Introduction to the Shoulder:
The shoulder joint is a “ball and socket” joint. In the shoulder, unlike the hip, the socket is rather flat. The advantage of a flatter/shallower socket in the shoulder is that it allows less restriction and more mobility. Shoulders have a tremendous range of motion as compared to the deeper socket and more constrained hip joint. However, the extra mobility and range of motion comes at a price. The hip is a very stable joint and very rarely will pop out of socket (dislocate), whereas the shoulder is a much less stable joint and is the most commonly dislocated large joint in the body.
Most Common Shoulder Problems:
Labrum Tears & Biceps Tendonitis, Tears:
The “looseness” of the shoulder can lead to tears of the labrum, which is a rim of cartilage around the perimeter of the glenoid which is the socket. It can also lead to stretching out of the capsule which is like the “casing” around a joint. One or both of these can lead to instability in the otherwise “normal” shoulder. Sometimes surgery is needed to repair the labrum back to the bone and/or tighten up the capsule so it is not loose anymore. Many times, this can be treated non-operatively with physical therapy by doing exercises that strengthen the muscles around the shoulder, particularly the rotator cuff.
Sometimes the biceps tendon in the front of the shoulder gets inflamed (biceps tendonitis), and we will inject the groove where the biceps tendon passes from the front (anterior) part of the shoulder. In the end, cortisone can lead to benefits of decreased pain and inflammation and increased ROM, allowing the patient to progress better with their exercise/P.T. program.
What is the AC Joint?
What kinds of problems occur at the AC Joint?
How do you treat arthritis of the AC Joint?
What can be done if those treatments do not work?
What is an AC Separation?
- Grade I Injury- the least damage is done, and the AC joint still lines up
- Grade II Injury-damage to the ligaments which reinforce the AC joint. In a grade II injury these ligaments are only stretched but not entirely torn. When stressed, the AC joint becomes painful and unusable
- Grade III Injury-AC and secondary ligaments are completely torn and the collarbone is no longer tethered to the shoulder blade, resulting in a visible deformity
What is Treatment for AC separation?
Instruction on when and how much to move the shoulder should be provided by your physician, physical therapist, or certified athletic trainer. The length of time needed to regain full motion and function depends on the severity or grade of the injury. Recovery for a Grade I AC separation usually takes 10 to 14 days, whereas a Grade III may take six to eight weeks.