Shoulder

I watched at a soccer game as the assistant coach helped a young player put his shoulder back in place after dislocating it. I was pretty surprised someone could do this on the field. The question is -- will it hold if surgery wasn't done to repair the torn ligaments and muscles?

Falls from skiing accidents, sports injuries, car accidents and other traumatic events account for many first-time shoulder dislocations. When the shoulder doesn't pop back in place on its own, the patient ends up in the emergency department or doctor's office for a reduction (put it back in the socket). There are many ways to reduce the shoulder but most require anesthesia to put the patient asleep and relax the muscles or strong narcotic medications for pain.




Taking Another Look at the Reverse Total Shoulder Replacement

The reverse shoulder total arthroplasty (rTSA) is used for older adults who have disabling shoulder pain and loss of function due to severe rotator cuff damage. In fact, for these patients, the rotator cuff (needed for a traditional total shoulder replacement) is beyond repair.




I can't figure out what's wrong with my arm. When I try to lift it up to comb my hair, I can only go so far and get stuck. It hurts like the dickens when I try to do that. But I can lie down on the bed holding on to my cane with both hands and the arm goes up all the way. Can you explain this to me?

You may have a condition referred to as pseudoparesis of elevation. Pseudo means like or similar to and paresis means paralysis. It seems like your arm is paralyzed in that it won't go through the motion you clearly have available. But there's no nerve damage or real paralysis going on.




I've heard that if I have a reverse total shoulder replacement, I won't need physical therapy. Is that true?

The reverse shoulder total arthroplasty (rTSA) is used for older adults who have disabling shoulder pain and loss of function due to severe rotator cuff damage. In fact, for these patients, the rotator cuff (needed for a traditional total shoulder replacement) is beyond repair.




I am 34-years old and a semi-professional golfer. I had an operation done for my right shoulder called a partial resuracing. I'm slowly getting back into shape. My biggest fear is that if I overdo it, the implant will break or get used up too fast. How can I get past this hurdle and back into full swing, so-to-speak?

Joint resurfacing has made it possible for younger, more active adults to avoid removing bone and replacing the joint. Instead, the surface of the bone is smoothed over and capped with a smooth, round metal piece called an implant.




When I was 16 years old, I had a pretty bad football injury to my left shoulder. Now at 28, I have limited shoulder motion and constant pain. The surgeon I saw has suggested a procedure called shoulder resurfacing. What can you tell me about it?

Joint resurfacing has been around for almost 30 years. Instead of removing bone and replacing the joint, the surface of the bone is smoothed over and capped with a metal component.This treatment technique has been proven safe and effective for both the hip and the shoulder.

Shoulder resurfacing is fairly new and becoming more popular. With joint resurfacing, there is less bone destroyed and fewer fractures. Best of all, the patient can still convert to a total joint if needed later.




Shoulder Resurfacing is Now Available

Hip resurfacing has been around for almost 30 years. This treatment technique has been proven safe and effective. Instead of removing bone and replacing the joint, the surface of the bone is smoothed over and capped with a metal component. Now shoulder resurfacing is becoming more popular. And for the same reasons that hip resurfacing has been used: less bone is destroyed, fewer fractures occur, and the patient can still convert to a total joint if needed later.




What's the difference between shoulder laxity and shoulder instability?

Laxity usually refers to looseness of the soft tissues around the joint. The affected structures can include ligaments, tendons, muscles, and/or the shoulder capsule. The capsule refers to the envelope of ligamentous tissue that surrounds the shoulder like an envelope. In the shoulder, the rotator cuff functions as a protective, stabilizing force to hold the head of the humerus (upper arm bone) firmly in the socket.




Causes and Mechanisms of Shoulder Throwing Injuries

Shoulder problems in the throwing athlete are common but very complex. It can be a real challenge to identify the specific cause of the problem and treat it quickly and easily. Many throwing athletes don't allow enough time to rest the shoulder between games and especially after an injury. The authors of this article provide a review of the causes and mechanisms of shoulder throwing injuries. They describe how the anatomy of the shoulder changes with repetitive throwing.




I have a shoulder separation that is bad enough to maybe need surgery. But it's also possible it could heal without surgery. I'm kinda left in the dark trying to figure out what to do. What do you advise?

It sounds like you have an injury to the acromioclavicular (AC) joint. Sometimes this is referred to as a shoulder separation. Treatment for AC joint injuries is usually based on the severity of the damage done to bone, ligaments, capsule, and nearby muscles. AC joint injuries are broken down into six categories classified as I through VI (from mild sprain to severe dislocation).





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