SHOULDER

Your shoulder joint is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (arm bone). Your shoulders are the most mobile joints in your body. Ligaments, muscles, and tendons stabilize the shoulder joint. Shoulder pain can result from injury or overuse of any of these structures, and may also be due to arthritis.

The shoulder specialists at Orthopedic Associates of Hartford have specific training in the diagnosis and treatment of shoulder problems such as tendonitis, rotator cuff tears, dislocations, fractures, frozen shoulder, arthritis, as well as other less common shoulder disorders.

Our mission is to serve patients and athletes at all levels who face sports-related injuries. The sports medicine physicians at Orthopedic Associates have extensive training and experience in the operative and non-operative management of sports-related injuries to help patients avoid injury or resume activities as quickly and safely as possible.

Our fellowship-trained sports medicine orthopedic specialists:

  • Provide comprehensive evaluation and medical care to professional athletes, student athletes, and those who are sidelined with sports-related injuries.
  • Use the most advanced motion sensing technology to prevent injuries before they happen.
  • Educate orthopedic surgery residents and other physicians in the community on the operative and non-operative aspects of sports medicine, ensuring continual improvement in patient outcomes and satisfaction.
  • Consult with numerous local high school, collegiate, and professional sports teams on injury prevention and treatment. Click here to view teams that we cover.
  • Provide pre-season athletic orthopedic evaluations to assess your readiness to participate in sports at any level, including amateur, high school, collegiate, and professional sports.
  • Partner with our in-house physical therapy team, which develops protocols based on the best, most current evidence for rehabilitation of your injury. We coordinate with our therapists to ensure you receive necessary therapy so you can resume activities.
  • Provide medical coverage for key sporting events throughout the state. Click here to view recent sporting events.
  • Provide follow-up care for sports-related injuries treated at our urgent care centers.

We are the regional leaders in the diagnosis and treatment of sports injuries and illness. We proactively help you stay safe and manage all aspects of your care so that you can return to an active lifestyle.

Common Conditions

Some of the most common shoulder problems include: 

Sprains and Strains are tears to the ligaments or muscles caused by being stretched beyond their capacity.

Dislocation of joints occurs when one of the two bones that make up a joint separates from the other bone.

Tendonitis is inflammation or pain along a tendon. Tendons are the structures that connect your muscles to your bones. Tendons in the shoulder that can experience tendonitis are the rotator cuff tendons and upper part of the biceps muscle.

Bursitis is inflammation of a bursa. A bursa is a fluid-filled sac that is found where tendons pass by bony surfaces. Bursitis in the shoulder commonly causes pain on the side or front of the arm, and is worse with activities that place the hand at or above shoulder level.

Torn Rotator Cuffs are a group of four muscles that cover the top part of the arm bone (humerus) and help stabilize and move the arm. These muscles have tendons that can tear and cause shoulder pain and/or weakness.

Frozen Shoulder is a condition that causes painful loss of motion in the shoulder. It often occurs without any known cause of injury or, occasionally, after minor trauma.

Fractures of the bones, or broken bones.

Arthritis occurs when the cartilage of a joint surface is injured. Arthritis can cause pain, swelling, and loss of motion.

Diagnosis

Medical History & Examination
The art of diagnosing shoulder problems involves getting a good history from the patient and a comprehensive shoulder exam. During the medical history, your doctor will want to understand the nature of your pain, how it started, the impact on daily living, and activities that increase the pain. An exam is conducted and there are dozens of shoulder exam tests that can be used to identify the issue. Follow-up tests such as X-ray, ultrasound, MRI, CT scan or nerve conduction studies are often required to confirm shoulder pain diagnosis and rule out other injuries.

X-Ray
Dense structures, such as bone, show up clearly on x-rays. X-rays may show problems in your shoulder, such as arthritis or dislocation.

Other Tests
Magnetic resonance imaging (MRI) and/or ultrasound: These studies can create better images of problems with soft tissues, such as a torn rotator cuff.

Symptoms

Symptoms associated with shoulder pain depend on the cause and may include:

  • Dull, aching shoulder pain
  • Pain and weakness with shoulder use
  • Problems sleeping at night due to shoulder pain
  • Stiffness in the shoulder
  • Discomfort when performing overhead activities
  • Feeling that the shoulder could pop out of the socket
  • Problems with activities of daily living that are encountered due to lack of shoulder strength
  • Symptoms vary in intensity from mild to severe.

Treatment Options

There are a number of non-surgical and surgical options to restore mobility and reduce pain.

Non-Surgical Options:
Many shoulder problems can be approached in a non-operative manner with medications, rest, ice, and use of slings to alleviate pain. For local inflammation, sometimes an injection of cortisone medication (steroids) is used to quiet the inflammation. Physical therapy can be beneficial and provide specific exercises to restore motion and strengthen the upper extremities.

Initiating early treatment for shoulder problems is often the best curative course. When symptoms interfere with your lifestyle or result in persistent, severe, or intermittent pain, it is important to make an appointment to have your shoulder evaluated.

Surgical Options:
If an operation is needed, most of these conditions can be treated by arthroscopic (scope) techniques, with limited incisions, and usually can be done as a same-day surgery.

Our surgical team is adept at the most advanced surgical techniques to inspect, diagnose, and repair shoulder problems.

Patient Education

The most common causes of shoulder pain can be seen here

Shoulder impingement and tendonitis are discussed here

Shoulder instability, the causes, and treatment options

Injuries to the acromioclavicular joint

Dr. Clifford Rios provides information about the evaluation and treatment of the unstable shoulder

The following videos provide useful information about the wide range of treatment options that can be used to treat injuries and conditions of the shoulder.

Bankart Repair
Capsular Shift
Diagnostic Arthroscopy
Distal Clavicle Resection
Partially Torn Rotator Cuff
Fully Torn Rotator Cuff
Loose Body Removal
Repair of Detached Labrum
SLAP Lesion Repair
Subacromial Decompression
Synovial Problems
Total Shoulder Replacement
Trimming of Torn Labrum