What You Need to Know About Navigating Shoulder Instability

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Article featured on OrthoUnited

What Is Shoulder Instability?

Shoulder instability occurs when the shoulder joint is too loose and frequently slips out of place. The shoulder is a ball-and-socket joint, where the ball (the head of the humerus) fits into the shoulder blade’s socket (the glenoid).

When the ligaments, tendons, and muscles surrounding the shoulder joint are stretched or torn, they can no longer keep the joint in place. This condition can lead to partial or complete dislocations and a sensation of the shoulder “giving out.”

People suffering from shoulder instability often experience pain, weakness, and a limited range of motion. The condition can be a result of trauma, repetitive use, or a structural abnormality of the shoulder.

How Does It Develop?

Shoulder instability can occur in several ways:

  • Trauma: The most common cause is a traumatic injury, such as a fall or a sports-related incident that forces the shoulder out of its normal position. Once the shoulder has been dislocated, it becomes more susceptible to repeated dislocations or subluxations (partial dislocations), leading to chronic shoulder instability.
  • Repetitive Strain: Another cause of shoulder instability is repetitive overhead movements, often seen in athletes like swimmers, baseball players, or tennis players. These activities can stretch and weaken the ligaments over time, leading to what is known as atraumatic shoulder instability.
  • Genetic Factors: Certain genetic factors can also contribute to shoulder instability. Some individuals are born with naturally looser ligaments, making them more prone to dislocations and subluxations. This condition is known as congenital shoulder instability.

How Is It Diagnosed?

Diagnosing shoulder instability begins with a comprehensive medical history and physical examination. Your healthcare provider will ask about your symptoms, previous injuries, and activity level. During the physical examination, the doctor will check for signs of instability, such as abnormal shoulder joint movement or a popping sensation when the shoulder is moved.

Imaging tests like X-rays, MRI, or CT scans may provide a more detailed view of the shoulder joint. These tests help identify any structural damage to the bones, ligaments, or cartilage that may contribute to the instability.

A proper diagnosis is crucial because the treatment plan will vary depending on the severity and type of shoulder instability. If you suspect you have shoulder instability, consult a specialist immediately for an accurate diagnosis.

Treatment Options for Shoulder Instability

Treatment for shoulder instability depends on the extent of the condition and the patient’s lifestyle. Here are some of the standard treatment options:

    • Physical Therapy: In many cases, physical therapy is the first line of treatment. A physical therapist will design a program that includes exercises to strengthen the muscles around the shoulder, improve flexibility, and restore the range of motion. Strengthening the rotator cuff muscles and scapular stabilizers is critical to improving shoulder stability.
    • Surgical Intervention: Surgery may involve repairing or tightening the ligaments and tendons that support the shoulder joint. In some cases, surgeons may perform a procedure called a Bankart repair to reattach the torn labrum to the socket. Another option is the Latarjet procedure, which involves transferring a piece of bone to the shoulder socket to prevent dislocation.
    • Medication: Your doctor may recommend anti-inflammatory medication or injections to reduce pain and inflammation in the shoulder joint.
    • Lifestyle Changes: Making specific lifestyle changes, such as avoiding activities that put excessive strain on the shoulder, can also help prevent further instability.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Prevent Injuries with Shoulder Stretches & Hamstring Stretches

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Article featured on NY Orthopedics

Why are Shoulder and Hamstring Stretches Important?

Stretching plays a critical role in maintaining flexibility, improving range of motion, and reducing muscle tension. Loose and flexible muscles are less likely to experience strains or tears during physical activities like backyard sports.

Regular stretching helps to improve blood flow to the muscles, enhancing their ability to recover quickly and efficiently after exertion. Stretching is especially important for those over the age of 30, those with chronic injuries, or those prone to muscular tears. Sudden bursts of activity, like those in football or baseball, can put extra stress on the muscles and joints, making stretching beforehand that much more necessary.

Shoulder Stretches for Injury Prevention 

Shoulder injuries are among the most common in many sports, particularly those that involve throwing or overhead movements like beach volleyball. To prevent these injuries, it’s important to keep your shoulder muscles and joints flexible and strong with some targeted stretches. Here are some common, easy-to-do stretches that can help you limber up before serving up some heat:

  1. Cross Body Shoulder Stretch: This stretch helps to improve the flexibility of the shoulder and upper back muscles. Stand tall and bring one arm across your body, using your opposite hand to pull the arm closer to your chest gently. Hold this position for about 30 seconds before switching sides.
  2. Shoulder Circles: Shoulder circles are the perfect stretch for enhancing the range of motion in your shoulders. Stand with your feet shoulder-width apart and extend your arms out to the sides. Make small circles with your arms, gradually increasing the size of the circles. Perform this for 30 seconds in each direction (forward and back circles).
  3. Doorway Shoulder Stretch: Stand in a doorway with your arms bent at 90 degrees and your forearms resting on the doorframe. Step forward slowly with one foot, keeping your back straight and pushing your chest through the doorway. You should feel a stretch across your chest and the front of your shoulders. Hold this position for 30 seconds, then step back and relax. Repeat as needed.

Hamstring Stretches for Flexibility 

Hamstring injuries are another common issue, especially in sports that involve running and jumping. Keeping your hamstrings flexible with targeted stretches can prevent strains and improve your overall performance. Here are some hamstring stretches to help you stay loose for those one-on-ones:

  1. Standing Hamstring Stretch: Stand upright with your feet hip-width apart. Extend one leg forward with the heel on the ground and toes pointing up. Keep your back straight and hinge at the hips, reaching towards your toes. Hold this stretch for 30 seconds before switching legs.
  2. Seated Hamstring Stretch: Sit on the ground with one leg extended straight and the other bent, with the sole of your foot against your inner thigh. Reach towards the toes of your extended leg, keeping your back straight. Hold the stretch for 30 seconds, and then switch legs.
  3. Lying Hamstring Stretch: Lie flat on your back with one leg extended straight on the ground and the other leg raised in the air. Hold the raised leg behind the thigh or calf and gently pull it towards you, keeping the leg as straight as possible. Hold the stretch for 30 seconds, then switch legs.

Incorporating Stretches into Your Routine 

To maximize the benefits of stretching, you should not only stretch before physical activity but incorporate stretching into your daily routine. Remember that stretches are meant to build muscle, joint flexibility, and strength. This doesn’t happen after one stretching session. Like any other exercise, it takes time and discipline to reap the full rewards.

Fortunately, most people notice results relatively quickly. You can start small with a gentle warm-up as you get out of bed to get your blood flowing before moving into the stretches—something light like jumping jacks. Then, try out some of the stretches we’ve provided here or integrate more full-body stretches.

By properly stretching your shoulders and hamstrings, you can significantly reduce the risk of injuries!

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Options To Treat Shoulder Bone Spurs

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Article featured on Modern Orthopedics

You’re lifting the canoe onto your car’s roof rack when you feel it again—that pain and weakness through your shoulder and down your arm. Rubbing your shoulder joint, you wonder what on earth is going on and how you’re going to address it.

If you’re experiencing unexplained pain in your shoulder, neck, arms, or upper back, shoulder bone spurs could be one of the possible culprits. While relatively common, these bony protrusions can significantly impact your daily routine and quality of life.

Fortunately, shoulder bone spurs are treatable in a variety of different ways, depending on their severity and your lifestyle goals. Below, we’ll explore what they are, how they’re diagnosed, and provide an overview of common treatment options.

If you suspect that you may have shoulder bone spurs, making an appointment with your orthopedic surgeon as soon as possible will help you determine the best course of action.

What Are Shoulder Bone Spurs?

Bone spurs (known medically as osteophytes) are bony projections that develop along the edges of bones. Often, they’re small, smooth, and go unnoticed in the body without causing any symptoms. But when bone spurs press or rub against other bones or soft tissues (including ligaments, tendons, and nerves), the results can be painful and seriously impede your day-to-day routine.

Why do bone spurs form? Most often, they develop in response to injury or inflammation in order to protect a joint or area of the body that has been damaged. Unfortunately, they sometimes also cause more damage in the process.

While bone spurs can form in many different parts of the body, including the hips, knees, and spine, the shoulder is one of the most common areas where they often become problematic. When bone spurs form under the acromion (the tip of the outer edge of your shoulder blade or scapula), they can cause significant discomfort and require proactive treatment.

Symptoms of Shoulder Bone Spurs

Because the size, location, and impact of shoulder bone spurs on the body vary from person to person, they can present in a variety of ways. Depending on the circumstances, symptoms of shoulder bone spurs may include one or more of the following:

  • Shoulder pain
  • Neck pain
  • Pain in the upper back or arms
  • Tingling or numbness
  • Tenderness
  • Weakness
  • Visible inflammation
  • Stiffness
  • Muscle spasms
  • Decreased range of motion
  • A visible lump under the skin (large bone spurs only)
  • Tearing of tendons or ligaments (in severe cases)

Causes of Shoulder Bone Spurs

Bone spurs form in response to joint inflammation. But inflammation always has an underlying cause. Underlying causes of bone spurs often include:

  • Arthritis (rheumatoid arthritis, osteoarthritis, or degenerative arthritis)—Bone spurs form in response to the breakdown of cartilage at the ends of bones in an attempt to repair the damage.
  • Acute injury—Acute shoulder injuries can be caused by direct impact or other damaging incidents.
  • Repetitive Injury—People who regularly perform repetitive overhead movements are at risk for the development of shoulder bone spurs along with injury to the rotator cuff tendons.
  • Genetics—Patients with a family history of bone spurs (or osteochondromas) may experience shoulder bone spurs more frequently than the general population.

Diagnosis of Shoulder Bone Spurs

Because the symptoms of shoulder bone spurs are varied and often exist within the context of a broader condition or injury, the most conclusive way to diagnose their presence is via a visual confirmation. Bone spurs are often diagnosed by X-ray, MRI, CT scan, or ultrasound. Your orthopedic surgeon will recommend the diagnostic method they believe will be most appropriate for your symptoms and circumstances.

Treatment for Shoulder Bone Spurs

If you’re diagnosed with shoulder bone spurs, your individual treatment plan will take into account your current level of pain, lifestyle, and personal goals. Reducing pain and avoiding future injuries will always be the priority. Your orthopedic surgeon will outline and consider less invasive treatment options before recommending surgery. Ultimately, your preferred course of treatment will be up to you.

Non-Surgical Treatments

In cases with mild symptoms, the following non-surgical treatments may be ideal:

Physical Therapy

A physical therapist can provide an exercise program tailored to your needs in combination with treatments such as deep tissue massage, ultrasound and more. Physical therapy can often drastically reduce the pain associated with shoulder bone spurs.  Decreasing the health of the surrounding tissues with stretching and strengthening, can decrease inflammation and therefore pain associated with bone spurs.

Medication

The most common medications associated with the treatment of shoulder bone spurs are over-the-counter anti-inflammatory drugs and pain relievers.

Rest and Lifestyle Modifications

Rest can sometimes work wonders for bone spur pain. Avoiding triggering movements and overuse in your daily life can promote effective healing—even the reabsorption of bone spurs by the body.

Minimally Invasive Procedures

If your body isn’t responding to the simple, non-surgical treatment options listed above, it may be time to consider a minimally invasive procedure.

Corticosteroid Injections

Therapeutic steroid injections can sometimes reduce pain and increase your range of motion.

Arthroscopic Surgery

Arthroscopic surgery for bone spurs in the shoulder joint involves trimming or removing bone spurs to open up space and relieve pressure on bones, ligaments, and tissues.

Surgical Treatments

Open Surgery

Open surgery is typically the last resort and is only considered in severe cases where bone spurs are seriously impacting your quality of life. Surgeries such as subacromial decompression (which can involve removing spurs and thickened ligaments as well as resurfacing shoulder bones) and shoulder arthroplasty (which is a replacement of the shoulder joint) often have excellent outcomes but are major procedures that involve a significant investment of time and require extensive rehabilitation.

Conclusion

To conclude, shoulder bone spurs are a common cause of shoulder pain and discomfort that can range from mild to severe. They typically occur as the result of an underlying cause or condition and require thoughtful and knowledgeable treatment.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Acute Vs. Chronic Rotator Cuffs

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Article featured on Modern Orthopaedics of New Jersey

Shoulder pain can be a common day-to-day occurrence. We’ve all experienced it at some point. However, if that pain lingers for a long time and affects your life on a day-to-day basis, it may be a sign there’s a bigger problem.

A rotator cuff tear is the most common reason for excessive and excruciating shoulder pain. The best way to determine if your shoulder pain is due to a rotator cuff tear is to see an orthopedic surgeon who specializes in treating the shoulder and who can evaluate and diagnose the underlying cause of your shoulder pain.  This is done by taking a detailed history, performing a physical exam, and ordering shoulder X-Rays and, if necessary, a shoulder MRI.

However, not all rotator cuff injuries are the same. In fact, there are two different types of rotator cuff tears: Acute rotator cuff tears and chronic rotator cuff tears.

We’ll explain everything you need to know about rotator cuff tears and how acute and chronic tears differ.

The Rotator Cuff

The shoulder is essentially a ball-and-socket joint, but the socket is very shallow.  The best way to think of this joint is a golf ball on a tee, but tipped 90 degrees to the side!  The ball is the head of the humerus (the upper arm bone) and it fits into the socket of the shoulder blade called the glenoid. The humeral head (“the golf ball”) is stabilized against the glenoid (“the tee”) by the rotator cuff tendons, which tension the humeral head onto the glenoid and prevent it from sliding off.  The rotator cuff tendons are part of a 4-muscle complex that both stabilizes the shoulder joint and generates movement of the arm for elevation, internal rotation, and external rotation.  Without the rotator cuff, the humeral head will start to slide off the glenoid and bump into the surrounding structures, often causing pain and difficulty moving the arm into elevation or rotation.

The rotator cuff consists of four muscles that each have an essential role to play:

  • Supraspinatus: This muscle holds your humerus in place and helps your arm maintain its stability. It also assists with elevation of your arm. The supraspinatus tendon is the most commonly torn tendon.
  • Infraspinatus: The main muscle of the four that facilitates shoulder external rotation.
  • Teres Minor: This muscle is the smallest, but it also helps your shoulder with external rotation (rotation of your arm away from your body).
  • Subscapularis: This muscle holds your upper arm to your shoulder blade and is the only cuff muscle that is responsible for internal rotation of your shoulder.

All four muscles begin at the shoulder blade and cross the shoulder joint as they combine into a “cuff” of tendons that attach onto the humeral head. Because these muscles all must work in unison, one or more torn muscles can cause extreme discomfort and dysfunction.

What’s a Rotator Cuff Tear?

The rotator cuff tendons of the shoulder are very susceptible to gradual “atraumatic” tears over time from repetitive use, and acute “traumatic” tears that can occur from a sudden violent force imparted onto the shoulder like from a fall or while playing sports. When the rotator cuff is torn, it is often painful, particularly if the tear is traumatic.  Rotator cuff tears can also cause biomechanical dysfunction, leading to an inability to elevate the shoulder.

Chronic Rotator Cuff Tears 

Chronic tears are often due to degeneration of the rotator cuff tendon tissue over time.  Over the years our muscles and tendons can degenerate. People over 40 years old are at higher risk of developing a rotator cuff tear. A chronic, “atraumatic” type of tear is typically the result of wear and tear over time from overuse in an aging rotator cuff. These rotator cuff tears often begin as partial tears, meaning the tendons aren’t completely torn. A partial rotator cuff tear can progress to a full-thickness, or complete tear over time, disconnecting one or more of the affected muscles from its connection to the humeral head.  Some of the most common causes of chronic rotator cuff tears occur in folks who have manual labor jobs in which they perform repetitive overhead activities with heavy loads.

Some risk factors for chronic rotator cuff tears include the following:

  • Repetitive Motion: Sports like baseball, tennis, rowing, or jobs that require repetitive motion can cause overuse in the shoulder joint and cause a degenerative cuff tear.
  • Decreased Blood Supply: As we age, the blood supply within the rotator cuff tendon decreases, making it harder for the body to heal a tear.
  • Bone Spurs: Bone overgrowth and spurs on the acromion bone can develop due to age. The spurs can sometimes impinge or rub against the rotator cuff tendons, creating a tear.

Acute Rotator Cuff Tears

Most acute rotator cuff tears happen during a fall or from lifting a heavy object. Many people sustain this type of injury from overstretching their arm or lifting something heavy with a quick-jerk motion. An acute tear can also occur in conjunction with other injuries, such as a broken collarbone or a dislocated or separated shoulder. Acute partial rotator cuff tears have a higher potential to heal than a chronic “atraumatic” partial rotator cuff tears. An acute partial tendon tear can take roughly six to eight weeks to heal if the tear is minor.

Rotator Cuff Tear Symptoms

Some more common symptoms of a rotator cuff tear include:

  • Pain in the shoulder while at rest
  • Pain that awakens you from sleep
  • Pain from lying on the affected shoulder
  • Shoulder weakness when lifting or rotating your arm
  • A crackling sensation when moving your shoulder

Sudden tears can cause intense pain almost immediately, especially from falling. You may even feel a snap or weakness in your upper arm.

Tears that develop slowly over time can also cause pain and weakness in your arm/shoulder. You may first notice pain when you lift your arm overhead. The longer you live with a slowly developing tear, the more discomfort you’ll feel, specifically while at rest. You’ll notice everyday tasks like combing your hair, brushing your teeth, or reaching for something off a shelf becomes much more difficult.

Your doctor can confirm the diagnosis of a rotator cuff tear by ordering an X-ray and an MRI (magnetic resonance imaging) or an ultrasound.

Treatment

While many rotator cuff treatment options are available, your doctor will determine the best course of action based on your:

  • Age
  • Activity level
  • General health
  • Type/degree of tear

Nonsurgical 

Nonsurgical treatment can relieve pain and improve shoulder function.

Some nonsurgical options include:

  • Rest: Rest and limiting activities will allow your muscles and tendons to recuperate.
  • Physical Therapy: Specific exercises can be prescribed by a physical therapist to strengthen your shoulder and restore movement. The exercises will mainly consist of stretches that improve shoulder flexibility and range of motion, and resistant band exercises that strengthen the rotator cuff muscles and the scapular stabilizing muscles.
  • Steroid Injections: Steroid (cortisone) injections can be temporarily effective at treating persistently inflamed bursitis and/or pain related to a rotator cuff tear, but in the long term, cortisone can have a detrimental effect on the rotator cuff tendon strength and its ability to heal itself or resist further tearing.  Caution should be used when considering a cortisone injection.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen can help reduce painful symptoms and swelling.

Surgical

A rotator cuff repair surgery through a scope may be necessary if nonsurgical treatment doesn’t help with the pain. Your doctor may consider surgery for your injury if:

  • Symptoms have lasted 6 to 12 months or more and have not responded to a course of physical therapy
  • The tear is full thickness and retracted
  • You’re experiencing significant weakness and loss of function

During rotator cuff surgery, your doctor will reattach the tendon to the bone at the head of your humerus. Physical therapy and other forms of treatment are recommended after surgery to ensure you regain your shoulder motion and strength.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

7 Suggestions to Help With Mouse Shoulder

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Article featured on The Leagrave Therapy Clinic

If you work in an office, you probably spend hours every day with one arm extended on your mouse, clicking and dragging items. Mouse shoulder is a condition that can create shoulder pain from using a mouse with the computer for long periods of time due to poor ergonomics or inappropriate arm or wrist support.

The pain tends to spread over one side of the neck and into the shoulder, it can develop over weeks or months and is often described as a “burning” or deep aching sensation. This repetitive strain injury (RSI) or work-related upper limb disorder can occur from constant repetitive movements in a limited area can lead to real pain problems in the shoulder, neck, and upper back. It may take several weeks or months to develop, but once established Mouse Shoulder can take less than one hour of mouse use a day to maintain this repetitive strain state.

The Canadian Centre for Occupational and Health Safety reports that we actually use our mouses THREE times as often as the keyboard. This repetitive use could occur during work or while playing video games. If you haven’t set up an ergonomic work station, your mouse with relation to your office desk could be positioned too low or too high. It could also be set up in a way where your arm has no or little support during the day.

If your mouse is too low, you’re constantly reaching your hand towards it. Too high and you’re constantly tensing the muscles in your upper arm, shoulder and neck and cause an imbalance of muscle use. With enough time and stress, any area of the body can succumb to a repetitive strain injury (RSI) which is what occurs with mouse shoulder.

How Do l Get Mouse Shoulder?

The shoulder and shoulder blade attach to the body by various muscles that insert into the spine, ribcage, neck and base of the skull. Holding a mouse with the arm held away from the body causes these muscles to contract and become tight, as they support the weight of the outstretched arm. Sitting like this for several hours with little variation or relaxation can lead to pain and weakness over time.

What can be done to help

Mouse Shoulder responds well to a combination of anti-inflammatory drugs (NSAIDs) and manual treatment. In acute cases medical acupuncture can reduce the severe pain and muscle spasm by treating the painful trigger points.

However, treatment alone is not the answer. Without any modification to work posture or lifestyle these symptoms will return within days or weeks. You are then at risk of becoming dependent on repeated, costly and long-term treatment.

7 Ways To Help Yourself

1. Become ‘ambi-moustrous’: learn to use the mouse with BOTH hands. This is a difficult skill to learn and will need to be practised little and often each day. Alternatively, learn to hold the mouse closer to your side and remember to drop the shoulder down.

2. Change your mouse to a Trackball or marble mouse and bring it closer to you. Research has shown that holding the mouse with the arm less than 10° abducted from the body can reduces the muscle activity by a factor of 25-60%.

3. One of the most important things to remember about Repetitive Strain Injuries is the word REPETITIVE. Add as much variety as you can to your desk and work practice. Share different designs of mouse between members of your office; swap them around every week or so, to add to the variety.

4. Get up and move about regularly. If possible, rather than emailing or telephoning someone else in your office – go and talk to them in person.

5. Activities such as racket sports, swimming, Pilates, archery or bell ringing, will exercise the upper back muscles.

6. Use a resistance band (Theraband) to exercise upper back muscles for 2-3 minutes, 2-4 times a day. Building up the upper back and neck muscles will help improve your neck support and encourage a better posture.

7. Self massage;  A tennis ball in a sock makes a good, cheap alternative to expensive self-massagers.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Common Rotator Cuff Injuries and How They’re Treated

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Article featured on SSMHealth

Your rotator cuff is made up of the muscles and tendons in your shoulder, which connect your upper arm bone (humerus) with your shoulder blade (scapula). The rotator cuff holds the ball of your humerus firmly in your shoulder socket. The term ‘rotator cuff injury’ can mean many different things and includes any type of irritation or damage to your rotator cuff muscles or tendons. About half the time, a rotator cuff injury can heal with the help of physical therapy. But sometimes, surgery is needed to repair the injury.

Rotator cuff pain is one of the most common shoulder problems in adults.

Types of Rotator Cuff Injuries

Rotator cuff injuries can be acute (traumatic) or chronic (ongoing) injuries that happen over time. These injuries include:

  • As you get older or participate in repetitive movement activities, the general wear and tear on your shoulder can cause a rotator cuff injury.
  • Tendinitis is inflammation of the tendons in your rotator cuff from overuse or overload. Shoulder tendinitis is a common repetitive motion injury for athletes who participate in overhead sports like swimming, tennis and volleyball.
  • Bursitis is inflammation or irritation of the fluid-filled sac (bursa) between your shoulder joint and rotator cuff tendons.
  • A partial or full tear can occur in the tendon connecting the muscle to the bone during an abrupt injury or as a result of repetitive motion. Untreated tendonitis can also lead to a tendon tear. A torn rotator cuff causes pain, weakness and inability to move the arm freely in full range of motion. It also tends to be painful when you try to lift and turn your arm during overhead activity.
  • Shoulder impingement, a common cause of shoulder pain, occurs when the rotator cuff rubs or catches on the bones in the shoulder. Shoulder impingement causes persistent pain as the tendons are injured and swell. Left untreated, shoulder impingement can lead to rotator cuff tears.

Diagnosing a Rotator Cuff Injury

If you have shoulder pain that’s limiting your day-to-day activities, our shoulder specialists will perform a thorough evaluation to determine if you’ve damaged your rotator cuff. This includes understanding your symptoms, a physical exam of your shoulder, and may also include imaging studies, such as an x-ray or MRI.

Rotator Cuff Injury Treatment

The best treatment for a rotator cuff injury depends on what your doctor finds during your evaluation and may include rest, medications, physical therapy, injections in the joint, and/or surgery. Rotator cuff injuries can take several weeks to several months to heal depending on the specific injury. Most rotator cuff tears will not heal on their own, but many times, you can relieve your pain and restore the function of your shoulder without surgery.

Rest and Physical Therapy

Rotator cuff injuries are usually treated first with rest and physical therapy. Your physical therapist will give specific exercises designed to help heal your injury, improve the flexibility of your rotator cuff and shoulder muscles, and provide balanced shoulder muscle strength. They also may recommend using non-steroidal anti-inflammatory medications (NSAIDS) or ice packs/heat packs to control the inflammation. Depending on the severity of your injury, physical therapy may be required for several weeks to several months.

Steroid Injections and Surgery

If rest and physical therapy don’t fully heal your injury, your doctor may recommend other treatments, including:

  • Steroid injections: Depending on the severity of your pain, your doctor may use a corticosteroid injection to relieve inflammation and pain in your shoulder region.
  • Surgery: If you have a large muscle tear in your rotator cuff, you may need surgery to repair the tear. During this type of surgery, doctors also may remove any bone spurs or calcium deposits.

Night Time Shoulder Pain

Many people with rotator cuff injuries have a hard time sleeping, but night time pain can often be relieved with a few simple steps. Try icing your shoulder for 15-20 minutes and taking non-steroidal anti-inflammatory medications, like ibuprofen, before bed to help ease the pain. Many people also find that experimenting with their sleep position can help them get some rest.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What is a Frozen Shoulder?

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Article featured on UCSF Health

Frozen shoulder, or adhesive capsulitis, is a common condition usually affecting people over 40, and women more often than men. Statistics suggest that 5 percent to 20 percent of the population will experience an episode of frozen shoulder. Individuals with a history of diabetes, thyroid problems, Parkinson’s disease or heart disease are at particular risk. Patients with frozen shoulder experience a progressive increase in pain and loss in range of motion.

To understand the condition, it helps to understand the shoulder’s structure. The shoulder is a ball-and-socket joint, yet the shoulder’s anatomy allows for an amazing amount of flexibility. The head of the humerus (upper arm bone) is a ball that sits in the glenoid fossa (shallow socket) of the shoulder blade. (Picture a golf ball on a tee.) Because the socket is so shallow, the shoulder relies on the surrounding soft tissues for stability. The labrum (cartilage lining the socket) and capsule (containing joint fluid and several ligaments) provide a majority of the shoulder’s stability. The muscles of the rotator cuff and shoulder blade also help.

Signs & symptoms

Patients with frozen shoulder usually have increasing pain as their shoulder loses mobility. Quick shoulder motions often exacerbate the pain. Worsening stiffness can even make it difficult for other people, such as a doctor performing an exam, to move the shoulder. Frozen shoulder has been divided into three stages (note that the condition typically improves as it moves through the stages):

  1. Freezing stage. There is a gradual increase in pain, sometimes brought on by an apparently minor injury. As the pain worsens, the shoulder loses range of motion.
  2. Frozen stage. The pain improves, but the shoulder remains stiff.
  3. Thawing stage. Shoulder mobility slowly returns to normal.

The freezing stage can last from one to nine months; the frozen stage, four to nine months; and the thawing stage, five months to two years.

Diagnosis

A doctor can usually make the diagnosis by doing a physical exam, but sometimes imaging tests, such as X-rays or MRI, are useful for ruling out other problems.

Treatments

Frozen shoulder will usually get better on its own, although it takes considerable time – sometimes two or three years. The goals of treatment are controlling pain and restoring motion.

Physical therapy

The mainstay of frozen shoulder treatment is aggressive physical therapy. Techniques include stretching and range-of-motion exercises, followed by applying heat or ice to the area. As with any physical therapy regime, a good home program is essential.

Medications

Taken orally, nonsteroidal anti-inflammatory drugs (NSAIDs, such as naproxen and ibuprofen) can relieve pain, especially during the first (“freezing”) stage.

Injections

A corticosteroid injection into the shoulder joint may foster a more rapid recovery, especially when done early in the disease process, as the shoulder is getting stiff. The procedure is performed in the office, often using ultrasound imaging to ensure the injection is placed accurately.

Surgery

More than 90 percent of patients improve without surgery. For those who don’t get better with physical therapy and time, surgical intervention can be considered. In the arthroscopic (minimally invasive) procedure, the surgeon uses specialized instruments to view and release the tissue that has contracted around the shoulder joint and to break up any other adhesions (damaged tissues that have grown together). Patients can usually go home the same day, and physical therapy begins a few days later. Recovery varies from six weeks to four months.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

5 Top 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.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What is a Total Shoulder Replacement?

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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.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Ways 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.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.