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My “Achy Breaky ” Shoulder Shoulder Pain and Treatment

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 ” Shoulder Shoulder Pain and Treatment

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  1. My “Achy Breaky” ShoulderShoulder Pain and Treatment Kennedy Club Fitness, Paso Mark G. Kowall, M.D., M.B.A. September 24, 2013

  2. The Orthopedic Specialty Hospital Knee and Shoulder Training

  3. Shoulder Pain Most common sources • Impingement Rotator Cuff Problems • Instability Labrum Tears • Trauma Less Common Sources • Arthritis • Frozen Shoulder

  4. Anatomy

  5. Impingement Syndrome(“umbrella diagnosis”) Bursitis (25-40 y/o) Tendinitis (40-50 y/o) Rotator Cuff Tear (>50 y/o)

  6. Impingement“Bursitis/Tendinitis”

  7. “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

  8. “Bursitis/Tendinitis”Treatment • Exam • XRays • NSAID’s • Physical Therapy or Home Therapy • Steroid Injection • MRI

  9. Surgical Treatment“Decompression”

  10. Rotator Cuff Tear

  11. Rotator Cuff Tear • Similar Symptoms as Bursitis • More pain • More weakness • Sometimes specific trauma but • More often “age related”

  12. MRI Edge of tendon

  13. Rotator Cuff Repair

  14. Instability(Labrum Tears) S.L.A.P. Lesion Bankart Lesion

  15. Repair of the Labrum through the Arthroscope

  16. TraumaShoulder Separation • AC Joint • Fall off Bike onto shoulder • Usually no surgery (Depends on severity)

  17. TraumaShoulder Dislocation • “Ball and Socket” Joint • Often requires ER visit • Can lead to recurrent dislocations

  18. TraumaFracture • Common in older population (Usually no surgery) • Younger population (more frequent surgery)

  19. “Arthritis”=“Tread Wear” Cartilage Healthy Joint Osteoarthritic Joint “tread wear”

  20. Arthritis“Acromioclavicular Joint” Normal Arthritis Common in younger patients “Weight lifters”, construction workers

  21. Acromioclavicular JointTreatment • NSAID’s • Activity Modification • Steroid injection • Arthroscopic Surgery (Removal of arthritic end of clavicle)

  22. Arthritis“Ball and Socket Joint”

  23. Shoulder X-RayArthritis Advanced Arthritis Normal Joint Space

  24. Arthroscopy – Microfracture • small awl used to make holes in bone • promote re-growth of cartilage

  25. Shoulder Replacement

  26. Frozen Shoulder(Adhesive Capsulitis)

  27. Frozen Shoulder Treatment • Pain control (NSAID’s, steroid medication and injection) • Physical Therapy • TIME, TIME, TIME • Sometimes manipulation of shoulder under general anesthesia

  28. Information Resource www.ShoulderKneeSpecialists.com

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