Shoulder pain and associated disability in function is an incredibly common joint that is affected, and there are many common causes of this problem. The shoulder joint is the second most common joint that patients seek treatments for at Utah Stem Cells, and our treatments have been largely successful. The most common diagnosis in patients with shoulder pain is bursitis or tendonitis of the rotator cuff. Bursitis and Rotator Cuff Tendonitis are different ways of describing the location of inflammation in the joint, and this leads to a condition called “Impingement Syndrome”.
Rotator Cuff Tears are another common occurrence when the tendons of the rotator cuff separate from the bone. Because of our dependence on the shoulder for many activities, these injuries can cause serious functional problems for many people. The rotator cuff is a group of four tendons and muscles that surround the shoulder joint. It is these tendons that connect the rotator cuff muscles to the bone, and when they become inflamed or torn, they cannot function properly. The most common symptom of Rotator Cuff Tears is pain. Patients usually complain of pain over the top of the shoulder and arm, and the pain can descend down the outside of the arm all the way to the elbow. The other common symptom of a rotator cuff tear is weakness of the shoulder. Weakness causes difficulty lifting the arm up overhead or difficulty with activities such as reaching, getting dressed, or carrying objects.
Adhesive Capsulitis, commonly known as a “Frozen Shoulder”, is a common condition that leads to stiffness and restriction of motion of the joint. The factors that lead to a Frozen Shoulder are not well understood, and the exact cause is often not uncovered. Frozen Shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.
Calcific Tendonitis is a condition in which calcium deposits within a tendon–most commonly within the rotator cuff tendons.
Shoulder Instability is a problem that causes a loose and unstable joint. Instability can be caused by a traumatic injury (dislocation), or may develop from heriditary factors. Shoulder instability is a problem that occurs when the structures that surround and stabilize the shoulder joint do not work to keep the ball tightly within its socket. This may allow the shoulder to slide partially out of place, causing a shoulder subluxation, and if it comes completely out of place, it is called a shoulder dislocation. Patients with shoulder instability often complain of an uncomfortable sensation that their shoulder may be about to shift out of place, and physicians call this “apprehension.” Patients who have sustained prior shoulder dislocations often develop chronic instability. The ligaments that support the shoulder are torn when the dislocation occurs. If these ligaments heal too loosely, then the shoulder will be prone to repeat dislocations and episodes of instability. When younger patients (less than about 35 years old) sustain a traumatic dislocation, shoulder instability will follow in about 80% of patients.
Athletes who compete in sports that involve overhead activities may have Multidirectional Instability (MDI). These athletes, such as volleyball players, swimmers, and baseball pitchers, stretch out the shoulder capsule and ligaments, and may develop chronic shoulder instability. While they may not completely dislocate the joint, the apprehension, or feeling of being about to dislocate, may prevent their ability to play these sports.
An AC Separation is commonly known as a “Shoulder Separation”, and these injuries are the result of a disruption of the acromioclavicular joint, which often result from falling directly on the shoulder joint. A shoulder separation is an injury to the acromioclavicular joint on the top of the shoulder. The shoulder joint is formed at the junction of three bones: the collarbone (clavicle), the shoulder blade (scapula), and the upper arm bone (humerus). The scapula and clavicle form the socket of the joint, and the humerus has a round head that fits within this socket. A shoulder separation occurs where the clavicle and the scapula come together. The end of the scapula is called the acromion, and the joint between this part of the scapula and clavicle is called the acromioclavicular joint. When this joint is disrupted, it is called an AC or Shoulder Separation.
The labrum is made of a thick tissue that is suscetible to injury with trauma to the shoulder, and can result in Labral Tears. The labrum becomes more brittle with age, and can fray and tear as part of the aging process. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable. This means that the bones of the shoulder are not held in place adequately, and therefore extra support is needed. To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. The labrum circles the shallow shoulder socket (the glenoid) to make the socket deeper. This cuff of cartilage makes the shoulder joint much more stable, and allows for a very wide range of movements. Interestingly, the range of movements your shoulder can make far exceeds any other joint in the body.
A SLAP Lesion is also a type of labral tear and commonly occurs from a fall onto an outstretched hand. This specific type of labral tear is called a SLAP Lesion, which stands for Superior Labrum from Anterior to Posterior. The SLAP tear occurs at the point where the tendon of the biceps muscle inserts on the labrum. Slap Lesions can also occur from repetitive overhead actions, such as throwing, or from lifting a heavy object. The area of the labrum where the SLAP tear occurs is susceptible to injury because it is an area of relatively poor vascularity. Other parts of the labrum often heal more easily because the blood supply delivers a healing capacity to the area of the tear. In the area of SLAP tears this is not the case, and chronic shoulder pain can result. Typical symptoms of a SLAP tear include a catching sensation and pain with shoulder movements, most often overhead activities such as throwing. Patients usually complain of pain deep within the shoulder or in the back of the shoulder joint. It is often hard to pinpoint symptoms, unless the biceps tendon is also involved. In cases of SLAP tears with associated biceps tendonitis, patients may complain of pain over the front of the shoulder.
Shoulder Arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery, which is highly invasive with prolonged recovery periods. Osteoarthritis is the most common type of shoulder arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by a progressive wearing away of the cartilage of the joint. As the protective cartilage surface of the joint is worn away by shoulder arthritis, bare bone is exposed within the shoulder, and the accompanying pain and functional disability ensues. Shoulder arthritis typically affects patients over 50 years of age, and is more common in patients who have a prior history of shoulder injury. There is also a genetic predisposition of this condition. Shoulder arthritis symptoms tend to progress as the condition worsens and invariably do so with aging