shoulder / elbow surgery

The Shoulder
The shoulder is a complex area that involves four joints. This allows you to move your arm in many directions. Because the shoulder is so vital to everyday activity, work and sports, it can be one of the most frustrating areas in which to have an injury.

One of the most common conditions is a rotator cuff injury. The rotator cuff is the group of four muscles and tendons that surround the shoulder’s ball-and-socket joint, and helps control shoulder joint motion. Certain types of activity can lead to overuse and impingement of the rotator cuff, causing painful conditions such as tendonitis or bursitis.

>> Click link for additional information about rotator cuff tendonitis, provided by the American Medical Society for Sports Medicine (AMSSM): http://amssm.org/Handouts/RotatorCuff.pdf

In addition to overuse injury, traumatic injuries to the shoulder area may affect the rotator cuff, bicep tendon and labrum. Subluxation (mild instability of the joint), dislocations, and AC (acromio clavicular) separations can also cause significant pain, tenderness and weakness in the entire area. Many of these conditions are associated with sports activities. Clavicle fractures are common injuries usually caused by contact sports or by accidents involving speed.

Aging can also bring about certain problems for the shoulder area. The rotator cuff tendons are especially susceptible to the process of aging. Weakened or degenerated tendons can tear more readily in an accident such as a fall, or by repeated motion. Arthritis of the AC joint and the ball-and-socket joint is also very common. Shoulder arthritis can be a very debilitating condition that affects the function of the entire upper extremity.

Diagnosis and Treatment
If you are experiencing pain, weakness, or stiffness in the shoulder area, you should be evaluated by an orthopaedic specialist. A consultation, physical examination, and tests such as X-ray or MRI can help diagnose the extent of your condition. Many rotator cuff problems may be treated simply with rest, exercise, physical therapy, medication and sometimes injections. If other treatment options do not relieve your pain, or improve your range of motion, you may need to consider a surgical solution.

Depending on patient age, shoulder arthroplasty, or replacement, may be an option for patients who have severe arthritis which has not responded to other treatments. Shoulder arthroplasty has been performed since the 1970’s with much success, though individual results vary depending on the type and progression of the disease or injury, and the condition of the bone and muscles (particularly the rotator cuff) in the shoulder area. Recovery can be greatly improved through post-operative rehabilitation. Talk with your orthopaedic surgeon to understand your options regarding shoulder surgery.

The Elbow
Elbow pain and injuries are common orthopaedic complaints. Throwing athletes such as baseball players, as well as swimmers and gymnasts, often experience such conditions as tennis elbow, nerve impingement and entrapment, though anyone can experience the elbow pain caused by overuse.

Lateral epicondylitis, or “Tennis Elbow,” is the most common injury in patients experiencing elbow pain, and is caused by small tears in the muscle attachment to the bone surrounding the elbow joint. Patients may experience pain on the outside of the elbow that is worsened by grasping or lifting objects and cocking back the wrist, and pain that radiates down the forearm.

Medial epicondylitis, or “Golfer's Elbow,” is similar to tennis elbow, with the main differences being the location of the pain and the activity that caused the injury. However, both conditions are due to overuse of the muscles and tendons of the forearm, leading to inflammation and pain around the elbow joint.

Nerve compression syndromes and conditions such as arthritis can cause pain, weakness, and stiffness in the elbow area as well. Pain in the hand and fingers, and weakness of the muscles in the hand may be a symptom of an elbow problem. An evaluation by an orthopaedic specialist can help determine the nature of your problem.

Diagnosis and treatment
A consultation, physical examination, and tests such as X-ray or MRI can help diagnose the extent of your condition. Many elbow conditions can be treated with splinting, physical therapy and medication. However, more severe cases may be treated with arthroscopic or open surgery. Talk with your orthopaedic surgeon about your options to relieve your pain and disability. Proper rehabilitation can speed your post-operative recovery.