• Shoulder

  • It has been estimated that more than 7 million people annually see a physician for shoulder pain.

    More than half of the visits are for rotator cuff issues.

  • The shoulder is the most complex joint in the body and has the largest range of motion. The humerus (upper arm bone) is loosely joined to the scapula (shoulder blade) and held in place by muscles, ligaments and tendons. Broken bones are less common shoulder injuries than injuries of the soft tissue surrounding the bones.

    Various factors contribute to shoulder pain or injury: sporting activities such as swimming, golf, or bowling; everyday activities such as painting walls or gardening; and repetitious tasks involving overhead motions.

    We also see patients with:
    • Rotator Cuff Tear
    • Tendonitis
    • Shoulder Separation
    • Overuse Pain
    • Dislocated Shoulders
    • Unstable Shoulders
    • Broken Collarbones

    Shoulder problems are most often first treated with R.I.C.E. 

    • Rest. Don't use the shoulder for 48 hours.
    • Ice. Put an ice pack on the injured area for 20 minutes, four to eight times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice wrapped in a towel.
    • Compression. Put even pressure (compression) on the painful area to help reduce the swelling. A wrap or bandage will help hold the shoulder in place.
    • Elevation. Keep the injured area above the level of the heart. A pillow under the shoulder will help keep it up.

    If the pain persists, the injury may require medical treatments such as cortisone injections or physical therapy.
    Common shoulder injuries that typically resolve themselves without surgical treatment include separated shoulders, "frozen" shoulders, and tendonitis.

  • Our team of specialists at Littleton Adventist Hospital are experienced in traumatic orthopedic injuries, including broken collarbones.

    In some cases, severely broken collarbones require surgery to align the broken bones with plates, pins and screws. The collarbone, or clavicle, is a long bone on either side of your chest. The collarbone connects the shoulder. The most common cause of a broken collarbone is some kind of trauma, but can often occur through a sport-related accident. Littleton, Colorado sports medicine specialists.

    Symptoms of a collarbone fracture can include:

    • Immediate pain in the area
    • Shoulder slumping
    • Bulging skin over the area of the break
    • Tenderness to the touch

    Seek immediate medical treatment for a broken collarbone to determine the extent of damage.
    Typically, the broken bones can be aligned and a sling used for several weeks to aid in healing. Other treatment for a broken collarbone includes over-the-counter pain medication and limited movement. In very rare cases, a patient will need surgery.

    Orthopedic specialists in Littleton, Colorado.Specialists at the Center for Orthopedics

    perform minimally invasive arthroscopic shoulder surgery, which requires just small incisions to look inside and repair the shoulder. Patients typically go home the same day and return to full activities in several weeks.

    Common signs of the humerus being dislocated include:

    • A square appearance
    • Extreme pain
    • Swelling, bruising & tenderness around the collar bone

    Depending on the direction of this movement, a more specific term will be used in diagnosis.

    Anterior dislocation, where the humerus is in front of the joint, is the most common dislocation and happens when the arm is suddenly pulled backwards. Once a shoulder has been dislocated, the ligaments and tendons may become stretched, which will make the shoulder unstable and reoccurrences of dislocation likely.

    Stabilize and seek medical attention for suspected dislocated shoulder as delays can permanently damage the tendons and ligaments.

    After the dislocated shoulder has been set, the pain will quickly stop.

    A sling may be used to reduce swelling and tenderness. Once the swelling has been reduced, exercises to strengthen and increase movement of the shoulder may be prescribed. Frequent bouts of dislocation can be treated with arthroscopic surgery to tighten stretched or torn tendons or ligaments.

    The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable.

    Rotator cuff tendonitis refers to irritation of these tendons and inflammation of the bursa lining these tendons.

    Rotator cuff repair in Colorado at Littleton Adventist Hospital.

    A rotator cuff tear occurs when one of the tendons is torn from overuse or injury.

    Rotator Cuff Tear

    The pain with a sudden tear after a fall or injury is usually intense. Weakness of the shoulder and arm is often present, along with a snapping sensation of movement.

    Symptoms of a chronic rotator cuff tear include a gradual worsening of pain, weakness, and stiffness or loss of motion. The exact point when a rotator cuff tear begins in someone with chronic shoulder tendinitis may or may not be noticed.

    Most people with rotator cuff tendon tears have pain at night. Pain that is worse at night may wake you up. During the day, the pain is more tolerable and hurts with certain movements.

    Over time, the symptoms become much worse and are not relived by medicines, rest or exercise.

    Different from a dislocated shoulder, separation occurs when the collarbone is moved out of position from the shoulder blade.

    This type of injury happens when a fall tears a ligament, causing the collarbone to move.

    Shoulder conditions in Colorado at Littleton Adventist Hospital.A separated shoulder is usually treated with rest and a sling. If it doesn’t heal quickly, or the ligaments have been severely torn, surgery may be necessary. The specialists at the Center for Orthopedics perform this surgery through minimally invasive techniques, typically allowing the patient to return to normal activities within two weeks.

    Shoulder arthroplasty  (Total Shoulder Replacement)

    Total shoulder arthroplasty (TSA) can be a successful treatment option for patients who suffer with end stage arthritis or degenerative disease of the shoulder joint. Many patients aren’t familiar with shoulder replacement as an option and tolerate pain and restricted motion for a long period of time before seeking medical intervention.

    The shoulder is a ball and socket joint held in place by muscles, tendons and ligaments.  In TSA the upper arm bone (humerus) is replaced with a prosthetic implant that has a rounded metal head. The socket part of the shoulder joint (glenoid cavity) is replaced with a smooth plastic shell, held in place with special cement. The size of the shoulder replacement is customized to the patient and their lifestyle. The surgery itself takes between 1 – 3 hours and with normal use, most replacement shoulders last for at least 10 years.

    Once the postoperative therapy program is complete most TSA patients are pain-free, and able to return to their normal activities without any significant strength limitations.

    As when considering any surgical procedure, patients should talk with their doctor to determine if total shoulder replacement is appropriate for their condition. Ideal candidates for shoulder arthroplasty tend to be older with no prior history of large, inoperable rotator cuff tears. Athletes who play contact sports or heavy laborers are not typically good candidates for the surgery because of the long-term demands they place on the shoulder. Patients experiencing early osteoarthritis may consider more conservative management such as physical therapy, over-the counter medication, cortisone or steroid injections, or even a minimally invasive arthroscopic procedure before opting for total shoulder replacement.

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