rub against each other and over time the joint can wear out, become larger and develop spiny projections or spurs. This results in osteoarthritis. Patients experience pain and swelling in the joint. People who do a lot of overhead activity, such as weightlifters or window cleaners, are particularly vulnerable.
Treatment: Non-operative treatments include anti-inflammatory medicine, steroid injections or joint lubricant injections. More serious cases may require keyhole surgery to remove the arthritic tissue and bone spurs from the joint.
Rotator Cuff Impingement
This is a frequent cause of shoulder pain. It involves the tendon of the shoulder joint becoming damaged due to trauma or chronic wear and tear. It is common in tennis players and swimmers and anyone who does a lot of overhead work. It is also frequently seen in people who lift weights.
Treatment: Non-operative treatment includes rest, anti-inflammatory medicine, steroid injections and physical therapy. This is successful in over 80% of patients. More serious cases may require keyhole surgery.
Rotator Cuff Tear
The rotator cuff is made up of the muscles and tendons that keep the ball of the shoulder in the socket of the shoulder, enabling people to raise and rotate their arms. The tendons of the shoulder joint can get torn as a result of a heavy impact or chronic wear and tear. This can result in pain and weakness in the shoulder. Patients experience pain, weakness and even paralysis in their arms. Tears can range in severity from mild inflammation to complete holes in the tendon.
Treatment: Patients with mild tears are treated with physical therapy to strengthen the muscles and tendons in the shoulder join and may also be offered steroid injections to reduce the inflammation around the torn tendons. Those with more serious tears may need keyhole surgery to repair or reconstruct the tendons or even total shoulder replacement.