Shoulder Surgery

Shoulder Conditions We Treat

• Shoulder instability
• Labral tears
• Rotator cuff tears

Shoulder injuries can occur due to trauma, such as a collision or fall, repetitive use, or degeneration due to age. Two common categories of shoulder injury include instability and tears.

Shoulder Instability

Instability refers to looseness of the "ball and socket" joint, known as the glenohumeral (GH) joint. The humeral head, or "ball" of the joint, may have too much motion toward the front, back, top, or bottom of the glenoid, or socket.

GH instability may be caused by an acute or chronic injury. There may be damage to the ligaments, labrum, rotator cuff, or capsule surrounding the shoulder joint. Genetic conditions such as Ehlers-Danlos Syndrome and Marfan Syndrome are also known to cause instability.

Instability results in pain and inflammation in the affected area, as well as a feeling of "looseness," as though the joint may pop out of the socket. Weakness of the affected shoulder may also occur, in addition to a grinding or clicking sensation.

Shoulder instability is diagnosed with a physical examination performed by your physician. Imaging such as an X-ray, CT scan, or MRI may also be necessary depending on the cause. Treatment will depend on the cause of your shoulder instability. Physical therapy is often used to strengthen the muscles surrounding the shoulder and provide greater support for the joint. Patients who do not find relief with physical therapy may require surgery.

Arthroscopy is a minimally invasive option to treat certain conditions, while an open procedure may be necessary for others.

Labral Tear

The labrum is a soft piece of cartilage that cushions the shoulder joint. A tear can occur at any point of the socket and may be caused by acute injuries, such as shoulder dislocations, or by chronic, repetitive stress to the joint. Athletes in sports such as baseball or volleyball are particularly susceptible to labral injuries.

Symptoms can vary depending on the location of the tear. Pain in the shoulder or bicep, weakness, or a clicking sensation may occur based on how and where the injury developed.

A labral tear is diagnosed through a physical examination and imaging such as an X-ray or MRI.

Treatment may be non-surgical or surgical depending on the patient's condition and the severity of the injury. Many patients respond well to physical therapy, anti-inflammatory medications, cryotherapy, injections, or activity modification. In athletes or patients who do not respond to non-surgical treatment, minimally invasive arthroscopic surgery may be recommended to repair or reattach the affected tissue.

Rotator Cuff Tear

The rotator cuff is a group of four muscles surrounding the shoulder joint that are responsible for most shoulder movement. Rotator cuff tears can occur due to acute injury, impingement syndrome (if left untreated), repetitive overhead activity, or age-related degeneration.

Rotator cuff tears can cause pain along the side of the shoulder, especially at night. Loss of motion or strength in specific directions may also occur depending on the severity and location of the tear. Larger tears may result in significant loss of motion. Pain can also radiate toward the neck.

Diagnosis is made through a physical examination assessing range of motion, pain, and strength. Imaging such as an X-ray or MRI may also be used.

Small or partial tears can often be treated without surgery using physical therapy, anti-inflammatory medications, cryotherapy, injections, or activity modification. Patients who do not respond to non-surgical treatment may require surgery. Many rotator cuff tears can be treated using minimally invasive arthroscopic techniques to repair partial tears or reattach tendons to bone.

After surgery, a sling is typically used to allow healing, followed by physical therapy to restore strength and flexibility.

If repair of the soft tissue is not possible, your physician may recommend a reverse total shoulder replacement to relieve pain and restore motion.

Frequently Asked Questions