Shoulder Pain and Injury

Pain and weakness felt in the front of the shoulder could be signs that you’re experiencing biceps tendinitis. Caused by inflammation or irritation to the upper biceps tendon, this condition can lead to a tendon tear or deformity if it’s left untreated.

Biceps tendinitis often occurs alongside other shoulder problems, including:

• Damage to the rotator cuff tendon
• Arthritis of the shoulder joint
• Tears in the glenoid labrum
• Chronic shoulder instability
• Shoulder impingement

Most often, biceps tendinitis is caused from degeneration or overuse. Any repetitive movement in which there is an overhead motion (swimming, tennis and baseball), the risk of acquiring this condition is greater. Symptoms include:

• Pain or tenderness in the front of the shoulder that worsens with activity
• Pain or achiness that moves down the upper arm bone
• Occasional snapping sound or sensation in the shoulder

Typically, biceps tendinitis is treated using nonsurgical methods such as rest, ice, anti-inflammatory medications, injections or physical therapy. If your condition does not improve using nonsurgical methods, surgery may be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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Your collarbone is one of the main bones of your shoulder, and a hairline fracture of it is one of the more common shoulder injuries. Most fractures are caused by a fall onto the shoulder.

Symptoms of a broken collarbone include:

• Sagging of the shoulder
• Inability to lift the arm due to pain
• Feeling of “grinding” when you try to lift your arm
• The presence of a bump over the break
• Bruising, swelling and tenderness over the collarbone area

Your treatment plan will depend on the severity of the break. If your bones can be reset and heal properly without surgery, the following may be recommended:

• Sling for arm support
• Pain medication
• Physical therapy

If your broken collarbone is more complex, surgery may be recommended. The OrthoNebraska team will work collaboratively with you to develop a treatment plan that best addresses your injury and goals.

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Frozen shoulder occurs when thick bands of tissue develop in the ligaments surrounding the shoulder joint, causing your shoulder to become stiff and tight.

Frozen shoulder becomes a likely culprit if your symptom is primarily dull or aching shoulder pain.

Frozen shoulder typically improves over time; however, it could take up to three years to fully recover. Treatment during this time generally includes pain management and physical therapy to restore motion and strength.

Additional treatment for frozen shoulder could include:

• Anti-inflammatory medications
• Injections
• Surgery

Surgery is typically only recommended if conservative treatment is not producing results. Your OrthoNebraska team will work with you to create a treatment plan that meets your individual needs.

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A rotator cuff tear occurs when one or more of the tendons in your rotator cuff is no longer fully attached to your humerus bone (arm). As with tears in other parts of the body, rotator cuff tears are most often caused by an acute injury such as a fall or from long-term wear and tear.

Additional risk factors for rotator cuff tears include repetitive lifting and overhead activities. Because of this, athletes and certain occupations are often impacted:

• Tennis players
• Baseball pitchers
• Painters
• Carpenters

You might have a rotator cuff tear if you have any of the following symptoms:

• Pain at rest and night
• Pain when lifting or lowering your arm
• Weakness when lifting or rotating your arm
• Feeling of a cracking sensation when moving your shoulder in certain ways

It is important to reduce activity and seek medical attention if you might have a rotator cuff tear. Continuing to lift or participate in sports can cause further damage. Your OrthoNebraska team will work with you to create a treatment plan that meets your individual needs, whether that involves nonsurgical or surgical treatment.

Nonsurgical treatment for rotator cuff tears includes:

• Rest
• Limited activity
• Anti-inflammatory medication
• Physical therapy
• Injections

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A tear in the ring of cartilage surrounding the socket of the shoulder joint is called a labrum tear or SLAP tear (superior labrum anterior and posterior). The location of the tear can also impact the bicep tendon and cause additional challenges. Throwing athletes and weightlifters have a higher risk of a labrum tear.

Acute trauma and repetitive shoulder motion are the primary causes of labrum tears. This includes:

• Motor vehicle accidents
• Fall onto an outstretched arm
• Forced pulling of the arm
• Forced movement of the arm when it’s raised above shoulder level
• Shoulder dislocation

Labrum tear symptoms include:

• A sensation of locking, popping, catching or grinding in your shoulder
• Pain with shoulder movement or holding your arm in specific positions
• Pain when lifting an object
• Reduced shoulder strength
• Feeling as though your shoulder might pop out of joint
• Reduced range of motion

It’s not uncommon for labrum tears to be treated without surgery. Nonsurgical treatment options include anti-inflammatory medication and physical therapy. If your symptoms and pain do not improve with medication and therapy, surgery may be recommended. OrthoNebraska’s specialists will work closely with you to develop a treatment plan that fits your individual needs and goals.

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Shoulder arthritis occurs when the joint becomes inflamed, causing pain, stiffness and difficulty with everyday movements like reaching or brushing your hair.

The most common symptom is pain, but you may also notice reduced range of motion and grinding, clicking or snapping sounds with movement.

There are five types of shoulder arthritis:

• Osteoarthritis (wear and tear)
• Rheumatoid arthritis (autoimmune)
• Post-traumatic arthritis (after injury)
• Rotator cuff tear–related arthritis
• Avascular necrosis (reduced blood supply)

Treatment typically begins with nonsurgical options such as rest, activity changes, physical therapy, medications, injections and heat or ice. If symptoms persist or limit daily function, surgery—most often shoulder replacement—may be recommended. Your OrthoNebraska team will create a plan tailored to your needs.

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Shoulder impingement often affects people with frequent overhead motion, such as athletes or those in jobs involving repetitive lifting. It can also develop after minor injuries.

Symptoms may start mild but can worsen and include:

• Pain with activity or at rest
• Pain radiating from the shoulder down the arm
• Pain with lifting, reaching or throwing

Over time, symptoms may progress to night pain, weakness, limited motion and difficulty with daily tasks.

Treatment usually begins with nonsurgical options like medications, physical therapy and injections. If symptoms persist, minimally invasive shoulder arthroscopy may be recommended.

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There are many different types of shoulder injuries, many of which are caused by athletic activities that require repetitive, overhead motion. However, the same can be true for any activity that involves repeated overhead movements such as washing walls and gardening.

You might have a shoulder injury if you answer “yes” to the following questions:

• Is your shoulder stiff?
• Do you have trouble moving your arm or shoulder into certain positions?
• Does your shoulder feel like it could “pop out” of the socket?
• Do you feel like you’ve lost shoulder strength during typical tasks?

Because the shoulder is comprised of bones, tendons, ligaments and muscles, the exact cause and solution to your injury should be diagnosed by an orthopedic specialist.

Treatment of your shoulder injury depends on the severity of your injury. More than likely shoulder strengthening exercises will be recommended, along with anti-inflammatory medication.

If relief is not achieved through nonsurgical methods, surgery may be recommended, typically a minimally invasive shoulder scope.

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A shoulder joint tear appears in the tissue rim that surrounds the shoulder socket. This type of injury can be the result of trauma such as falling, a direct blow or sudden pull or from repetitive shoulder movement like throwing.

You may have a shoulder joint tear if any of the following symptoms are present:

• Feeling of instability in your shoulder
• Dislocation
• Pain with overhead activities
• Sounds of catching, locking, popping or grinding
• Night pain
• Reduced range of motion
• Loss of strength

Initial treatment for a shoulder joint tear could include anti-inflammatory medication and rest followed by rehabilitation exercises. However, if your injury does not appear to heal, surgery may be recommended, typically a minimally invasive shoulder scope.  Your OrthoNebraska team will work with you to create a treatment plan that meets your individual needs.

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