Shoulder

Are you unable to move your arm normally?
Is your shoulder stiff?
Does your shoulder feel like it is going to pop or slide out of the socket?
Is your shoulder weak?
Is your shoulder strong enough to carry out desired activities?
Does your shoulder catch or grind with use?
If you answered “yes” to any of the above questions, you may have a common mechanical problem with your shoulder.

Other problems with shoulders include arthritis of the neck, various pain syndromes, nerve irritation, bone infection and bone tumors. These conditions typically produce pain whether or not the shoulder is being used.

Common conditions of the shoulder include:

Shoulder Impingement
One of the most common causes of shoulder pain, impingement results from pressure on the rotator cuff caused by part of the shoulder blade (scapula) as the arm is raised.

The pain may result from a bursitis – an inflammation of the bursa overlying the rotator cuff – or a tendonitis of the cuff itself. A partial tear of the rotator cuff can also be a cause of impingement pain.

Impingement is common in both young athletes and middle-aged people. Swimmers, baseball players and tennis players are especially susceptible to impingement as are those who perform work that involves overhead lifting such as painting, construction, or paper hanging. Repetitive lifting is another cause. Pain can also result from a minor injury or from no apparent cause.

You might suffer from shoulder impingement if you experience:

Sudden pain with lifting or reaching;
Minor pain that is present at all times;
Pain radiating from the front of the shoulder to the side of the arm; or
Pain when throwing a ball or serving a tennis ball.
Rotator Cuff Tears
Weak shoulders can be caused by poor coordination or deficits in the nerve, muscle, or tendon. It can often by corrected by a strengthening program. If shoulder weakness is not responsive to strengthening exercises, it may be due to a nerve injury or rotator cuff problem. Rotator cuff problems are the most common cause of shoulder weakness.

Frozen Shoulder
Shoulder stiffness problems are generally caused by problems with the humerus and scapula. If the ordinarily supple capsule around the joint becomes stiff, it is a condition known as frozen shoulder. It can occur after a period of disuse of the arm or can occur for no apparent reason. It is especially severe in those who are diabetic.

Shoulder stiffness can also be caused by scarring from a previous surgery or injury, known as post-traumatic stiff shoulder. Another cause of stiffness is arthritis, when the joint surfaces have become rough.

Yet another cause of shoulder stiffness is limited scapulothoracic motion or the motion between the chest wall and shoulder blade. Limited scapulothoracic motion can be caused by acromioclavicular or sternoclavicular arthritis; rib or scapular fracture; contracture; post traumatic scarring; dislocation; tumor or other causes that affect the scapulothoracic motion interface.

Although a chronic condition, it can often be improved by a set of shoulder exercises performed at home. However, if after six months of dutifully performing the exercises the condition hasn’t improved, a more forceful approach might be considered. This may include gentle manipulation under anesthesia or an open surgical release.

Shoulder Dislocations
Shoulder dislocations, also known as glenohumeral instability, usually happen in the joint between the glenoid and the humerus. However, it is possible to have instability at other shoulder joints. This condition is an inability to maintain the humeral head centered in the glenoid.

It can happen because of an injury to the rotator cuff, labrum, bone, capsule and/or the ligaments. These ligaments do not tear easily; it would take a hard fall on the arm for this to happen, and this is called traumatic instability.

Recurrent traumatic instability typically generates symptoms when the arm moves into position near that of the original injury. If the ligaments do not heal after the first injury (which is often a complete dislocation), the arm continues to be unstable when it is rotated backward or held out to the side. In this case, a surgical repair of the ligaments generally restores shoulder stability. However, conscientious practice of the post-operative exercises is essential to a full recovery.

When a shoulder becomes unstable without a major injury, this is known as atraumatic instability. This happens from loss of ability to balance the muscles around it, and the joint slips when the arm is down at the side or out in front. A muscle balancing exercise program is necessary to regain the balance. If exercise is not successful, surgery to tighten the tissues around the joint can offer temporary relief. Ultimately, however, it is an exercise regimen that is vital to the restoration of muscle balance and stability. The postoperative rehabilitation after this surgery is particularly important.

Arthritis of the Shoulder
Arthritis of the shoulder causes shoulder roughness. Since this generally comes on slowly, it is often easy to treat with exercises to improve shoulder function.