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My “Achy Breaky ” Shoulder Shoulder Pain and Treatment. Kennedy Club Fitness, Paso Mark G. Kowall , M.D., M.B.A. September 24, 2013. The Orthopedic Specialty Hospital. Knee and Shoulder Training. Shoulder Pain. M ost common sources Impingement Rotator Cuff Problems Instability
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My “Achy Breaky” ShoulderShoulder Pain and Treatment Kennedy Club Fitness, Paso Mark G. Kowall, M.D., M.B.A. September 24, 2013
The Orthopedic Specialty Hospital Knee and Shoulder Training
Shoulder Pain Most common sources • Impingement Rotator Cuff Problems • Instability Labrum Tears • Trauma Less Common Sources • Arthritis • Frozen Shoulder
Impingement Syndrome(“umbrella diagnosis”) Bursitis (25-40 y/o) Tendinitis (40-50 y/o) Rotator Cuff Tear (>50 y/o)
“Bursitis/Tendinitis”Symptoms • Pain with overhead motion • Shoulder to elbow location • Night time awakening • Pain with lifting • Occasional neck pain radiation • Usually no numbness/tingling
“Bursitis/Tendinitis”Treatment • Exam • XRays • NSAID’s • Physical Therapy or Home Therapy • Steroid Injection • MRI
Rotator Cuff Tear • Similar Symptoms as Bursitis • More pain • More weakness • Sometimes specific trauma but • More often “age related”
MRI Edge of tendon
Instability(Labrum Tears) S.L.A.P. Lesion Bankart Lesion
TraumaShoulder Separation • AC Joint • Fall off Bike onto shoulder • Usually no surgery (Depends on severity)
TraumaShoulder Dislocation • “Ball and Socket” Joint • Often requires ER visit • Can lead to recurrent dislocations
TraumaFracture • Common in older population (Usually no surgery) • Younger population (more frequent surgery)
“Arthritis”=“Tread Wear” Cartilage Healthy Joint Osteoarthritic Joint “tread wear”
Arthritis“Acromioclavicular Joint” Normal Arthritis Common in younger patients “Weight lifters”, construction workers
Acromioclavicular JointTreatment • NSAID’s • Activity Modification • Steroid injection • Arthroscopic Surgery (Removal of arthritic end of clavicle)
Shoulder X-RayArthritis Advanced Arthritis Normal Joint Space
Arthroscopy – Microfracture • small awl used to make holes in bone • promote re-growth of cartilage
Frozen Shoulder Treatment • Pain control (NSAID’s, steroid medication and injection) • Physical Therapy • TIME, TIME, TIME • Sometimes manipulation of shoulder under general anesthesia
Information Resource www.ShoulderKneeSpecialists.com