SHOULDER & ELBOW INJURIES
Treatment for Orthopaedic Shoulder Injuries
The shoulder is the most mobile joint in the body. Due to its mobility and flexibility, the joint is not very stable, which can easily lead to injury or shoulder problems such as dislocation, rotator cuff tear or separation. Based on your needs and goals, we tailor a treatment plan geared towards regaining your full mobility, so you can get back in the game or return to your daily acitivites. Our orthopaedic doctors offer non-surgical, minimally invasive and open surgery to restore the full use of your shoulder.
Rotator Cuff Tears
The normal aging process causes the ends of the muscles near their attachment site (tendons) to thin and ultimately weaken, leading to partial or complete tears, also known as rotator cuff tears. Sometimes rotator cuff tears may occur with minimal or no trauma. In a younger patient, a partial or complete rupture more normally is seen with acute trauma. Rotator cuff tears are typically located at or near the tendonous connection to the bone.
Osteoarthritis is a progressive degenerative condition involving the lining (articular cartilage) of the joint surfaces. Degeneration or thinning and pitting of these surfaces creates a roughened and worn joint surface. Long-term and continuous shoulder pain and usually a progressive loss of range of motion are the classic symptoms that indicate the need for consideration of total shoulder replacement surgery. This condition and related symptoms are most commonly age related. Tearing of the surrounding muscle/tendon tissues (rotator cuff complex) is often seen simultaneously with this aging process.
Shoulder pain and shoulder swelling is common in the athletes and anyone 40 years of age and over. Due to repeated and strained movements, shoulder tendinitis causes pain when one elevates the arm. Shoulder pain and shoulder swelling will occur in the event these elevation motions are repetitive or occur under excessive loads or velocities.
Shoulder instability is the result of a condition or injury in which the ball of the joint physically moves out of the socket. Shoulder instability can generally be classified as mild to severe. In cases of severe instability, the ball dislocates completely out of the socket and may require shoulder jsurgery. In less severe cases the ball may only partially slip or “sublux.”
Shoulder Adhesive Capsulitis (Frozen Shoulder)
Frozen shoulder is a common condition more prevalent in women over the age of 40 and is commonly thought to occur in the diabetic population as well as people with known thyroid disease. This condition has been noted to occur in both shoulders in approximately 10% of population.
Acromio-Clavicular Joint Sprain (Separated Shoulder)
A separated shoulder joint is one of the most common shoulder injuries diagnosed. It is most commonly seen in sporting activities such as football, cycling, skiing, snowboarding and soccer. The injury is often caused by a fall directly onto the point of the shoulder or a jamming upward of the arm from a fall onto the point of the elbow.
A conservative, non-surgical approach of physical therapy is always best initially for shoulder pain, with goals to restore stability, strength and function of your shoulder. Physical therapy is directed at restoring the strength and control of the shoulder or rotator cuff muscles, by retraining them to provide greater reflexive control of the joint stability.
In many instances, physical therapy and injections can provide enough recovery to avoid surgery, depending on the type and degree of injury or condition. A key to long-term shoulder health is the amount and type of future stresses the patient desires to place on the injured joint.
Physical therapy alone may not suffice to completely alleviate all shoulder pain, and arthroscopic shoulder joint surgery may be indicated. There are multiple factors that should be considered by the surgeon and patient before proceeding with minimally invasive or open shoulder joint surgery.
The primary surgical consideration is the extent to which this pain or instability limits your ability to lead a normal lifestyle. Additional factors such as the length of time the shoulder has been unstable, as well as any subsequent damage to other tissues such as nerves, muscle or the actual joint surface must also be considered.
At Cary Orthopaedics, we offer multiple shoulder-specific surgical procedures:
- Shoulder arthroscopy
- Total shoulder replacement
- Stabilization shoulder joint surgery
- Capsular release arthroscopy
- Shoulder acromioplasty
Treatment for Orthopaedic Elbow Injuries
The elbow is a hinging joint that allows the forearm and hand to function properly. Common elbow conditions include tendinitis (or tennis elbow), arthritis and bursitis. Without the stability of this important structure, your regular daily activities can be greatly impacted. Cary Orthopaedics provides a comprehensive treatment approach to fully restore your elbow mobility. Whether you need conservative care, minimally invasive surgery, our bone and joint experts strive to get you back in the game or back to you pain-free life.
- Elbow arthritis
- Dislocated elbow
- Distal biceps tendon rupture
- Elbow ulnar entrapment
- Elbow fracture
- Elbow instability
- Tennis elbow
- Olecranon elbow bursitis
- Elbow stiffness
Due to the variety of elbow injuries and disorders, we treat each case differently. Generally, we will first approach your treatment conservatively, which may include activity modification, cold or heat therapies, splinting, anti-inflammatory medications, physical therapy, etc.
In the case of an acute elbow dislocation or major injury, we will order x-rays or other tests to arrive at an accurate diagnosis. A dislocated elbow would be relocated to its normal position, and the elbow will then be immobilized usually in a brace or splint. Additional examination for stability, circulation and any nerve injury will be conducted. Any findings of circulatory or nerve damage will need to be addressed immediately by a specialist.
In more severe cases, surgery may be necessary. In many instances, your elbow is more likely to return to its full mobility if surgery is performed sooner rather than later. At Cary Orthopaedics, we use leading techniques like minimally invasive surgery, which has led to high success rates. Our surgical options include:
- Ligament reconstruction arthroscopy
- Elbow arthritis surgery
- Elbow tendon repair
- Elbow joint replacement
- Nerve transposition surgery
If surgery must be performed, it will be important that physical therapy for the elbow be instituted to maximize its use along with the wrist and hand. This regimen will take several months after the procedure has been completed and healing is underway.