Shoulder
We have extensive experience in the treatment, rehabilitation and preventative management for shoulder pain and injuries.
Below provides a list of the most common shoulder conditions. Each patient requires an individual assessment to determine the exact type of injury, the causes and any rehabilitation program required. During an appointment with either a Sports Doctor or a Physiotherapist you can expect the following assessment questions:
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History of the pain, including location, severity, referred pain, things that make the pain worse or better.
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Previous related injuries
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Occupational or Sporting activities
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Previous treatments
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Physical assessment of the shoulder.
We recommend a booking with a Physiotherapist or Sports Doctor as a first assessment. Our physios will refer you to a Specialist Sports Physician if required.
Disclaimer
The common conditions below and the associated information have been produced as a guide only. They do not replace the judgement of a clinician. The below information should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each patient. Patients should consult with an appropriate clinician as soon as practicable post injury to avoid complications.
Common Conditions
Dislocated shoulder signs and symptoms may include:
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A visibly deformed or out-of-place shoulder
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Swelling or bruising
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Intense pain
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Inability to move the joint
Shoulder dislocation may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, often increasing the intensity of your pain.
When to see a doctor
Get medical help right away for a shoulder that appears dislocated.
While you're waiting for medical attention:
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Don't move the joint. Splint or sling the shoulder joint in its current position. Don't try to move the shoulder or force it back into place. This can damage the shoulder joint and its surrounding muscles, ligaments, nerves or blood vessels.
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Ice the injured joint. Applying ice to your shoulder can help reduce pain and swelling by controlling internal bleeding and the buildup of fluids in and around your shoulder joint.
Treatments
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Closed reduction. Your doctor or physiotherapist may try some gentle manoeuvres to help your shoulder bones back into their proper positions. Depending on the amount of pain and swelling, you may need a muscle relaxant or sedative or, rarely, a general anesthetic before manipulation of your shoulder bones. When your shoulder bones are back in place, severe pain should improve almost immediately.
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Surgery. You may need surgery if you have a weak shoulder joint or ligaments and tend to have recurring shoulder dislocations despite proper strengthening and rehabilitation. In rare cases, you may need surgery if your nerves or blood vessels are damaged. TSM Sports physicians will refer you to one of our visiting surgeons if they feel this is required.
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Immobilization. Your Physiotherapist may use a special splint or sling for a few days to three weeks to keep your shoulder from moving. How long you wear the splint or sling depends on the nature of your shoulder dislocation and how soon the splint is applied after your dislocation.
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Medication. Your doctor might prescribe a pain reliever or a muscle relaxant to keep you comfortable while your shoulder heals.
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Rehabilitation. After your shoulder splint or sling is removed, you'll begin a gradual rehabilitation program designed to restore range of motion, strength and stability to your shoulder joint. Our physiotherapist will develop a program suitable to your needs
If you have a fairly simple shoulder dislocation without major nerve or tissue damage, your shoulder joint likely will improve over a few weeks, but you'll be at increased risk for future dislocation. Resuming activity too soon after shoulder dislocation may cause you to injure your shoulder joint or to dislocate it again.
The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.
Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury also increases with age.
Many people recover from rotator cuff disease with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.
Sometimes, rotator cuff tears may occur as a result of a single injury. In those circumstances, medical care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons or joint replacement.
Treatments
Conservative treatments — such as rest, ice and Physiotherapy — sometimes are all that's needed to recover from a rotator cuff injury. If your injury is severe and involves a complete tear of the muscle or tendon, you might need surgery.
First step in assessment should be to see your Physiotherapist, if they feel you require more invasive interventions than exercise and stretches they can refer you to our sports doctor for further assessment.
Injections
There are a number of different types of injections that may aid in recovery by reducing pain or accelerating the healing process. Our Sports Physicians and doctors will recommend this treatment only in cases where conservative treatments have failed to achieve desired result.
Surgery
Many different types of surgeries are available for rotator cuff injuries, including:
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Arthroscopic tendon repair. In this procedure, surgeons insert a tiny camera (arthroscope) and tools through small incisions to reattach the torn tendon to the bone.
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Open tendon repair. In some situations, an open tendon repair may be a better option. In these types of surgeries, your surgeon works through a larger incision to reattach the damaged tendon to the bone. Compared to arthroscopic procedures, open tendon repairs typically heal in the same length of time but recovery may be more uncomfortable.
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Tendon transfer. If the torn tendon is too damaged to be reattached to the arm bone, surgeons may decide to use a nearby tendon as a replacement.
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Shoulder replacement. Massive rotator cuff injuries may require shoulder replacement surgery. To improve the artificial joint's stability, an innovative procedure (reverse shoulder arthroplasty) installs the ball part of the artificial joint onto the shoulder blade and the socket part onto the arm bone.
