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My Achy Breaky Shoulder Shoulder Pain and Treatment Kennedy Club Fitness, Paso Mark G. Kowall, M.D., M.B.A. September 24, 2013.

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Presentation on theme: "My Achy Breaky Shoulder Shoulder Pain and Treatment Kennedy Club Fitness, Paso Mark G. Kowall, M.D., M.B.A. September 24, 2013."— Presentation transcript:

1 My Achy Breaky Shoulder Shoulder Pain and Treatment Kennedy Club Fitness, Paso Mark G. Kowall, M.D., M.B.A. September 24, 2013

2 Knee and Shoulder Training The Orthopedic Specialty Hospital

3 Shoulder Pain Most common sources Impingement Rotator Cuff Problems Instability Labrum Tears Trauma Less Common Sources Arthritis Arthritis Frozen Shoulder Frozen Shoulder

4 Anatomy

5 Impingement Syndrome (umbrella diagnosis) Bursitis (25-40 y/o) Tendinitis Tendinitis (40-50 y/o) (40-50 y/o) Rotator Cuff Tear Rotator Cuff Tear (>50 y/o) (>50 y/o)

6 Impingement Bursitis/Tendinitis

7 Pain with overhead motion Pain with overhead motion Shoulder to elbow location Shoulder to elbow location Night time awakening Night time awakening Pain with lifting Pain with lifting Occasional neck pain radiation Occasional neck pain radiation Usually no numbness/tingling Usually no numbness/tingling Bursitis/Tendinitis Symptoms

8 Exam Exam XRays XRays NSAIDs NSAIDs Physical Therapy or Home Therapy Physical Therapy or Home Therapy Steroid Injection Steroid Injection MRI MRI Bursitis/Tendinitis Treatment

9

10 Surgical TreatmentDecompression

11 Rotator Cuff Tear

12 Similar Symptoms as Bursitis Similar Symptoms as Bursitis More pain More pain More weakness More weakness Sometimes specific trauma but Sometimes specific trauma but More often age related More often age related

13 MRI MRI Edge of tendon

14 Rotator Cuff Repair

15 Instability (Labrum Tears) S.L.A.P. Lesion Bankart Lesion

16 Repair of the Labrum through the Arthroscope

17 Trauma Shoulder Separation AC Joint Fall off Bike onto shoulder Usually no surgery (Depends on severity) (Depends on severity)

18 Trauma Shoulder Dislocation Ball and Socket Joint Often requires ER visit Can lead to recurrent dislocations

19 Trauma Fracture Common in older population (Usually no surgery) (Usually no surgery) Younger population (more frequent surgery) (more frequent surgery)

20 Healthy Joint Osteoarthritic Joint tread wear Cartilage Arthritis = Tread Wear

21 Arthritis Acromioclavicular Joint Normal Arthritis Common in younger patients Weight lifters, construction workers

22 Acromioclavicular Joint Treatment NSAIDs Activity Modification Steroid injection Arthroscopic Surgery (Removal of arthritic end of clavicle) (Removal of arthritic end of clavicle)

23 Arthritis Ball and Socket Joint

24 Shoulder X-Ray Arthritis Normal Advanced Arthritis Joint Space

25 Arthroscopy – Microfracture small awl used to make holes in bone small awl used to make holes in bone promote re-growth of cartilage promote re-growth of cartilage

26 Shoulder Replacement

27 Frozen Shoulder (Adhesive Capsulitis)

28 Frozen Shoulder Treatment Pain control (NSAIDs, steroid medication and injection) Physical Therapy TIME, TIME, TIME Sometimes manipulation of shoulder under general anesthesia

29 Information Resource


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