Shoulder Questions and Answers
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Questions & Answers – Page 5
Questions relating to shoulder pain or previous surgery answered by Dr Joe de Beer.
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Ask Dr Joe de Beer a question regarding your shoulder problem or surgery you had in the past.
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My arm started paining (between the elbow and shoulder) and the pain has spread up tp my shoulder and the back of my shoulder.. it hurts when i lift my arm or use it. it has gotten worse over the last couple of weeks. i have gone to the doctor but only received pain medication.. the whole shoulder, arm and neck feels stiff.
The cause of this could be one of a few things – frozen shoulder, rotator cuff impingement, calcific tendonitis or even a rotator cuff tear. You should see a shoulder specialist to make the diagnosis and suggest the appropriate treatment. You are welcome to contact us on 021 9111 017 for an appointment.
Dr Joe de Beer
Orthopaedic Shoulder Surgeon
Dr Joe de Beers’ practice is confined to the care of shoulder problems of all types, and he does both open and arthroscopic surgery. He is a keen shoulder arthroscopist, and has developed an expertise in ultrasound of the shoulder, both diagnostically and for intervention.
Dr Joe de Beer specialises in the following shoulder surgery types.
Frozen Shoulder
Frozen Shoulder is a condition with no known cause in the majority of cases, with
spontaneous onset. It is most common in females (40-50 years) but could affect males and
other age groups.
Calcific Tendinitis
A calcium deposit accumulates in one of the tendons of the shoulder. The cause is unknown
and not related to injury, diet or osteoporosis. The patient most commonly affected is a
female 40-50 years of age.
Pectoralis Major Tendon Rupture
The pectoralis major (large pectoral) is a large muscle on the front of the upper chest
and arm. There are 2 “heads” – the clavicular and sterno-costal.
Proximal Humeral Fractures
Fractures of the proximal humerus (ball) account for 5-15 % of all fractures. Majority of
these occur in elderly individuals with osteoporosis, and are a cause of major
morbidity. In younger individuals, these fractures occur after high-velocity trauma.
SLAP Tears
S.L.A.P. is an acronym for Superior Labrum Anterior Posterior, which simply means that
the attachment of the long tendon of the biceps is torn away from the upper end of the
shoulder socket. (Superior Labrum = Biceps attachment, Anterior = front, Posterior =
back).
Shoulder Instability & Dislocation
The shoulder consists of a ball (humeral head) and socket (glenoid). The ball is
stabilized in the socket by a cartilage rim (“labrum”, which means “lip”) and the
ligaments, which attach to the labrum.
Subscapularis Tendon Tears
The subscapularis is a most important muscle at the anterior (front) of the shoulder
joint. It is often mentioned separately from the rest of the rotator cuff
(supraspinatus, infraspinatus and teres minor) but is essentially part of this group of
muscles.
Rotator Cuff Tears
Most tears are as a result of degeneration or “wear and tear”. The circulation to the
tendon becomes impaired in older people and leads to degenerative tears.
Osteoarthritis of the Shoulder (Arthritis)
The shoulder joint (gleno-humeral joint) is one of the most mobile joints in the body.
The gleno-humeral joint consists of a ball (humeral head) and socket (glenoid). As in
any other joint, the bone surfaces are covered with a specialised cartilage layer.
Impingement
A shoulder condition found mostly in people in the 40-60 year old age group.
The overlying acromion may squeeze or impinge upon the rotator cuff, causing inflammation and pain when elevating the arm.
The overlying acromion may squeeze or impinge upon the rotator cuff, causing inflammation and pain when elevating the arm.
Thoracic Outlet Syndrome
The thoracic outlet is the upper aperture of the chest, between the collar bone and the
first rib.This narrow passageway is crowded with blood vessels that run out of the chest
to the arm (subclavian vein and artery), as well as the nerves that exit the spine in
the neck to supply the arm.
Suprascapular Nerve Entrapment
Suprascapular nerve injuries have become increasingly recognized as a cause of shoulder
pain and dysfunction1. Recent advances in diagnostic and surgical techniques have
simplified the management of injuries of this nerve.
Clavical Fracture
The clavicle is prone to fracture because of its very superficial localisation. A fall
onto the arm, a lateral blow or a direct impact over the clavicle can cause a fracture.
The Biceps Tendon
The Biceps is an upper arm muscle that acts across the shoulder and elbow joints. At the
elbow, it helps to bend the joint. At the shoulder, its function is more complex and
incompletely understood.
Acromio-Clavicular Joint (AC Joint) Degeneration
This is the small joint on the top of the shoulder. It connects the tip of the clavicle
(collar bone) to the acromion (shoulder bone). It is held together by ligaments between
the two bones as well as strong ligaments between the collar bone and the coracoid (a
protrusion from the shoulder blade).
Acromio-clavicular (AC) Joint Dislocations
The acromio-clavicular joint is between the clavicle (collar bone) and the acromion
(shoulder bone). This injury usually results from a fall onto the tip of the shoulder or
on to the back of the shoulder.
Os-acromiale
Os-acromiale is a loose / mobile acromion of the shoulder which may or may not cause
pain. In the most cases the loose acromion may go undetected as it does not lead to any
painful symptoms.
Shoulder Injections
Injections around the shoulder joint are necessary for diagnostic and therapeutic reasons
in the course of evaluation of shoulder pain. The injection consists of local
anaesthesia and cortisone, either separately or mixed together.