Shoulder Injuries and Treatment | Gleneagles Hospital

Common Conditions Affecting the Shoulder

The shoulder is a ball and socket joint consisting of 3 bones – the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle) – held in a stable position by ligaments, tendons and muscles. The shoulder provides the greatest range of motion in our body. It allows us to lift and rotate our arms in many directions. Common shoulder injuries, key medical conditions affecting the shoulder and the treatment options available are explored in this section.

Common Shoulder Injuries

Shoulder injuries often occur during sporting activities, especially those that need repetitive and excessive overhead motion, eg. tennis, badminton, swimming and weightlifting. Injuries may also occur during daily activities like hanging the laundry. Most problems develop slowly, and the ligaments, muscles and tendons are the areas that tend to be affected. Shoulder problems may be minor or serious, depending on the severity of the injury and how long it is left untreated. Common injuries include:

Dislocation

Being the body’s most mobile joint, the shoulder is prone to dislocation. Shoulder dislocation is when the upper arm bone pops out of the socket that is part of the shoulder blade, and is a painful and traumatic injury often caused by a fall or during contact sports.

If treated immediately, shoulder function can be fully regained. However, in some cases, the shoulder joint becomes unstable after a dislocation, making it more prone to future dislocations.

Warning signs and symptoms of a dislocation include swelling or bruising, intense pain, a visibly out-of-place shoulder, numbing sensation along the neck area, and being unable to move the shoulder joint. Seek medical help immediately for a shoulder that appears to have been dislocated.

Fracture

Trauma may fracture the bones that make up the shoulder, and the injury may need surgery if the impact caused bones to break and displace from their original positions. For minor cases, treatment usually needs a sling support to limit any movements until the bone fragments heal, which normally takes about 6 – 8 weeks.

The symptoms of a shoulder fracture include pain in the shoulder, tenderness, swelling, discolouration or deformity at the affected area and limits in shoulder movement.
Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is when the shoulder turns stiff and movement becomes painful and difficult. The condition develops slowly, usually after an injury. It may also be related to diseases such as diabetes. Swelling of the joint occurs, leading to the formation of scar tissue, causing the tissue around the shoulder joint to stiffen.

Signs & Symptoms

Frozen shoulder usually starts with pain, causing the affected person to avoid using the shoulder. This leads to stiffness and further reduction in motion over time.

Key signs and symptoms are:

– Pain
– Stiffness
– Limitation in movement

Diagnosis

Your doctor may check your medical history and examine your shoulder. These diagnostic tests may be used to assess the severity of your injury:

– X-ray
– Magnetic resonance imaging (MRI)

Treatment

Your doctor may prescribe non-steroidal anti-inflammatory medication (NSAIDS) to help ease the pain. Physiotherapy may also help to increase the shoulder’s range of motion over time. In certain cases, your doctor may advise surgical intervention such as a shoulder arthroscopy.

Shoulder arthroscopy, or arthroscopic shoulder surgery, is a minor surgery where a scope at the end of a long, thin tube is inserted into the shoulder area to evaluate the entire shoulder joint. The surgeon may then make small cuts to treat the problem. Speak to your doctor to understand the treatment options available.
Rotator Cuff Tear

The rotator cuff consists of tendons and muscles that work together to hold your arm in place and help in shoulder rotation and movement. Stress may cause partial tears and swelling, whereas abrupt force may cause one of the tendons to tear in the middle or pull away from the bone. This condition is known as a rotator cuff tear. Athletes in contact sports like tennis, football, or even swimming are prone to this condition. It may also be caused by accidental falls or lifting heavy weights.

Signs & Symptoms

Tears of the rotator cuff are often painful and can lead to potential disability depending on the severity of the injury. The onset of pain can be sudden or builds slowly, with or without weakness at the shoulder area. Symptoms include:

– Weakness or tenderness
– Pain
– Limited movement
– Snapping sound when moving the shoulder
– Not able to sleep on the side

Diagnosis

Your doctor may check your medical history and perform a physical examination. These diagnostic tests may be used to assess the severity of your injury:

– X-ray
– Magnetic resonance imaging (MRI)

Treatment

Rotator cuff tears usually heal on their own. However, surgery may be needed if results from the x-ray or MRI suggest that the mechanics of the shoulder are affected by the tear, which may result in irrecoverable damage, or if symptoms do not improve upon appropriate rehabilitation or physiotherapy.

Arthroscopic shoulder surgery, a minor surgery, can be used to treat a rotator cuff tear. A scope at the end of a long, thin tube is inserted into the shoulder area to evaluate the entire shoulder joint. The surgeon may then make small cuts to fix the injury. Speak to your doctor to understand the treatment options available.
Tennis Elbow

Tennis elbow, also known as lateral epicondylitis, is common in racket sport players like tennis and badminton, though the condition is also on the rise outside of sports activities. Any activity, be it sports or recreational, that involves excessive or repetitive turning or lifting of the muscles and tendons of the forearm near the elbow joint, may lead to this condition.

Tennis elbow occurs when the repetitive motion causes strain to the muscles and tendons attached to the elbow, thereby leading to tiny tears and swelling near the bony lump (lateral epicondyle) on the outside part of the elbow.

If your condition is caused by repeated strain on your elbow joint (eg. in playing tennis), taking a break or a change in technique may help relieve the problem. Avoiding stress on the muscles and tendons surrounding your elbow area may also help prevent the condition from worsening.

Signs & Symptoms

People suffering from tennis elbow usually experience pain and tenderness on the outer part of the elbow. Pain may also be felt in the forearm as well as the back of the hand.

Common signs and symptoms include:

– Pain on the outside of part of the elbow
– Tenderness and swelling
– Pain when bending or lifting the arm, writing or gripping objects
– Pain along with stiffness upon full extension of the arm

Diagnosis

Your doctor may check your medical history and examine for swelling and tenderness. Further diagnostic tests like an ultrasound or magnetic resonance imaging (MRI) scan may be used, especially if there is suspected damage to the nerves.

Treatment

With rest and reduction of the activity causing the condition, tennis elbow usually heals on its own. If there is a need, your doctor may prescribe non-steroidal anti-inflammatory medication (NSAIDS) to help ease the pain. Physiotherapy may also help to relieve the pain and stiffness, while helping to increase the range of motion over time. Surgery may be needed should there be damage to part of the tendon. Consult with your doctor to understand the treatment options available.