Common Rotator Cuff Injuries and How They’re Treated

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The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Total Shoulder Replacement: What is it?

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Article featured on Orthopaedic Institute Brielle Orthopaedics

Total shoulder replacement is a surgical procedure that treats severe shoulder osteoarthritis that does not respond to nonsurgical treatment options.

At The Orthopaedic Institute Brielle Orthopaedics our Shoulder Specialists have extensive experience and utilize the latest technology in performing shoulder replacement procedures.

The procedure is effective because it removes osteoarthritic bone and cartilage and replaces it with functional metal and plastic components that serve as a “new shoulder”. After recovery and physical therapy, patients experience tremendous pain relief and live normal lives with minimal restrictions.

Important procedure steps are:

  1.  Anesthesia. A Board Certified Anesthesiologist administers general anesthesia so no pain or discomfort is felt during the procedure.
  2. Incision. A small incision is made on the front of the shoulder. Muscles and soft tissues are retracted so the joint can be visualized.
  3. Bone preparation. The head of the humerus (arm bone) and glenoid cavity are carefully cut in preparation of implants.
  4. Trial implants. Trial implants are placed in the shoulder until the perfect size is found. A physical examination confirms the implants fit and the shoulder moves properly.
  5. Permanent implants. Biological cement is placed over the bones and permanent metal and plastic implants are put in place. Once the cement hardens, an additional physical examination is performed.
  6. Incision closure. Sutures and skin staples close the incision and sterile dressings cover it. A shoulder sling is put on to keep the shoulder in a neutral position.

Total procedure time is usually 1 hour depending on osteoarthritis severity and shoulder anatomy.

A short hospital stay is necessary for pain management, infection prevention and physical therapy purposes. In some cases, a partial total replacement (one bone is replaced) or reverse total shoulder (implant positions are reversed) replacement are performed.

It is always best to receive a shoulder osteoarthritis diagnosis as soon as possible. Early treatment relieves symptoms and prevents the chronic condition from becoming worse.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Top 5 Causes of Shoulder Dislocations

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Article featured on Coastal Orthopedics

It is a great compliment to be described as having “broad shoulders.” This indicates a person with strength, skill, and experience, able to take on many responsibilities and handle any criticisms without complaint.

The same holds true in athletics, in which big, broad shoulders are an indicator of power, endurance, and durability. And in general, the expression holds considerable truth: strong shoulders are a necessity for most sports, most of which require excellent upper-body skills such as swinging, throwing, and lifting—sometimes with extreme force.

However, no matter how strong or broad one’s shoulders may be, this feature does not change the fact that a dislocated shoulder is the #1 most common joint dislocation injury.

What is a Dislocated Shoulder?

The shoulders are the human body’s most mobile joints. Able to rotate in nearly every direction and every angle, they provide remarkable flexibility and power for every conceivable usage of the arm, from the most demanding athletic activities to the most subtle and delicate of gestures. But this versatility comes with a major compromise: that of structural strength and stability.

Structurally speaking, the shoulder is evolved more for flexibility and motion, and not as much for strength and stability. Our arms normally do not require the heavy lifting power of our legs; our shoulders don’t need to anchor and support the entire weight of the head and torso, as do our hips.

The compromise of freedom-of-motion over stability is what leaves the shoulder so susceptible to dislocation. More than half of all joint dislocations treated across the country are for the shoulder.

How Does a Dislocated Shoulder Happen?

A shoulder dislocation generally occurs when the ball-shaped top of the upper arm bone (humerus) is pulled partially or completely out of its shallow, cup-shaped socket in the shoulder blade (scapula). A ring of tough cartilage lines that socket, and the bones are connected by the ligaments of the joint capsule and the tendons of the rotator cuff, forming a kind of protective sleeve holding the joint together.

The entire structure provides remarkable resiliency to the stresses of everyday motions. Significant force is required to pull the humerus out of its socket, and to overcome the cushioning and shock absorption abilities of the tissues of the joint capsule. This is why a dislocation often includes damage to any or all of the surrounding tissues, adding complications to the injury such as torn ligaments, severed tendons, internal bleeding, inflammation, etc.

Most shoulder dislocations occur when the shoulder is forcibly moved upwards and back—the one direction the shoulder cannot easily go. However, if enough pressure is applied to the joint, the top of your humerus may become dislocated in any direction or angle.

Type of Shoulder Dislocations

Doctors classify shoulder dislocations into three groups:

  1. Traumatic dislocation – With this dislocation, the shoulder has been subjected to a strong traumatic force, one powerful enough to have pulled the shoulder out of joint. This generally results in a serious injury that will require rehabilitation and surgery to correct.
  2. Atraumatic dislocation – With this type dislocation, the shoulder dislocates with little force, caused by everyday activities like reaching for something on a high shelf, or rolling onto the shoulder in bed. This injury may happen repeatedly to a person with loose ligaments (“double joints”) with no pain or damage.
  3. Positional non-traumatic dislocations – Some people’s shoulder muscles operate in unusual patterns, resulting in the ability to pull their shoulders out of joint easily, painlessly, and at will. Physical therapy or surgery may be used to correct the issue, should it become painful or problematic, but most people who can do this trick would rather keep this skill and use it to frighten their children or impress their friends.

The Five Most Common Causes of Dislocated Shoulders

A dislocated shoulder may occur from five common sources: sports injuries, impact injuries, falls, repetitive stress injuries (RSIs), and “loose ligaments.”

1. Sports injury

Shoulder dislocations occur most commonly in sports and athletic activities, particularly those that require repeated, forceful use of the shoulder. In addition, any impact that includes a twisting motion increases the likelihood of a resulting shoulder dislocation.

  • Injuries common in all the following sports often result in a dislocated shoulder (specific activities that can cause this injury are listed for each activity):
  • Football: High-speed impact with other players; full-speed falls to the turf; throwing too hard; overreaching to catch or grab; hyperextensions; hard tackles; overtraining.
  • Hockey: High speed impacts with other players wearing heavy protective gear; crashes into walls and barriers; falls onto the ice; impact with hockey sticks.
  • Rock climbing: Hanging too long with one’s full weight on one arm; slipping and making an emergency grab; catching heavy falling equipment.
  • Rugby: Heavy impacts with one or more players; crashing to the turf with other players (especially when one or more fall on top of you); tackling; falling.
  • Soccer: Falls at all-out running speeds; tackles; impact with hard-kicked balls.
  • Skiing: High-velocity falls; long skidding crashes; impacts onto icy or hard surfaces.
  • Volleyball: Falls; hyperextensions; being hit by a ball hit a high speeds.
  • Gymnastics: Impacts, especially those requiring the placement of one’s full weight on one’s hands; falls from heights; impact with equipment such a balance beam or pommel horse.

2. Impact injury

  • Car accidents: Shoulders often bear the brunt of blows during motor vehicle accidents.
  • Hard impacts to the shoulder: Such as accidentally ramming a door frame while running, or taking a blow to the shoulder during an altercation.
  • Violent seizures or shocks: These may cause powerful muscle spasms that result in injuries throughout the body, including shoulder dislocations.

3. Falls

  • Trying to break a fall: Throwing out your hand is totally instinctive, but this often results in either a dislocated shoulder or, worst case, a snapped clavicle.
  • Any fall: Falling from as little as 4 or 5 feet can be dangerous, whether it is falling off of a ladder onto your shoulder, or tripping and falling full onto the floor. Either may result in a dislocated shoulder.
  • Impacts onto hard surfaces: Falling onto surfaces such as a concrete sidewalk or a wood floor can be hard enough to cause a dislocation.

4. Repetitive Stress Injury

  • Overtraining: Often caused by overtraining in specific sports-related movements, e.g. practicing a golf swing; swimming too many laps; serving too many tennis balls or volleyballs; or throwing too many baseball pitches, football passes, or basketball foul shots.
  • Work-related activities: These may also result in a shoulder dislocation; for example, sawing wood, moving heavy bags, or digging.

5. Loose ligaments

  • Connective tissue loosening: The connective tissue in the shoulder that normally keeps the head of the upper arm bone in the shoulder socket may become “loose” due to injury, overuse, or from previous shoulder dislocations. Such an unstable joint may become likely to suffer repeated dislocations.
  • Multi-directional instability: This is a fancy name for a genetic condition commonly known as “double jointedness.”

Summary

Dislocated shoulders are very common, especially in athletics. If you or your child is headed back into the sports season soon, you may wish to see a doctor for a pre-season physical to rule out risk factors and to learn more about how to prevent this injury.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Symptoms & Causes of Rotator Cuff Injuries

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Article featured on MedlinePlus

What is a rotator cuff?

Your rotator cuff is part of your shoulder joint. It’s a group of muscles and tendons that holds the top part of your upper arm bone firmly in your shoulder socket. The rotator cuff keeps your shoulder stable when you move your arm in any direction.

What are rotator cuff injuries?

Rotator cuff injuries are common. Most of them are wear-and-tear injuries from doing the same arm movements over and over – especially reaching over your head. With time, the tissues in the rotator cuff break down, leading to these injuries:

  • Tendinitis. The tendons in the rotator cuff connect your muscles to your shoulder bones. In tendinitis, the tendons become irritated and swollen from being pinched during shoulder movements.
  • Bursitis. The bursa is a small, fluid-filled sac that pads the space between the rotator cuff and the bones of your shoulder. Bursitis happens when the muscle and bone rub the bursa too much. It swells with extra fluid, which causes pain
  • Rotator cuff tears. Tears in a rotator cuff tendon can happen over time or suddenly from an injury, such as falling on an outstretched arm or lifting something heavy. A tear may go part way through a tendon (partial tear) or all the way through (full tear).

Who is more likely to develop a rotator cuff injury?

Anyone can develop a rotator cuff injury. But certain people are more likely to have one:

  • People over age 40. Most rotator cuff injuries are from the wear and tear of aging. By age 80, most adults have tears.
  • Athletes. Playing sports with repeated shoulder movements increases the risk of a rotator cuff injury, for example, tennis, swimming, and baseball – especially pitching.
  • People in jobs that require a lot of reaching overhead or heavy lifting. Carpenters, construction workers, and painters are examples of workers who may be more likely to have rotator cuff problems.

What are the symptoms of rotator cuff injuries?

Rotator cuff injuries don’t always cause pain. But when they do, the pain is often in the top part of your arm or shoulder. You may feel more pain when you:

  • Lie down, especially on the injured shoulder
  • Lift your arm or lower it to the front or side
  • Reach behind your back

Other symptoms from a torn rotator cuff may include:

  • Loss of strength in the arm
  • Clicking or popping sounds when you move your arm

How are rotator cuff injuries diagnosed?

To find out if you have a rotator cuff injury, your health care provider:

  • Will examine your shoulder. This includes checking the range of motion and where the pain is.
  • Will test your arm and shoulder strength.
  • May order imaging tests, such as x-rays, an ultrasound, or an MRI scan.

What are the treatments for rotator cuff injuries?

The best treatment for you depends on your age, how much your injury bothers you, and whether your injury was sudden or happened from wear and tear.

Treatments for rotator cuff injuries often include:

  • Rest
  • Putting ice or a cold pack on the sore area
  • Pain relievers to lessen pain and swelling, such as ibuprofen or aspirin
  • Physical therapy exercises to strengthen your shoulder and improve movement
  • A corticosteroid shot into your shoulder joint if other treatments don’t help with the pain

Treatments for rotator cuff tendinitis and bursitis may also include ultrasound therapy. Surgery may be an option if your shoulder doesn’t feel better in 6 to 12 months.

Treatments for a torn rotator cuff may also include heat to the sore area or electrical stimulation of the nerves and muscles (transcutaneous electrical nerve stimulation, TENS).

You provider may suggest surgery if your tear is large or is from a recent injury, or symptoms last for 6 to 12 months.

When should I see a health care provider for shoulder pain?

If certain activities bother your shoulder, it’s best to stop doing them and check with your provider. That’s because early treatment can prevent mild rotator cuff injuries from becoming more serious later on. If you your arm feels weak right after a sudden injury to your shoulder, see your provider as soon as possible.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Deal with Severe Shoulder Pain

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Article featured on HealthPartners

A diagnosis of osteoarthritis can be tough. But golfing, swimming and tennis don’t have to be over. Neither do activities like playing catch with the grandkids and working out.

Some shoulder pain can be relieved with medicine, exercise, physical therapy, ice and heat. But if your pain still won’t go away, it may be time to consider shoulder replacement surgery.

When you move your shoulder, your bone, muscles, tendons and cartilage have to work together. They’re part of what makes lifting, reaching and flexing possible. But over time, the cartilage that cushions the bone in your shoulder joint can break down.

If you don’t have much of this cushioning left, surgery may be a good option for you. Surgery can also help if your pain is unbearable and won’t go away with other options.

Surgery replaces the damaged part of your upper arm bone, which can help with cartilage issues. Afterward, your shoulder won’t move as far as it did before. But it should feel better and have less pain.

Orthopedic centers have many options to relieve shoulder pain. Total joint replacement surgery is one of those options.

So when shoulder pain becomes unbearable, don’t shrug it off.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Symptoms & Solutions: Rotator Cuff Tears

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Article featured on Arkansas Surgical Hospital

Rotator cuff tears are intensely painful injuries to the rotator cuff area, which is a group of muscles in the shoulder that allows you to make a wide range of movements. While a minor rotator cuff tear can be treated in various ways, a severely torn rotator cuff often requires surgery for a full recovery.

Most rotator cuff tears result from a single incident, such as a sports accident, a fall, or lifting something that’s too heavy. Sometimes, a tear can result from a bone spur in the shoulder. Rotator cuff tears are also prevalent in individuals who use repetitive motions, such as lifting boxes or reaching above their heads. For example, construction workers and delivery people often develop rotator cuff tears after years of overusing their shoulder joints.

Symptoms of a Torn Rotator Cuff Pain

The first and most noticeable sign of a rotator cuff tear is pain that can be excruciating. The pain will cover a large area, including the outside of your shoulder and upper arm. The discomfort increases when you lift your arm over your head and is usually worse when you’re trying to sleep. Because nerves run down the arm from the rotator cuff, some patients experience pain as far down as their elbow. A constant, dull throbbing or ache in the shoulder is also common.

Movement Limitations

If the rotator cuff is torn, it will be difficult to move your arm and shoulder normally. Simple activities like brushing your hair, getting dressed, and preparing food will cause a great deal of pain. Carrying even small items may be difficult because you don’t have a full range of motion.

Stiffness

Your shoulder becomes stiff and tender when you have a torn rotator cuff. If you stop moving your arm, the area will become even more inflexible. This complicates the situation since movement is painful but not moving the joint can lead to a stiff or frozen shoulder.

Weakness

When your rotator cuff is torn, your shoulder can’t support as much weight as it normally does. Lifting something even as light as a book or a mug of coffee may be difficult. Your grip may be weak, making it difficult to keep hold of things.

Treatment Options for a Torn Rotator Cuff

Rest, Ice, & Physical Therapy

If the tear is minimal, resting the area and periodically icing it to reduce the inflammation may be helpful. Doctors usually combine this method with physical therapy to promote movement and keep the area from stiffening and impacting your range of motion. After several days, ice may be alternated with heat to improve blood flow. Patients may want to use a sling to support the shoulder and minimize discomfort when they’re not in physical therapy. In addition, over-the-counter pain medications can alleviate shoulder pain.

Steroid Injections

For intense pain, steroid injections into the joint near the tear can reduce swelling and help you rest comfortably. These injections provide temporary relief so you can continue with physical therapy and sleep better. However, using them for too long or at high doses should be avoided to minimize the risk of weakening the damaged tendon.

Rotator Cuff Surgery

There are several surgical options for rotator cuff tears. And if the injury is severe enough, surgery may be the only option.

Your physician can help you determine whether surgery is the best option for you. If you have to use your arms to lift or reach over your head for work or sports, surgery may be a good idea. Other indications that rotator cuff repair surgery may be the right choice for you include:

  • Pain that has lasted at least 6 months
  • A tear resulting from an acute injury
  • A tear larger than 3 centimeters in an otherwise healthy tendon
  • Weakness, loss of function, or a limited range of motion that lasts several months

Types of Surgery for Rotator Cuff Tears

Partial Rotator Cuff Repair

A partial rotator cuff repair is performed when the tendon is torn but hasn’t fully detached from the underlying bone. Part of the acromion bone—which is located on the scapula, or shoulder blade—is removed during the procedure. This gives the rotator cuff more room for movement.

Arthroscopic surgery is then performed to removed the inflamed bursa sac and smooth the frayed ends of the torn tendon. If needed, a damaged ligament may also be removed. This procedure is done through small incisions on the side and back of the shoulder.

Full Rotator Cuff Repair

A full rotator cuff repair surgery is needed if the tendon has torn through completely or is completely detached from the humerus, or upper arm bone. A full rotator cuff repair may be performed in a few different ways based on the extent of the damage.

  • Arthroscopic surgery: Small incisions are made in the back and side of the shoulder, debris is flushed out with a saline solution, and the surgeon removes any damage such as bone spurs. Then, the tendon is reattached the humerus with suture anchors.
  • Open surgery: This is done only in cases of severe joint degeneration or severe injury. Bone and tissue grafts from other areas of the body are used to replace damaged bone, cartilage, and tendons. The tendon is then reattached to the head of the humerus bone.
  • Mini-open surgery: This “in-between” option is sometimes done if the surgeon needs a larger incision than is used in arthroscopic surgery, but grafts or opening the entire shoulder joint aren’t required.

Get Help for Your Torn Rotator Cuff

If shoulder pain and limited movement impact your daily life, it’s essential to see a doctor who’s familiar with the treatment options for rotator cuff tears.

Physicians will use x-rays, MRIs, arthroscopy, and other tools, combined with a physical exam, to determine the extent of the damage and advise you on your treatment options.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

10 Stretches for Shoulder Tightness

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Article featured on MedicalNewsToday

Shoulder stretches can help relieve muscle tension, pain, and tightness in the neck and shoulders.

Stiff or tight shoulders can cause discomfort and limit a person’s range of motion. If the tightness goes unchecked, it can lead to neck pain and cause tension headaches.

In this article, we describe 10 shoulder stretches and their benefits. We also discuss what causes shoulder tightness and how to prevent it.

1. Neck stretches

Neck stretches can help release tension at the top of the shoulders. To do a neck stretch:

  • Stand with the feet hip-width apart.
  • Let the arms hang down by the sides.
  • Look forward.
  • Tip the head to the right, trying to touch the right ear to the right shoulder.
  • Feel the stretch in the left side of the neck and shoulder.
  • Tip the head to the left, trying to touch the left ear to the left shoulder.
  • Feel the stretch in the right side of the neck and shoulder.Each time, hold the position for 10 seconds.
  • Repeat this three times on each side.

2. Shoulder rolls

Shoulder rolls are an easy way to stretch the shoulders. To do shoulder rolls:

  • Stand with the feet hip-width apart.
  • Let the arms hang down at the sides of the body.
  • Breathe in and lift the shoulders up toward the ears.
  • Move the shoulders back, squeezing the shoulder blades together.
  • Exhale and drop the shoulders back.
  • Move the elbows forward, feeling the stretch at the back of the shoulders.
  • Repeat this 10 times.

3. Pendulum stretch

The pendulum is a gentle way to increase movement in the shoulder using the force of gravity. To do this stretch:

  • Stand with the feet hip-width apart.
  • Lean forward and look at the ground.
  • Place the right hand on a table or chair for support.
  • Let the left arm hang down.
  • Swing the left arm gently in small circular motions, letting gravity do most of the work.
  • Continue for 30 seconds to 1 minute.
  • Change the direction of the motion.
  • Repeat this, using the other arm.

4. Cross-body arm swings

Arm swings help warm up the shoulder joint and increase movement. To do cross-body arm swings:

  • Stand with the feet hip-width apart.
  • Inhale and lift the arms out to the sides, squeezing the shoulder blades together.
  • Exhale and gently bring the arms in toward each other.
  • Cross the right arm under the left, keeping both arms straight.
  • Inhale and swing the arms back out to the sides, squeezing the shoulder blades together.
  • Exhale, and gently swing the arms in toward each other again.
  • This time, cross the left arm under the right, keeping both arms straight.
  • Repeat this 10 times.

5. Cross-body shoulder stretch

The cross-body shoulder stretch helps extend the back of the shoulder. To do this stretch:

  • Stand with the feet hip-width apart.
  • Stretch the right arm out straight.
  • Bring the right arm across the body, so that the hand points to the floor on the other side of the left leg.
  • Bend the left arm at the elbow.
  • Hook the left forearm under the right arm, supporting the right arm above the elbow.
  • Use the left forearm to pull the right arm further in and across the body, stretching the back of the right shoulder.
  • Hold this for 20 seconds, then repeat the stretch on the other side.

6. Child’s Pose

Child’s Pose is a gentle yoga pose that can help stretch the back of the shoulders. To do this pose:

  • Kneel on the ground or a mat.
  • Touch the big toes together.
  • Spread the knees apart.
  • Sit up straight.
  • Inhale and reach the arms above the head.
  • Exhale and bow forward, toward the floor, reaching the arms out in front.
  • Touch the ground with the palms.
  • Bring the elbows to the ground.
  • Sit back, bringing the bottom of the back toward the heels.
  • Feel the stretch in the back of the shoulders.
  • Breathe deeply, and hold the position for 1 minute or longer.

7. Ragdoll Pose

Ragdoll Pose is a forward-bend yoga pose that may help release tension in the shoulders. To do Ragdoll Pose:

  • Stand with the feet hip-width apart.
  • Bend the knees slightly.
  • Bend forward and try to touch the toes.
  • Keep the stomach against the bent knees to support the lower back.
  • Place each hand on the elbow of the opposite arm.
  • The crown of the head should point toward the floor.
  • Let the head hang heavily, releasing tension in the neck and shoulders.
  • Stay in the pose for 1 minute or longer.

8. Eagle arm stretch

The eagle arm stretch is inspired by the upper body position in the Eagle Pose in yoga. This stretch may increase flexibility in the shoulders. To do it:

  • Stand with feet hip-width apart.
  • Inhale and lift the arms to the sides.
  • Exhale and swing the arms in toward the body.
  • Allow the right arm to cross under the left.
  • Cradle the left elbow in the crook of the right elbow.
  • Bring the palms together if they reach.
  • If the palms are not touching, hold the backs of the hands together.
  • Take three or four deep breaths.
  • Release the stretch and repeat it on the other side, with the left arm crossed under the right.

9. Cow Face pose

The Cow Face pose is another yoga stretch for the shoulders. To do the Cow Face pose:

  • Stand with the feet hip-width apart.
  • Reach the right arm up straight toward the sky.
  • Bend the right arm at the elbow.
  • Keeping the elbow raised, reach the right hand over the head and down the back.
  • Stretch the left arm down toward the ground.
  • Reach the left hand behind and up the back.
  • Bring the left and right hands close together, clasping them if it feels comfortable.
  • Take three or four deep breaths.
  • Release the stretch and repeat it on the other side.

10. Side-lying thoracic rotation

The side-lying thoracic rotation may sound complicated, but it is easy to do. This shoulder stretch helps improve mobility in the thoracic spine, lumbar spine, and shoulders.

To do a side-lying thoracic rotation:

  • Lay on your right side on the ground or a mat.
  • Bend the knees slightly.
  • Stretch the right arm straight ahead.
  • Place the left hand on top of the right.
  • Keep your gaze fixed on the left hand.
  • Reach the left hand straight up.
  • Rotate the left arm toward the floor behind the back, as if drawing an arch in the air.
  • Keep the knees and hips pointing to the right throughout.
  • Bring the left arm back over to meet the right hand.
  • Repeat the drawing motion several times.
  • Then, practice it on the other side.

Benefits

When a muscle stretches, its fibers and the surrounding fascia, or bands of connective tissue, extend to full length. This improves the ability of the muscle and fascia to extend during activity.

Shoulder stretches have numerous potential health benefits. Stretching can:

  • reduce tension
  • relieve pain
  • increase mobility
  • reduce the risk of muscle and joint injury
  • improve posture

Research suggests that stretching alone is as effective as stretching alongside strength training for people looking to reduce chronic neck pain. Shoulder tension can cause this pain.

A small-scale 2015 study found that a 4-week regular stretching program could reduce neck and shoulder pain. The researchers noted that the stretching program improved neck function and the quality of life among office workers with chronic, moderate-to-severe neck pain.

What causes tight shoulders?

Tight shoulders can result from:

  • improper posture
  • sitting for long periods
  • working at a laptop or desktop that is not well-positioned
  • the overuse of a cell phone
  • stress
  • carrying heavy bags
  • injury
  • arthritis

Shoulder tension may worsen with age.

Preventing shoulder pain and tightness

Regular stretching can help prevent the shoulders from becoming tight in the first place. Getting plenty of exercise is also important. Yoga may help reduce stress and tension and increase flexibility.

When working at a computer, use a stand to place the screen at eye-level. This reduces the need to bend the neck and shoulders and lowers the risk of shoulder tension.

Maintaining good posture is also important. If a person notices that they are slouching, the shoulder roll exercise above can help with repositioning the shoulders.

Practicing good posture while sitting and standing, especially during long periods at a desk, can reduce shoulder and neck tension in the long term.

Outlook

Shoulder pain and tightness are common and treatable. Practicing the stretches above may reduce tightness and increase a person’s range of movement.

When ongoing shoulder pain does not improve with stretching, massage therapy may help.

If shoulder pain is severe, a person should see their doctor, who can diagnose and treat any underlying conditions.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Rotator Cuff Problem: Do You Need Surgery?

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Article featured on WebMD, Reviewed by Tyler Wheeler, MD on May 16, 2021

Some rotator cuff problems are easily treated at home. But if yours is severe, or lingers for more than a few months, you may need surgery.

What Causes Rotator Cuff Problems

Your rotator cuff is a group of tendons and muscles in your shoulder. It helps you lift and rotate your arm. It also helps keep your shoulder joint in place. But sometimes, the rotator cuff tendons tear or get pinched by the bones around them. An injury, like falling on your arm, can cause this to happen. But wear and tear over time can take its toll on your shoulder, too. The pain can be severe.

Treatment

Home care can treat many rotator cuff problems. Your doctor will tell you to rest your shoulder joint and ice the area. Over-the-counter pain relievers can help ease your pain and swelling while your rotator cuff heals. Physical therapy will help restore your shoulder strength.

What About Surgery?

If you’re not getting any relief with these steps, surgery may be the next option for you.

You may need surgery if:

  • Your shoulder hasn’t improved after 6 to 12 months
  • You’ve lost a lot of strength in your shoulder and find it painful to move
  • You have a tear in your rotator cuff tendon
  • You’re active and rely on your shoulder strength for your job or to play sports

What Type of Surgery Do I Need?

Surgery can relieve your pain and restore function to your shoulder. Some are done on an outpatient basis. For others, you may need to stay in a hospital.

The most common types are:

Arthroscopic repair. After making one or two very small cuts in your skin, a surgeon will insert a tiny camera called an arthroscope and special, thin tools into your shoulder. These will let them see which parts of your rotator cuff are damaged and how best to fix them.

Open tendon repair. This surgery has been around a long time. It was the first technique used to repair the rotator cuff. If you have a tear that’s very large or complex, your surgeon may choose this method.

A large incision is made in your shoulder, then your shoulder muscle is detached so the surgeon has direct access to your tendon. This is helpful if your tendon or shoulder joint needs to be replaced. Both of these surgeries can be done under general anesthesia, which allows you to sleep through the whole thing. They can also be done with a “regional block,” which allows you to stay awake while your arm and shoulder stay numb.You can talk to your doctor ahead of time about the type of anesthesia you prefer.

Recovery

Recovery from arthroscopic surgery is typically quicker than open tendon repair. Since open tendon repair is more involved, you may also have more pain right afterwards.

No matter which surgery you have, a full recovery will take time. You should expect to be in a sling for about 6 weeks. This protects your shoulder and gives your rotator cuff time to heal. Driving a car will be off limits for at least a month.

Most people don’t get instant pain relief from surgery. It may take a few months before your shoulder starts feeling better. Until then, your doctor will advise you to take over-the-counter pain relievers.
Physical therapy will be a key part of your recovery. Your doctor will give you exercises to do every day or you can work with a physical therapist. The movements you learn will help you regain your shoulder strength and range of motion.While the recovery from rotator cuff surgery can be a challenge, most people are back to their normal routine within 6 months.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

Frozen shoulder: What you need to know

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Article on MedicalNewsToday, medically reviewed by William Morrison, M.D. — Written by Caroline Gillott on December 5, 2017

Frozen shoulder is a common condition in which the shoulder stiffens, reducing its mobility. It is also known as adhesive capsulitis.

The term “frozen shoulder” is often used incorrectly for arthritis, but these two conditions are unrelated. Frozen shoulder refers specifically to the shoulder joint, while arthritis may refer to other or multiple joints. It commonly affects people aged between 40 and 60 years, and it is more likely in women than in men. It is estimated to affect about 3 percent of people. It can affect one or both shoulders.

Exercises

Frequent, gentle exercise can prevent and possibly reverse stiffness in the shoulder.

The American Association of Orthopaedic Surgeons (AAOS) suggest some simple exercises:

Crossover arm stretch: Holding the upper arm of the affected side, gently pull the arm across in front of you, under the chin. Hold for 30 seconds. Relax and repeat.

Exercises should be guided by a doctor, an osteopath, or a physical therapist. Anyone experiencing stiffness in the shoulder joint should seek medical attention sooner rather than later to prevent permanent stiffness.

Harvard Medical School suggest the following exercises for relieving a frozen shoulder:

Pendulum stretch

Stand with the shoulders relaxed. Lean forward with the hand of the unaffected arm resting on a table. Let the affected arm hang down vertically and swing in a small circle, around 1 foot in diameter. Increase the diameter over several days, as you gain strength.

Towel stretch

Grab both ends of a towel behind your back. With the good arm, pull the towel, and the affected arm, up toward the shoulder. Repeat 10 to 20 times a day.

Symptoms

A person with a frozen shoulder will have a persistently painful and stiff shoulder joint. Signs and symptoms develop gradually, and usually resolve on their own.

Causes

The shoulder is made up of three bones: The shoulder blade, the collarbone, and the upper arm bone, or humerus. The shoulder has a ball-and-socket joint. The round head of the upper arm bone fits into this socket. Connective tissue, known as the shoulder capsule, surrounds this joint. Synovial fluid enables the joint to move without friction.

Frozen shoulder is thought to happen when scar tissue forms in the shoulder. This causes the shoulder joint’s capsule to thicken and tighten, leaving less room for movement. Movement may become stiff and painful. The exact cause is not fully understood, and it cannot always be identified. However, most people with frozen shoulder have experienced immobility as a result of a recent injury or fracture. The condition is common in people with diabetes.

Risk factors

Common risk factors for frozen shoulder are:

  • Age: Being over 40 years of age.
  • Gender: 70 percent of people with frozen shoulder are women.
  • Recent trauma: Surgery or and arm fracture can lead to immobility during recovery, and this may cause the shoulder capsule to stiffen.
  • Diabetes: 10 to 20 percent of people with diabetes develop frozen shoulder, and symptoms may be more severe. The reasons are unclear.

Other conditions that can increase the risk are:

  • stroke
  • hyperthyroidism, or overactive thyroid
  • hypothyroidism, or underactive thyroid
  • cardiovascular disease
  • Parkinson’s disease

Stages

Symptoms are usually classified in three stages, as they worsen gradually and then resolve within a 2- to 3-year period.

The AAOS describe three stages:

  • Freezing, or painful stage: Pain increases gradually, making shoulder motion harder and harder. Pain tends to be worse at night. This stage can last from 6 weeks to 9 months.
  • Frozen: Pain does not worsen, and it may decrease at this stage. The shoulder remains stiff. It can last from 4 to 6 months, and movement may be restricted.
  • Thawing: Movement gets easier and may eventually return to normal. Pain may fade but occasionally recur. This takes between 6 months and 2 years.

Over 90 percent of people find that with simple exercises and pain control, symptoms improve. A frozen shoulder normally recovers, but it can take 3 years.

Diagnosis

Doctors will most likely diagnose frozen shoulder based on signs, symptoms, and a physical exam, paying close attention to the arms and shoulders. The severity of frozen shoulder is determined by a basic test in which a doctor presses and moves certain parts of the arm and shoulder. Structural problems can only be identified with the help of imaging tests, such as an X-ray or Magnetic Resonance Imaging (MRI).

Treatment

The aim is to alleviate pain and preserve mobility and flexibility in the shoulder. In time and with treatment, 9 out of 10 patients experience relief. However, recovery may be slow, and symptoms can persist for several years. There are several ways to relieve pain and alleviate the condition.

Painkillers: Nonsteroidal anti-inflammatory drugs (NSAIDs) are available to purchase over-the counter, and may reduce inflammation and alleviate mild pain. Not all painkillers are suitable for every patient, so it is important to review options with the doctor.

Hot or cold compression packs: These can help reduce pain and swelling. Alternating between the two may help.

Corticosteroid injections: However, repeated corticosteroid injections are discouraged as they can have adverse effects, including further damage to the shoulder.

Transcutaneous electrical nerve stimulation (TENS): This works by numbing the nerve endings in the spinal cord that control pain. The TENS machine sends small to electrodes, or small electric pads, that are applied to the skin on the affected shoulder. Various TENS machines from different brands are available to purchase online.

Physical therapy: This can provide training in exercises to maintain as much mobility and flexibility as possible without straining the shoulder or causing too much pain.

Shoulder manipulation: The shoulder joint is gently moved while the patient is under a general anesthetic.

Shoulder arthroscopy: A minimally invasive type of surgery used in a small percentage of cases. A small endoscope, or tube, is inserted through a small incision into the shoulder joint to remove any scar tissue or adhesions. The doctor will suggest a suitable option depending on the severity of signs and symptoms.

Prevention

Frozen shoulder can only be prevented if it is caused by an injury that makes shoulder movement difficult. Anyone who experiences such an injury should talk to a doctor about exercises for maintaining mobility and flexibility of the shoulder joint.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Shoulder Replacement Surgery: What to Know

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Medically Reviewed by Tyler Wheeler, MD on December 08, 2019 from WebMD

If your shoulder joint gets seriously damaged, you might need surgery to replace it. Before you have your procedure, you should know some things.

About Your Shoulder

The joint where your upper arm connects to your body is a ball-and-socket joint. The bone in your upper arm, called the humerus, has a round end that fits into the curved structure on the outside of your shoulder blade.

Ligaments and tendons hold it together. Ligaments connect the bones, while tendons connect muscles to the bone. A layer of tissue called cartilage keeps the bones apart, so they don’t rub against each other.

The ball and socket lets you move your arm up and down, back and forward, or in a circle.

Why You’d Need It Replaced

You may have to have it done if you have a condition that makes it painful and hard to use your arm, such as:

  • A serious shoulder injury like a broken bone
  • Severe arthritis
  • A torn rotator cuff

Your doctor will probably try to treat you with drugs or physical therapy first. If those don’t work, they may recommend surgery.

Shoulder replacement surgery is less common than hip or knee replacements. But more than 50,000 shoulder replacements are done in the U.S. each year.

What to Expect

An orthopedic surgeon will replace the natural bone in the ball and socket of your shoulder joint with a material that could be metal or plastic. It’s a major surgery that’ll keep you in the hospital for several days. You’ll also need several weeks of physical therapy afterward.

There are three types of shoulder replacement surgeries:

Total shoulder replacement: This is the most common type. It replaces the ball at the top of your humerus with a metal ball, which gets attached to the remaining bone. The socket gets covered with a new plastic surface.

Partial shoulder replacement: Only the ball gets replaced.

Reverse shoulder replacement: Usually, you’d get this if you have a torn rotator cuff. It’s also done when another shoulder replacement surgery didn’t work. The metal ball gets attached to your shoulder bones, and a socket is implanted at the top of your arm.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm