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My “Achy Breaky” Shoulder Shoulder Pain and Treatment

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Presentation on theme: "My “Achy Breaky” Shoulder Shoulder Pain and Treatment"— 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 The Orthopedic Specialty Hospital
Knee and Shoulder Training

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

4 Anatomy

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

6 Impingement “Bursitis/Tendinitis”

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

8 “Bursitis/Tendinitis” Treatment
Exam XRays NSAID’s Physical Therapy or Home Therapy Steroid Injection MRI


10 Surgical Treatment “Decompression”

11 Rotator Cuff Tear

12 Rotator Cuff Tear Similar Symptoms as Bursitis More pain More weakness
Sometimes specific trauma but More often “age related”

13 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)

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)
Younger population (more frequent surgery)

20 “Arthritis” = “Tread Wear”
Cartilage Osteoarthritis is a particular type of arthritis which affects the cartilage in the joints, causing it to breakdown and eventually be lost all together. Healthy Joint Osteoarthritic Joint “tread wear”

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

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

23 Arthritis “Ball and Socket Joint”

24 Shoulder X-Ray Arthritis
Advanced Arthritis Normal Joint Space

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

26 Shoulder Replacement

27 Frozen Shoulder (Adhesive Capsulitis)

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

29 Information Resource

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