Specialized Care for Shoulder Problems

The shoulder is a common source of pain, ranging from tendonitis to severe arthritis to fractures, limiting mobility and every day activities. The Upper Extremity Center at Summit Orthopedic Specialists offers state-of-the-art shoulder diagnosis and treatment for patients with all types of shoulder injuries and conditions.

At Summit, orthopedic shoulder treatment options are available for patients with even the most complex problem. From minimally invasive arthroscopic techniques to complicated fractures, shoulder surgeons at Summit have the specialized training and experience to treat your pain. Our goal is to help restore function in each patient, from athletes to active seniors.

Shoulder Conditions and Injuries

Summit diagnoses and treats a wide range of shoulder problems. Some of these injuries and conditions are listed below.

Biceps tendonitis or tear at the shoulder

Repetitive overhead motion, such as baseball, tennis and swimming, can inflame and irritate the upper biceps tendon or cause a partial or complete tear. Symptoms may include a sudden, sharp pain, an audible popping or snapping, cramping of the biceps muscle, bruising, tenderness, and weakness.

For many, non-surgical treatment, including anti-inflammatory medication, rest, steroid injections and physical therapy, is a reasonable option. People with continued pain may require surgical intervention to cut or reattach the tendon.

Chronic shoulder instability

The shoulder is the most mobile joint in the body. The greater range of motion, however, can lead to instability. Instability occurs when the ball of the shoulder does not stay centered in the socket, as a result of injury or generalized laxity of tissues surrounding the shoulder. Symptoms include pain, repeated shoulder dislocations, and a persistent feeling of the shoulder being loose or unstable.

Chronic shoulder instability is usually treated with non-surgical methods first, including activity modification, anti-inflammatory medication, and physical therapy. Surgery may be necessary to repair torn or stretched ligaments to improve stability.

Clavicle Fracture

A broken collarbone is a very common fracture that can occur as the result of a fall onto the shoulder or a car accident. These fractures are very painful and may make it hard to move your arm. Other symptoms include a sagging shoulder, inability to lift the arm, a grinding sensation when trying to lift the arm, and a bump over the break.

If the broken ends of the bones have not shifted out of place and line up correctly, you may not need surgery. Non-surgical treatment includes arm support, medication, and physical therapy. Surgery may be needed if the bones are displaced.

Dislocated Shoulder

Because the shoulder is the body’s most mobile joint, it also makes it an easy joint to dislocate. The shoulder can be partially or completely dislocated out of the socket. Symptoms to look for include swelling, numbness, weakness and bruising. Sometimes dislocation may tear ligaments or tendons in the shoulder and damage nerves.

A dislocated shoulder should be reduced emergently and is usually treated with a period of immobilization or possible surgical repair if tendons or ligaments are torn.

Rotator Cuff Tears

The rotator cuff keeps the arm in the shoulder socket. Wear and tear or an acute injury can cause a partial tear or complete tear of one or more of the rotator cuff tendons. The most common symptoms include pain at rest and at night, pain when lifting and lowering arms, and weakness when lifting or rotating your arm.

Early treatment can prevent your problems from getting worse. Non-surgical treatment includes, rest, activity modification, anti-inflammatory medication, strengthening exercises, physical therapy and steroid injections. If pain does not improve or you have a large tear or significant weakness, surgery to repair the torn rotator cuff may be recommended.

Shoulder Impingement/Rotator Cuff Tendinitis

The rotator cuff is a common source of pain. Pain can be caused by irritated or damaged tendons; inflamed or swollen bursa; or pinching of the tendon and bursa between bones of the shoulder. The pain may be mild in the early stages. As the problem progresses, symptoms may include pain at night, loss of strength and motion, and difficulty performing overhead activities or reaching behind the back.

In most cases, initial treatment is non-surgical and may include rest, anti-inflammatory medication, physical therapy or steroid injections. When non-surgical treatment is ineffective, either arthroscopic or open surgery may be needed to create more space for the rotator cuff.

Scapula (Shoulder Blade) Fractures

Scapula fractures are uncommon and typically occur from high-energy, blunt trauma, such as a car accident or falling from a significant height. Symptoms include extreme pain when moving the arm and swelling around the back of the shoulder.

Non-surgical treatment with a sling works well for most fractures. Certain types of scapula fractures may require surgery to reposition the bone fragments in their normal alignment.

Shoulder Arthritis

While there is no cure for arthritis, there are many treatment options to manage pain and stay active. The most common symptom of arthritis is pain, which is aggravated by activity and progressively worsens. Limited range of motion is another symptom, along with popping or grinding in the shoulder.

As with other forms of arthritis, initial treatment of shoulder arthritis is non-surgical, including modifying activities, physical therapy, anti-inflammatory medication, and steroid injections. Surgical treatment includes arthroscopy to clean out the shoulder joint and shoulder joint replacement.

Shoulder Injuries in the Throwing Athlete

Overhand throwing places high stress on the shoulder, particularly to the anatomy that keeps the shoulder stable. In throwing athletes, these high stresses are repeated many times and can lead to a wide range of overuse injuries. Although throwing injuries in the shoulder most commonly occur in baseball pitchers, they can be seen in any athlete who participates in sports that require overhand motions, such as tennis, volleyball, and some track and field events.

In many cases, the initial treatment for a throwing injury is non-surgical and may include activity modification, ice, anti-inflammatory medication, physical therapy, and cortisone injection. If surgery is needed, most throwing injuries can be treated with arthroscopic surgery.

Shoulder Separation

A shoulder separation involves the joint where the collarbone meets the highest part of the shoulder. The injury usually results from a fall directly onto the shoulder and can range from a mild to severe separation, completely tearing ligaments and putting the joint noticeably out of position.

Non-surgical treatments such as a sling, cold packs, and medications can help manage the pain. If the pain continues or the shoulder deformity is severe, surgery may be considered.

Shoulder Fractures and Dislocation

Shoulder fractures, dislocations and other injuries to the area are very common. Fractures commonly involve the clavicle (collar bone), proximal humerus (top of the upper arm bone), and scapula (shoulder blade). Symptoms typically include pain, swelling and bruising, inability to move the shoulder, a grinding sensation when the shoulder is moved, and deformity.

Dislocations, which occur when the bones on opposite side of a joint don’t line up, can involve any of the three shoulder joints. The symptoms of a shoulder dislocation include a prominence about the front of the shoulder, inability to move the arm, an arm rotated outward, and the sensation of a dead arm.

Fractures and dislocations are often treated without surgery and may require immobilization, icing and pain medications.

Surgical Treatment for Shoulder Problems

Should you need surgery, our doctors are skilled in the latest surgical procedures, including:

  • Shoulder arthroscopy
  • Rotator cuff repair
  • Fracture surgery
  • Total shoulder replacement

If you are experiencing shoulder pain, please call Summit Orthopedic Specialists at (916) 965-4000.

Summit Orthopedic Specialists physician who diagnose and treat shoulder problems include:
Hunter Greene, M.D.
Scott Tanaka, M.D.