Shoulder

We offer an assortment of treatments for various injuries to the shoulder, including:

• Injections for bursitis
• Therapy for shoulder injuries or strains
• Arthroscopic rotator cuff repair
• Labrum repair and debridement
• Arthroscopic Bankart repair
• Total shoulder replacement
• Hemi arthroplasty
• Repair for proximal bicep tendon rupture
• Open reduction and internal fixation (ORIF) of clavical fractures and non-unions

Injections for Bursitis

Shoulder bursitis is a common problem seen from injury or overuse of the shoulder. It can also result from sleeping improperly, with the arm raised in an overhead position. When shoulder bursitis occurs, it can be very painful to raise the arms into an overhead position, such as reaching for a glass from a shelf. Treatment includes rest, anti inflammatories, physical therapy for rotator cuff strengthening. If this does not improve the situation, oftentimes an injection of Cortisone is placed into the bursa to reduce swelling. If symptoms persist or return, usually surgical decompression, most commonly performed arthroscopically, will be performed to create more space between the rotator cuff and the bones of the shoulder.

Therapy for Shoulder Injuries or Strains

Shoulder injuries or strains can occur through athletic pursuits as well as everyday activities, including gardening and routine housework. Oftentimes rest and anti inflammatories are all that are required. Many times physical therapy can be performed to help improve shoulder strength and reduce pain by strengthening the rotator cuff. Modalities are also used through physical therapy to reduce pain and swelling and to improve healing.

Arthroscopic Rotator Cuff Repair

Rotator cuff injuries can occur through repetitive use or traumatic injury. It can also be associated with shoulder dislocation. Arthroscopic rotator cuff repair is the preferred method of treatment, especially if treatment is addressed initially soon after injury occurs. If a patient leaves the shoulder untreated, an open procedure may be required to help mobilize the tendon or to help augment the repair.

Labrum Repair and Debridement

Labral injuries to the shoulder are commonly seen with repetitive use as well as traumatic events. These events normally occur with the arm extended away from the body. A rotational component often results in further injury. Dislocation may also result in labral injury. Arthroscopic repair is usually indicated if there is persisting pain and popping of the shoulder. An MRI is used to verify an injury to the labrum. Arthroscopic repair allows for minimally invasive procedures to roughen the bone and reattach the cartilage to the bone with suture anchors. Physical therapy is usually initiated six weeks after initial repair.

Arthroscopic Bankart Repair

Arthroscopic Bankart repair is often required after shoulder dislocation, due to improper healing and rest. It usually requires several weeks of immobilization in a sling or an immobilizer. Arthroscopically the shoulder can be visited to allow for good visualization of the cartilage and ligaments that stabilize the anterior portion of the shoulder. Arthroscopic repair is then initiated to reapproximate the cartilage and ligaments into an anatomic position. Good healing is usually required, which can extend six to eight weeks after surgery, prior to beginning physical therapy.

Total Shoulder Replacement

Over time our joints can wear out. Sometimes this is due to a traumatic injury that accelerates the process, but in many cases it simply results from wear and tear over time. The shoulder joint, when cartilage wears out and large bone spurs form, can be very painful. Total shoulder arthroplasty is a good way to reduce pain and still allow for use of the shoulder for years to come. Total shoulder replacement is designed to replace the ball as well as the cup. Total shoulder replacement usually requires a two to three day hospital stay and then several months of therapy to restore range of motion and strength.

Hemi Arthroplasty

Shoulder hemi arthroplasty is a treatment that is available for both arthritic applications as well as traumatic injuries to the proximal humerus, including comminuted fractures of the humeral head. Shoulder hemi arthroplasty allows for placement of a prosthesis that matches the curvature of the previous shoulder joint to allow for good restoration of range of motion and strength to the shoulder in a relatively pain-free setting.

Repair for Proximal Bicep Tendon Rupture

Injuries to the long head of the bicep tendon at the shoulder are typically seen after a traumatic injury or an excessive load with the upper arm in tension. With a complete rupture of the bicep tendon, options include physical therapy and/or surgical repair. Physical therapy is typically selected for patients that are lower demand and certainly not high performance athletes or heavy construction workers, as strength is only able to be restored to about 80 percent of prior levels. Repair of the bicep tendon allows for good tensioning of the muscle and restoration of the length of the muscle belly. Typically patients are able to regain 100 percent of their strength through adequate physical therapy.

Open Reduction and Internal Fixation (ORIF) of Clavical Fractures and Non-unions

Fractures of the midshaft of the clavicle are often seen as the result of a traumatic injury or blow to the shoulder. These can occur through sports, heavy construction work, horseback and bull riding, motocross riding, and even a simple fall to an outstretched hand. With minimal displacement, it is appropriate to treat with a sling and/or a figure of eight splint. With marked displacement and gapping of the bone as well as a shortening and overlapping of the bone, surgical fixation with a plate and screws is recommended. Typical bone healing time can be between six and twelve weeks. Once x-rays verify progressive healing, physical therapy for range of motion and strengthening can occur.