Shoulder

The main stabilizers of the shoulder are the rotator cuff tendons which are key to a healthy functioning shoulder. Tendons attach muscles to bones and muscles move the bones by pulling on the tendons. The rotator cuff helps raise and rotate the arm. The rotator cuff also keeps the humerus tightly in the socket of the scapula as the arm is moved. Rotator cuff tendons are subject to a lot of wear and tear, or degeneration, as we use our arms. Tearing of the rotator cuff tendons is an especially painful injury. A torn rotator cuff creates a very weak shoulder. Most of the time patients with torn rotator cuffs are in late middle age. But rotator cuffs tears can happen at any age. 

Adhesive Capsulitis, or a frozen shoulder, is a poorly understood condition in which the deepest layers of soft tissue, called the joint capsule, become diseased. In frozen shoulder, inflammation in the joint makes the normally loose parts of the joint capsule stick together. This seriously limits the shoulder’s ability to move and causes the shoulder to freeze. No one fully understands why this condition occurs so suddenly. Frozen shoulder may begin after a shoulder injury, fracture, or surgery. It can also start if the shoulder is not being used normally. This can happen after a wrist fracture, when the arm is kept in a sling for several weeks. For some reason, immobilizing a joint after an injury seems to trigger the autoimmune response in some people. Frozen shoulder has also been known to occur after surgery unrelated to the shoulder, even after recovering from a heart attack. Other shoulder problems like bursitis, rotator cuff tears, or impingement syndrome can end up causing a frozen shoulder. Doctors theorize that the underlying condition may cause chronic inflammation and pain that make you use that shoulder less. This sets up a situation that can create frozen shoulder. Usually, the frozen shoulder must be treated first to regain its ability to move before the underlying problem can be addressed.

Impingement syndrome occurs when the rotator cuff tendons rub against the roof of the shoulder, the acromion. Impingement becomes a problem when it causes irritation or damage to the rotator cuff tendons. The most common symptom of impingement syndrome is pain, usually sharp when moving the arm and achy at rest, generally surrounding the shoulder. This pain will get worse with reaching overhead, reaching behind the back, or lying on that side.