Shoulder Injuries

Restoring Everyday Motion

Think about these every day movements: reaching for a can on a supermarket shelf, shampooing your hair, changing the car radio. Consider these tasks with shoulder pain or without fluid shoulder mobility.

The shoulder is the most movable and flexible joint. This very flexibility also makes it one of the most fragile joints, prone to sudden injury—such as that experienced by a major league pitcher who tears a rotator cuff—and wear and tear from everyday use.

“Shoulder pain is relatively common,” says William D. Emper, M.D., orthopedic surgeon at the Bryn Mawr Hospital Orthopedic Center in the Philadelphia suburbs. "Early diagnosis and treatment should be a priority for anyone experiencing persistent shoulder pain or weakness to prevent it from progressing to more serious consequences."

Common Shoulder Conditions

The team of orthopedists at Bryn Mawr treat a variety of shoulder injuries, including:

• Shoulder impingement syndrome: The leading cause of shoulder pain is a group of conditions called shoulder impingement syndrome. With any of these problems, a continuous dull ache can become a sharp pain when you try to move your arm, especially over your head.
• Bursitis: Bursitis is an irritation of the bursa, a fluid-filled sac providing a cushion between the rotator cuff tendons and the shoulder bone.
• Tendinitis: Tendinitis is a swelling of the tendons of the rotator cuff deep in the shoulder that, along with muscles, help stabilize the upper arm bone in the shoulder joint and allow the arm to rotate.
• Irritated rotator cuff: Excessive wear can lead to severe irritation, roughening, and eventually ulceration and tearing of the rotator cuff.

Shoulder pain can also occur with:

• arthritis
• cartilage tears
• tears of the labrum (the soft, fibrous tissue rim that surrounds the shoulder socket)
• dislocated shoulder (when the ball comes partially or completely out of the socket)

Treating Shoulder Injuries

A large percentage of shoulder conditions are treated conservatively with anti-inflammatory medications, rest, ice or cortisone injections. Once the pain and inflammation are under control, a program of physical therapy can help many patients regain motion.

When these treatments don't bring relief, surgery may be recommended. Many shoulder problems—including impingement syndrome, rotator cuff tears, torn cartilage and an unstable joint—can be corrected through arthroscopy, a minimally invasive surgical technique. In some cases, however, if the damage is severe, a shoulder replacement is the only option for pain-free motion.

"People with shoulder pain tend to wait to seek treatment, which is appropriate to some degree," says orthopedic surgeon, Joseph V.Vernace, M.D. "But when rest, ice and anti-inflammatory medications are not effective, that indicates the need to be evaluated. When necessary, shoulder surgery is highly effective. Many patients, in fact, say that they wish they had sought treatment earlier."

What Our Patients Say

Rotator Cuff Repair: A Personal Story

The rotator cuff consists of muscles and tendons that hold the shoulder in place. It is one of the most important parts of the shoulder. The rotator cuff allows a person to lift his or her arm and reach up. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities. Rotator cuff tears are also due to aging.

Whitey Rigsby of Malvern, Pa., is director of the V Club, the booster fundraising club for Villanova University Athletics, and he knows firsthand about rotator cuff injuries. "I played basketball as a student at Villanova, and I can still do all the things I did when I was 20—at least in my mind! I was playing basketball with my sons last year when I tore my rotator cuff. Dr. Emper looked at my MRI and said, 'For your quality of life, you have to have surgery.' I've known the doctors at Bryn Mawr for years. I've seen them treat the Villanova athletes, as well as friends of mine. I trust those guys, and I didn't give it a second thought. When I got the phone call confirming that it was okay for me to resume playing golf, I was already on the eighth fairway at Torrey Pines!"

Read more about shoulder problems and the anatomy of the shoulder in our Health Library.