Treatment of the Shoulder Murrieta Sports Medicine
The shoulder is a very complex joint. In fact, what we usually refer to as the shoulder is actually made up of several different joints that all work in concert to produce movements of the arm.
Because it’s so complex, there are a large number of different problems that can occur with the shoulder joint. When the shoulder isn’t working properly, this can cause significant difficulties with everyday activities, such as combing your hair. At our Fallbrook sports medicine clinic, Dr. Erwteman focuses on treatment of a variety of problems with the shoulder.
Shoulder Instability Murrieta Sports Medicine
The shoulder joint is vulnerable to instability, because of the fit of the humerus (the upper arm bone) into the glenoid (a cup on the side of the shoulder blade). An unstable shoulder may be repeatedly dislocated, making it difficult to perform activities using that arm. Those who experience dislocations may benefit from surgical stabilization of the shoulder.
To stabilize the shoulder joint, a labral repair is usually performed, but in some cases, a procedure known as the Latarjet procedure may be used. This involves taking a small piece of bone from the coracoid process (a bony finger of bone that sticks off of the front of the shoulder blade) and transferring it, along with its attached muscles, to the shoulder joint. There, it blocks the humerus (the upper arm bone) from dislocating out of the glenoid fossa (the cup in which it sits).
Shoulder Impingement Murrieta Sports Medicine
When you raise your arm, the acromion (the point of bone on the outer part of the shoulder) and one of the ligaments in the shoulder, may rub against the structures of the rotator cuff. This is called impingement, and it causes pain in the shoulder.
A subacromial decompression is a procedure in which some of the bone tissue on the underside of the acromion is removed, making more room for the other structures of the shoulder and reducing the symptoms of impingement. This can be done in an open procedure, or using arthroscopy. With arthroscopic subacromial decompression, recovery time is reduced and there is much less scarring resulting from the procedure.
Rotator Cuff Tears Murrieta Sports Medicine
The rotator cuff is a group of muscles that actively stabilize the shoulder. These muscles also produce several movements of the shoulder, including rotating the upper arm bone (hence the name).
A tear of the rotator cuff produces shoulder pain, often with difficulty sleeping as a result, and may also cause weakness with certain movements of the shoulder. In some cases, a rotator cuff tear is produced by a specific injury. In other cases, the tear is a result of years of chronic wear. A procedure known as rotator cuff repair can often be completed arthroscopically.
Superior capsular reconstruction is used in cases where the rotator cuff cannot be repaired. This usually occurs when the rotator cuff tear happened a long time ago, because the detached muscle begins to atrophy (shrink and turn to fat) after a long period of not being used. This makes it impossible to effectively reattach the muscle and repair the rotator cuff. In this case, a superior capsular reconstruction may be the best option. This arthroscopic procedure uses a thick graft, which is placed along the top of the rotator cuff where the muscles and tendons would normally be. Although this procedure does not fully restore the function of the rotator cuff muscles, it does stabilize the shoulder joint and prevent some of the joint problems that can result over time in those without a functional rotator cuff. In many cases, it will allow the patient to raise their arm overhead again, and significantly improve shoulder function.
When you visit our Fallbrook sports medicine clinic, Dr. Erwteman will discuss with you which procedure he recommends in your individual case to treat your rotator cuff injury.
Click on the play button to hear Dr. Erwteman’s interview on this topic by RadioMD.
Labral Tears Murrieta Sports Medicine
The labrum is a rim of cartilage that sits on the outer part of the socket of the shoulder. It helps to stabilize the shoulder and distribute the forces of movement. When the labrum is torn, there may be pain in the shoulder, and it may not function properly. Dislocations are more common. A labral repair is a surgical procedure to repair a damaged labrum, restoring stability and function to the shoulder.
Tendon Problems Murrieta Sports Medicine
The biceps brachii muscle has two attachments near the shoulder and one near the elbow. One of the biceps tendons attaches at the labrum. When the biceps contracts, the force it places on the labrum can cause the labrum to be damaged.
When the labrum is torn near the attachment of the biceps tendon, this is known as a SLAP tear. A SLAP tear can occur from an acute injury, or it can result from chronic wear, such as from repetitive motions of the shoulder in sports that involve throwing or overhead weightlifting.
A biceps tenodesis is a procedure that detaches the biceps tendon from the labrum and inserts it directly into the humerus (the upper arm bone). This takes pressure off of the labrum. Dr. Erwteman performs arthroscopic biceps tenodesis, making recovery easier and leaving only a few very small scars.
AC Joint Injuries Murrieta Sports Medicine
The acromioclavicular joint, or AC joint, is the joint where the clavicle (the collarbone) meets the acromion, which is the bone on the outside of the shoulder. Although it doesn’t make huge movements, the movement of the AC joint is very important to the shoulder as a whole.
An injury to the AC joint usually occurs from a fall directly onto the shoulder. The most common causes of AC joint injury are contact sports (such as football) and car crashes. There may be injury to the ligaments around the AC joint, and when the injury is severe, the joint may be dislocated, meaning that the two bones of the joint are moved away from each other. This is known as a separated shoulder.
There are many nonsurgical ways to treat an AC joint injury. When these are not successful, there are a few surgical options. One is distal clavicle excision, in which the damaged end of the collarbone is removed. Another surgical option is reconstructing the ligaments around the joint to stabilize it. The type of surgery performed depends on the individual patient.
Shoulder Arthritis
Arthritis of the shoulder can have a significant impact on your daily life. Simple activities such as reaching up to comb your hair become difficult or painful when you have arthritis of the shoulder. In many cases, the shoulder is affected by osteoarthritis, which occurs when wear and tear on the shoulder causes damage to the cartilage of the joint over time. This is made more likely in shoulders that move abnormally; for example, shoulders that are injured may be more likely to move in unusual ways, which can later lead to osteoarthritis.
In a shoulder with severely damaged articular cartilage, the best option is often a shoulder arthroplasty. This involves resurfacing the bones to remove the damaged cartilage and replace it with artificial surfaces, allowing the joint to move smoothly again. This procedure is sometimes referred to as a shoulder replacement, although only the surface of the bones is actually replaced. Shoulder arthroplasty is a special interest of Dr. Erwteman, and he focused on becoming highly skilled at performing this procedure during his postgraduate medical training.
