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Overview of Shoulder Problems

The National Center for Health Statistics and the Centers for Disease Control report that many millions of people go to the doctor because of shoulder pain every year. Athletes are susceptible, but so are weekend athletes - or anyone involved in an activity that includes excessive overhead motion. This could be swimming or tennis - but it also could be gardening, stacking heavy boxes, or washing windows.

Here are the questions to ask yourself, according to the American Academy of Orthopedic Surgeons. If you answer yes to any of them, it is time to call your orthopedist.

• Can you rotate your arm in all normal positions?
• Does the shoulder feel as if it could pop or slide out of its socket?
• Are you unable to carry out your daily activities because you lack the strength in your shoulder?

Here's what your doctor will be checking for:

Many shoulder problems come from the muscles, tendons and ligaments which allow a wide range of motion, rather than from the bones themselves. Your doctor will check for any signs of instability.

He or she will also check for what is called "impingement " - or excessive rubbing of the rotator cuff and top part of the shoulder, which can cause painful inflammation.

Your rotator cuff is important because it's made up of a group of muscles and tendons that hold the shoulder joint in place and allow you to "rotate" your shoulder enough to lift things overhead.

• Rotator cuff injury

Rotator cuff injury - The rotator cuff is a large tendon comprised of four muscles which combine to form a "cuff" over the upper end of the arm. Injuries to this "cuff" can result from repetitive athletic motion, or from other wear and tear.

• Shoulder Tendonitis

Shoulder Tendonitis - A tendon is a cord which connects muscle to bone or other tissue. Most tendonitis is a result of wear and tear over a period of years. But some is caused by sports or work-related activities.

• Shoulder Dislocation

Shoulder Dislocation occurs when the shoulder is all or partially out of its socket. A simple treatment will usually suffice, although repeated dislocations may require surgical treatment.

• Shoulder replacement (arthroplasty)

Shoulder replacement (arthroplasty)

Total shoulder replacement is not nearly as common as knee or hip replacement, but it can be just as successful at relieving pain.

There are several different types of shoulder replacements. The usual total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball and plastic socket.

Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.

• Arthroscopy

Arthroscopy is a surgical procedure orthopedic surgeons use to visualize, diagnose and treat problems inside a joint. The term literally means "to look inside a joint." It involves making a tiny incision about the size of a buttonhole, and inserting pencil sized instruments.

• Arthritis

Arthritis

In general, Arthritis can take 3 possible forms; osteoarthritis , or the kind caused by wear and tear; posttraumatic arthritis , which is the kind that sets in after an injury; or rheumatoid arthritis, which is a systemic inflammation of the joint lining.

• AC (acromiclavicular)

AC (acromiclavicular) refers to the acromioclavicular joint, which is where the collarbone (clavicle) meets the tip of your shoulder.

• Acromioclavicular arthritis

Acromioclavicular arthritis is the term used for arthritic pain in that particular joint of the shoulder.

• Shoulder separation

Shoulder separation is not a separation of the shoulder joint, but an injury to the ligaments that surround and stabilize it. The most common cause for a 'separation' of the AC joint is from a fall directly onto the shoulder. The fall injures the ligaments that surround and stabilize the AC joint.

• 'Frozen shoulder' (adhesive capsulitis)

'Frozen shoulder' (adhesive capsulitis) is a marked by stiffness, pain and loss of motion in the shoulder. Though the causes of frozen shoulder are not fully understood, the process involves the contracting and thickening of the capsule surrounding the shoulder joint.

• Rotator cuff tear arthropathy

Rotator cuff tear arthropathy is a chronic condition of the large tendon made up of four muscles which combine to form a "cuff" over the upper end of the arm. In arthropathy, patients with long standing rotator cuff tears may develop arthritis and destruction of the joint cartilage.

• Impingement syndrome

Impingement syndrome is one of the most common causes of pain in the adult shoulder. It results from pressure on the rotator cuff as the arm is lifted, and is frequently seen in athletes and those who lift things overhead.

• Fracture

Fracture literally means 'broken.' A bone may be completely fractured or partially fractured. Sometimes this is caused by trauma, or as a result of osteoporosis. Fractures can even occur with overuse, such as an athlete's stress fracture.

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