Injuries to the rotator cuff tendons are frequently seen in workers with physically demanding jobs, athletes, and physically active people. It can due to a traumatic injury or from repetitive use of the shoulder. Rotator cuff tears generally do not heal without treatment.
Patients with a rotator cuff tear often experience pain when lifting or lowering their arm, muscle weakness and atrophy. These symptoms may appear suddenly after the tendon is torn, or develop gradually after long-term wear. Physical examination, X-rays and MRI are used to confirm the diagnosis.
Depending on several factors, the problem may respond well to therapy, injections and medication or it may require arthroscopic surgery. Arthroscopic Rotator Cuff Surgery can be performed to repair torn tendons following a rotator cuff injury. Because it is minimally invasive, Arthroscopic Rotator Cuff Repair results in a much quicker and less painful recovery.
Arthroscopic Rotator Cuff Repair has been performed successfully in an outpatient setting for many years to help people of all ages regain maximum use of their shoulder and resume normal routines and physical activities. Arthroscopic repair is superior to the traditional open repair and is successful even with very large tears, so there is no reason to settle for an open repair.
Athletes, workers and anyone who uses their shoulder for overhead activities often suffer shoulder pain caused by excessive rubbing or squeezing (impingement) of the rotator cuff and shoulder blade. The rotator cuff is a group of muscles and tendons that stabilizes the shoulder and permits lifting and rotating movements. If the rotator cuff weakens or is injured, the bone of the upper arm can lift up, pinching the rotator cuff against the shoulder blade.
In addition to rotator cuff injuries such as tendonitis and tearing, impingement may be the result of bursitis, an inflammation of the cushioning sac between the rotator cuff and the shoulder blade. A torn rotator cuff is a potential outcome of shoulder impingement.
People most at risk for developing impingement are athletes, especially those who swim or play baseball or tennis, and people whose occupations include repetitive lifting, reaching or overhead movements, such as painting and construction.
At first, you may feel mild pain in the shoulder, which may radiate from the front of the shoulder to the side of the arm. The pain may worsen when you lift your arm, reach for something, or throw a ball. As impingement progresses, pain and stiffness worsen until you may not be able to lift or lower your arm.
History, physical examination, X-rays and sometimes MRI is used to diagnose shoulder impingement.
Once impingement is diagnosed, anti-inflammatory medication, activity modification, exercises and sometimes a corticosteroid injection is the recommended treatment. Sometimes a course of physical therapy is recommended. In cases where there is not enough improvement, an arthroscopic, minimally invasive, outpatient procedure to remove the inflamed bursa and bone spurs is performed to relieve the pain of impingement.
Frozen shoulder, also known as adhesive capsulitis, is a common condition that causes pain and stiffness in the shoulder as a result of a tightening or thickening of the capsule that protects the structures of the shoulder. Frozen shoulder most often affects patients between the ages of 40 and 60 and is more common in women.
Physical examination will reveal the loss of both active and passive range of motion. X-rays and sometimes an MRI will be used to establish the diagnosis and helps rule out other possible shoulder conditions.
Treatment for frozen shoulder usually focuses on managing pain and other symptoms as the condition progresses. This may include anti-inflammatory medications, corticosteroids and physical therapy.
Minimally invasive surgical procedures, such as arthroscopy and manipulation, may also be performed with a goal of stretching or freeing up the contracted joint capsule. Most patients have significant improvement from this minimally invasive procedure.
The shoulder is the most mobile joint in the human body. The soft tissues around the shoulder, including the labrum, capsule, ligaments, and rotator cuff muscles, stabilize the shoulder. Tearing, stretching, or injury of these tissues can result in an unstable shoulder.
A physical examination will determine how loose a shoulder is. X-rays and MRI are used to determine the integrity of the ligaments, capsule and tendons supporting the shoulder.
Physical therapy and strengthening of the muscles which support the shoulder will provide stability to the shoulder in place of the torn labrum and capsule.
Surgery should be considered when recurrent instability occurs despite an adequate course of physical therapy or if the likelihood of recurrent instability is high. Dr. Li performs all of his shoulder stabilization surgeries arthroscopically and with minimal invasion. Therapy is a key component of the recovery process and is started the day after surgery.
The acromioclavicular (AC) joint is the meeting point of the acromion and clavicle bones, often indicated with a visible bump in the area. It is a structural joint and not a functional joint.
AC joint injuries often occur as a result of a fall or other trauma, which may cause the acromion to move or separate from the clavicle, or cause the ligaments to be stretched or torn. Arthritis can occur in the AC joint, causing pain and swelling. This condition can be seen in weightlifters and workers with jobs that place a heavy demand on their shoulder.
There is usually a history of a traumatic injury and the physical exam will demonstrate pain, and swelling and bruising around the top of the shoulder at the AC joint. X-rays can be helpful in the diagnosis.
Ice and anti-inflammatory medications will reduce the swelling and pain. As the pain and swelling subsides, exercises are used to restore function. If there is chronic pain, a corticosteroid injection in the AC Joint is performed. If the acute separation is severe or if there is chronic unrelieved pain, then surgery is considered.