Shoulder Pain and Injury

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 broken (fractured) humerus is a break in the lower part of your upper arm, near your elbow joint.

Humerus fractures occur most often from:

• falling directly on your elbow
• a traumatic hit on or near your elbow, such as from a baseball bat or car or workplace accident
• a FOOSH (Falling On Out-Stretched Hand) injury

Symptoms of a humerus break are similar to other fractures, and include:

• Pain
• Swelling
• Bruising
• Tender to the touch
• Stiffness
• Instability, or feeling like your elbow is going to “pop out”

Fractures can be diagnosed by physical examination and X-ray, in our orthopedic clinic with a shoulder or elbow specialist or orthopedic urgent care. Treatment will depend on the severity of the fracture. Sometimes, a split and pain medications are sufficient. More severe fractures may require surgery.

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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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A type of reconstructive surgery, SLAP repairs are a common surgery to fix a torn labrum, a piece of fibrocartilage lining the rim of the shoulder socket

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 separated shoulder occurs at the AC joint, which is where the collarbone meets the highest point of the shoulder blade. The most common cause of a separated shoulder is from a fall directly onto the shoulder. The injury can range from a mild sprain to a complete tear of the AC ligament.

Symptoms of a separated shoulder can include a sizable bump on the affected area and pain.

Nonsurgical treatments for a separated shoulder include:

• Sling
• Cold packs/ice
• Pain medications

If the bump, or deformity is severe and pain persists even after nonsurgical treatments, surgery may be recommended. OrthoNebraska works with each patient to create a treatment plan that meets individual needs.

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When areas of the shoulder become inflamed, this could be considered shoulder arthritis. The pain and stiffness it causes can make daily tasks like brushing your hair or reaching into a cabinet challenging.

The most common symptom of shoulder arthritis is pain. However, you may also experience a limited range of motion and hear grinding, clicking or snapping sounds as you move.

There are five types of shoulder arthritis:

• Osteoarthritis (wear and tear)
• Rheumatoid (autoimmune disease)
• Post-traumatic (after an injury)
• Related to a rotator cuff tear
• Avascular necrosis (restricted blood supply)

Initial treatment of shoulder arthritis is nonsurgical. The following may be recommended as part of your treatment plan:

• Rest
• Change in activities
• Physical therapy
• Anti-inflammatory medications
• Injections
• Moist heat and ice
• Dietary supplements

If your symptoms are not improved with nonsurgical treatments or if your pain causes disability, surgery may be recommended, typically shoulder replacement. Your OrthoNebraska team will work with you to create a treatment plan that meets your individual needs.

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How this surgery is typically performed

Your rotator cuff is used during many daily activities, which makes it more susceptible to injury or wear and tear. Pain can stem from tendinitis (irritated tendons), bursitis (inflamed bursae) or impingement (acromion rubs against the tendon and bursae in your shoulder).

Shoulder impingement can affect athletes who participate in activities that involve them swinging their arms overhead such as swimming, baseball and tennis. It can also affect those whose occupation involves repetitive lifting or overhead activities like construction or painting. Lastly, shoulder impingement can be the result of a minor injury.

Symptoms likely start out as being fairly mild but can quickly escalate to any of the following:

• Pain during activity and rest
• Radiating pain from the front of the shoulder to the side of the arm
• Sudden pain with lifting and reaching
• Pain when throwing

Without treatment, these symptoms will likely worsen over time to include night pain, loss of strength and motion, difficulty with activities such as buttoning or zipping.

Nonsurgical treatments can typically provide relief from shoulder impingement:

• Anti-inflammatory medications
• Physical therapy
• Injections

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

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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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