Your shoulder is the most mobile joint in your body. It’s a ball and socket joint that enables you to rotate your arm, lift it up and away from your body, and move it forward and backwards. Any injuries or damage to the structures of your shoulder can seriously hamper your ability to move freely, have an impact on your work or leisure activities and affect your sleep.
The power and movement in your shoulder comes from the rotator cuff – a system of tendons that attach your shoulder bones to the muscles of your upper arm, chest and shoulder. Smooth movement and cushioning is enabled by slippery cartilage on the joint surfaces and a fluid-filled sac. Strong, fibrous ligaments provide stability.
Any of these structures can get damaged – either by a jarring impact, repetitive intensive activity or wrenching. Shoulder injuries can lead to degenerative bone disease such as arthritis – leading to ongoing pain, restricted movement and inflammation.
The Capital Orthopaedics team offers expert diagnosis and treatment for shoulder pain, stiffness, shoulder injuries and long term shoulder problems. Our treatments include:
Your upper arm bone (humerus) sits in a socket (glenoid) in your shoulder blade (scapula). It can be pulled out of place by being wrenched or as a result of an impact – making it particularly common in contact sports and sports that involve falls on an outstretched arm. Once you’ve had a dislocated shoulder, it may become prone to instability and repeat dislocations. It can also lead to further structural issues, such as tendon or ligament damage and osteoarthritis. Our physiotherapy and surgical treatments can improve stability and resolve other conditions in your shoulder joint.
Frozen shoulder, also known as adhesive capsulitis, is a painful and disabling condition. The connective tissue (shoulder capsule) surrounding your shoulder joint becomes inflamed and stiff, resulting in chronic pain and a severely restricted range of motion. The Capital Orthopaedics team offers intra-articular hydrodilation injections – high-volume injections of local anaesthetic, saline and steroid – which work by stretching the shrunken joint capsule. This is successful in 80% of patients. If the problem persists, you may require arthroscopic surgery.
If a tendon in your shoulder joint becomes inflamed and swollen, it can get pinched between the bones of your shoulder, causing pain as you try to move your arm in an arc. Impingement can be caused by a repetitive activity, or can be the result of other structural problems in the joint – such as bone spurs and osteoarthritis.
Treatment initially involves a physiotherapy programme and anti-inflammatories, followed by ultrasound-guided injections to reduce inflammation and promote healing. These measures are successful in over 80% of patients. Occasionally, arthroscopic surgery may be necessary to resolve the issue.
The acromioclavicular joint (ACJ) is the bony lump at the top of your shoulder where your collarbone (clavicle) attaches to the shoulder blade (scapula). The joint can be displaced by a direct impact onto the outside of your shoulder or a heavy fall onto an outstretched arm. The strong, fibrous ligaments that secure the bones of your ACJ can get stretched, causing instability or a complete dislocation. The Capital Orthopaedics team offers physiotherapy and anti-inflammatory injections, as well as surgery to repair dislocated ACJs.
Like all the joints in your body, your shoulder is prone to osteoarthritis through overuse or injury. The degenerative bone disease starts with damage to the slippery cartilage coating on the joint surfaces, which leads to increased friction and deterioration of the bones – including bony lumps called bone spurs. This in turn can cause damage and inflammation to other tissues in your shoulder. Our team offers expert diagnosis and treatment for arthritis in the shoulder – from ultrasound guided injections, physiotherapy to improve shoulder function, arthroscopic surgery for tissue damage, through to complete shoulder joint replacements.
The tendons that connect your biceps muscle to your shoulder joint can get damaged through suddenly lifting a heavy weight or through overuse (it’s common in swimmers, tennis players and golfers). Tendonitis is the inflammation of your tendon due to micro-tears, and it can cause a deep, throbbing ache where it connects to the front of your shoulder joint. We treat most biceps tendonitis with anti-inflammatory injections and physiotherapy rehabilitation programmes. The condition might require keyhole surgery, particularly if it is a complete biceps tear or accompanied by other shoulder problems such as a rotator cuff tear.
The labrum is a ring of rubbery cartilage that lines the socket of your shoulder joint. SLAP stands for Superior (topmost) Labral tear from Anterior (front) to Posterior (back) – it usually occurs as a result of repetitive movements, aging or a direct trauma to your upper arm. The labrum can become frayed at the top due to overuse, it can become detached along with your biceps tendon, or part of it can droop into the joint. The Capital Orthopaedics team treats minor SLAP tears with anti-inflammatory injections and physiotherapy. More severe cases are effectively treated using arthroscopic surgery.
The inner tube of tendons that enables your shoulder joint to move is called the rotator cuff. The tendons can be damaged due to a forceful wrenching of your arm muscles, an impact on your shoulder or due to repetitive movements causing micro-traumas to the tendons. Our team can resolve rotator cuff tears non-surgically by offering physiotherapy to help your body recover and to strengthen the joint, and injecting steroids or other agents to reduce inflammation and stimulate healing. If the pain is ongoing, or if there are other conditions in your shoulder, we can provide arthroscopic surgery to resolve the issue.
If you have pain in your shoulder, our expert consultants and radiologists will diagnose your problem and offer the best programme of treatment.
Where possible, we provide non-surgical solutions – our physiotherapists have the expertise to resolve your joint problems through carefully targeted rehabilitation programmes. We offer ultrasound guided injections to help reduce inflammation and pain, and to promote healing.
With our expertise in keyhole (arthroscopic) surgery, we aim to treat your shoulder pain with minimal recovery times and the best rehabilitation programmes – so you can get you back to work, back to sport and back to normality.
Simon Moyes is an internationally renowned orthopaedic surgeon and leader in the field of arthroscopic (keyhole) surgery. His Capital Orthopaedics team works from The Cromwell Hospital in London, with its state-of-the-art diagnostic and surgical equipment, and top sports medicine professionals.
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Simon Moyes is an internationally renowned consultant orthopaedic surgeon and leader in the field of arthroscopic (keyhole) surgery. The Capital Orthopaedics team is made up of highly experienced medical professionals – including surgeons, radiologists, nurses, anaesthetists and physiotherapists.
In this instructional video from Simon Moyes, our model demonstrates a quadruped weight exercise to help increase shoulder strength and stability.
Frequently asked questions about treatment for shoulder conditions and injuries.
– Frozen shoulder – tightening and stiffening of the capsule around your shoulder joint
– Arthritis – bone degeneration (osteoarthritis) or joint inflammation (rheumatoid arthritis)
– Tendonitis – inflammation of the tendons that connect your muscles to the bones of your shoulder
– Impingement – pinching of tendons and nerves in your shoulder joint
– Instability or subluxation – the bones of your shoulder being misaligned
– Dislocation – the bones of your joint wrenched out of place
– Pain – especially at night
– Reduced mobility
You should see a doctor about any shoulder pain that doesn’t respond to rest, ice and over-the-counter pain medication after two weeks. If you suspect a fracture or dislocation, you should seek immediate medical attention.
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