The shoulder is a region of the body comprised of several bones, muscles and tendons. The shoulder’s main function is to help position the hand in space whether it is scratching your back to throwing a football. But mobility has its price: it can lead to increasing problems with instability or impingement of the soft tissues in your shoulder, resulting in pain that may be temporary or continuous.
Most shoulder problems fall into five major categories:
- Tendon inflammation and tears
- Fracture (broken bone)
Tendon Inflammation and tears
Overuse activities tend to affect people in the form of bursitis and tendinitis. Tendonitis is an inflammation of the tendon, while bursitis is the inflammation of a bursa. A bursa is a small fluid-filled sac usually found over the joints and between tendons and bones that allows for easy gliding.
The most commonly affected tendons in the shoulder are the four rotator cuff tendons. Rotator cuff tendonitis and bursitis are usually caused by a shoulder injury or overuse of the shoulder, such as a job that involves a lot of overhead lifting. With any kind of should injury, the tendons or bursa may become inflamed, meaning there is less space within the joint for the tendons and muscles to move. If the tendon is repeatedly scraped against the shoulder bones, it can gradually weaken and will sometimes tear. This is often referred to as impingement.
Causes: Rotator cuff tendonitis and bursitis are usually caused by a shoulder injury or overuse of the shoulder, such as a job that involves a lot of overhead lifting.
Treatments: Resting the shoulder and avoiding activity or positions that cause pain is often the first course of treatment. Your doctor might prescribe a cortisone injection to reduce the inflammation and control the pain, followed by physical therapy.
Shoulder instability occurs when the head of the upper arm bone, known as the humeral head, is forced out of the shoulder socket. This can range from a slipping or “catching” feeling in your shoulder, to a complete dislocation where the ball comes all the way out of the socket. Once the ligaments, tendons, and muscles around the shoulder become loose or torn, dislocations can occur repeatedly, which can cause pain, unsteadiness and ultimately arthritis.
Causes: It takes significant trauma, such as a fall or being tackled in a football game, to cause a completely dislocated shoulder.
Treatments: Doctors will maneuver the arm bone back into the shoulder socket. Once repaired, you’ll likely wear a sling for a few weeks. For recurring dislocations, shoulder surgery may be required.
Shoulder pain can also result from arthritis. The most common type of arthritis in the shoulder is osteoarthritis, also known as “wear and tear” arthritis. Often people will avoid shoulder movements in an attempt to lessen arthritis pain. This can lead to a tightening or stiffening of the soft tissue parts of the joint, resulting in a painful restriction of motion.
Causes: Osteoarthritis may be related to sports or work injuries and chronic wear and tear. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining (e.g. rheumatoid arthritis).
Treatments: Lifestyle changes, such as range-of-motion exercises, physical therapy, or rest. Medications such as ibuprofen or other anti-inflammatory medications may also be helpful to calm inflammation and reduce pain. In some cases once conservative measures have failed, the joint may need to be replaced with an artificial joint.
Fractures are broken bones. Shoulder fractures commonly involve the clavicle (collarbone), humerus (upper arm bone), and scapula (shoulder blade). Fractures often cause severe pain, swelling, and bruising about the shoulder.
Causes: Shoulder fractures in older patients are often the result of a fall from standing height. In younger patients, shoulder fractures are often caused by a high energy injury, such as a motor vehicle accident or contact sports injury.
Treatments: A simple sling or “figure of 8” strap is worn for three to eight weeks, depending on the patient’s pain. Surgery may also be necessary, which may include placing plates and screws or wires and sutures.
When your shoulder is injured, it can disrupt your normal routine. The orthopedic surgeons at Emory Orthopaedic & Spine Center specialize in treating all types of shoulder conditions and injuries. Our physicians are nationally recognized leaders in their surgical field, helping to initiate and design new shoulder treatment techniques and train future surgeons. They also work along each patient and his/her family to tailor each treatment plan to achieve the best possible outcome. This highly-focused and individualized care has resulted in our patients consistently awarding us with the highest level of patient satisfaction scores.
To make an appointment to see one of our Emory shoulder specialists, please call 404-778-3350 or complete our online appointment request form.
About Dr. Gottschalk
Dr. Michael Gottschalk grew up in Dallas, Texas as the youngest of three boys. He went on to graduate from JJ Pierce High School in the top 10% of his class and as an AP Scholar with Distinction. Dr. Gottschalk received an academic scholarship to attend the Business Honors Program at the University of Texas at Austin. After graduating from UT Austin, he then went to complete medical school at the University of Texas Health Science at San Antonio. Upon completion of medical school, Dr. Gottschalk completed his Orthopaedic Surgery Internship and Residency at Emory University. While in his training, Dr. Gottschalk received multiple accolades and awards for his outstanding research and was elected as a resident leader to the esteemed American Orthopaedic Association.
After the completion of his Orthopaedic Surgical Training, Dr. Gottschalk was selected to the prestigious Emanuel Kaplan Hand and Upper Extremity Fellowship at the NYU Hospital For Joint Diseases. He was selected as the Hand and Upper Extremity administrative fellow and served on the resident council for quality and safety. During his training at the Hospital for Joint Diseases, Dr. Gottschalk helped treat work related injuries to the NYPD, NYFD, and hotel trade union.
Dr. Gottschalk and his wife Kim are delighted to be back in Atlanta with their new addition to their family, Reese Gottschalk. When not at work he enjoys spending time with his family and dog, Riley the Rhodesian Ridgeback. His other hobbies include working-out, golf, tennis, and fly-fishing.