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Shoulder joint
The shoulder joint truly works miracles. No other joint in the human skeleton is able to move in the same way. However, it isn’t perfect: Shoulder problems represent more of a gap in the evolutionary process than a disease of civilisation. Although humans have evolved to walk upright, the bone and tendon structure has never sufficiently adapted to support this form of movement.
Pains and restricted mobility are some of the consequences that arise as a result of this. And these should not be taken lightly. The sooner shoulder problems are treated, the higher the patient’s chances of preventing wear, making a full recovery and avoiding major surgical procedures, such as an artificial joint replacement.
On this page you will find an overview of the most common shoulder problems and some examples of how these can be treated. If surgical intervention is necessary, this is almost always carried out in the form of an arthroscopy. ORTHOmedic is specialised in this minimally invasive procedure. Your expert for shoulder diseases here at ORTHOmedic is Professor Schofer.
Rotator cuff tear
Tear of the tendon or joint capsule of the humerus. Usually age-related, this problem tends to occur from the age of 45, but it may also occur as a result of a sports accident. Warning: Tendons do not heal by themselves. But they can heal with treatment. Refixation of a tendon can be carried out by means of an arthroscopy, using suture anchors. Unfortunately, tendons take time to heal. We help you through this process with individual physiotherapy sessions.
Shoulder instability as a result of luxation (dislocation)
The shoulder socket is very small in relation to the humeral head. The joint is strengthened by what is known as the glenoid ligament (glenoid labrum). This ligament circles the shoulder socket and can be damaged by overexertion, falls or, most commonly through sport. Special movement and stress tests can help to diagnose shoulder instability. The glenoid ligament can easily be operated on. Biodegradable suture anchors are used to fix the glenoid ligament in its original place.
SLAP tear (lesion of the biceps tendon)
The biceps muscle is fixed to the shoulder joint by two tendons. The long head of the biceps tendon begins at the glenoid cavity. A torn glenoid cavity is a common sports injury. Symptoms include a sharp pain, particularly when making throwing or backwards-reaching motions, which may become more severe under strain. A diagnosis can be made using provocation tests and X-rays/MRIs. SLAP lesions should be surgically treated by means of an arthroscopy. This procedure repairs the glenoid cavity, enabling the biceps tendon to heal onto it.
Injuries to the shoulder ligaments or the acromioclavicular (AC) joint
EThese types of injuries most commonly occur as a result of a fall, typically during sporting activities. The impact damages the AC joint, ligaments or joint capsule. These types of injuries have a highly individual nature, which means the course of treatment should be adapted for each individual case. It is possible to heal the musculoskeletal system via suture fixation or tendon transplantation, for example. An in-depth specialist knowledge of the human anatomy is required to decide on an appropriate method of treatment, which is exactly what our specialists offer at ORTHOmedic.
Shoulder impingement syndrome (trapped tendon as a result of bone protrusion)
The muscle tendon that enables movement in the shoulder joint runs through a tunnel of bone. If this tunnel is abnormally narrow, the tendon can become trapped and damaged. Impingement syndrome is often classified as an occupational disease or chronic injury. It is important to diagnose and treat it as early as possible, not only to preserve the tendon but also because the syndrome can be extremely painful. If recognised early enough, impingement syndrome can be treated with conservative treatment methods. Arthroscopic surgery is required in advanced cases.
Calcific tendinitis of the shoulder (tendinitis calcarea)
Calcific tendinitis occurs as a result of calcium deposits in the shoulder tendons, though it remains unclear why these deposits form. What we do know is that they form in the tendon rather than on the joint itself, usually on the supraspinatus tendon. The disease progresses in waves. Pain occurs primarily as a result of the transformation of the calcium deposits into liquid form, which triggers an inflammatory reaction. This should first be treated with medication, which can be accompanied by shockwave therapy if necessary. If these methods are unsuccessful, the calcium deposits can be removed via an arthroscopic surgical procedure.
Frozen shoulder (adhesive capsulitis)
There are three causes for frozen shoulder. The most common is primary frozen shoulder, which occurs spontaneously as a result of inflammation with no external cause. Secondary frozen shoulder is caused by inactivity, either following an accident or as a result of another form of shoulder disease. The third cause of frozen shoulder is arthrosis of the shoulder joint. Frozen shoulder often heals by itself, but this is an extremely long and painful process. Medication and physiotherapy are usually sufficient methods of treatment. In severe cases, the centre of inflammation should be removed, which releases the blocked shoulder.
Arthrosis (joint wear)
Joint wear is a widespread disease and is usually age-related. The number of cases of arthrosis diagnosed increases in line with the average age of the population. Arthrosis damages the capsules, cartilage and bones in the shoulder and severely restricts mobility. If the disease is not treated early enough, artificial joint replacement is usually required. In order to avoid a major surgical procedure, there are various minimally invasive interventions that can be carried out. The inflamed tissue may be removed, for example, or a cartilage repair or transplantation procedure may be carried out.
Bone fractures
Following serious falls, the shoulder joint, which is otherwise very sturdy, can sometimes break. Fractures can occur on the glenoid cavity, at the humeral head or the clavicle. Often, resting the shoulder joint is enough to allow the healing process to take place. If the position of the bones has shifted significantly, they should be surgically reset to make the shoulder joint stable and to prevent arthrosis. Even these types of complex surgical procedures can sometimes be carried out via an arthroscopy.
