The shoulder is an intersection of several joints essential for providing strength and a full range of motion when using the arm. A shoulder condition is any injury or disease that causes problems in the shoulder joint, often leading to pain, discomfort, loss of strength, and stiffness.

Shoulder conditions can be caused by a myriad of factors, such as acute or chronic trauma, overuse, and age. Shoulder conditions are some of the most common sports injuries since this area of the body is heavily utilised when throwing, lifting, catching, and a range of other movements.

Shoulder Anatomy

The clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone) are the three bones that make up the shoulder joint. These bones are connected and supported by a series of muscles, ligaments, and tendons found in the rotator cuff.

The rotator cuff comprises four muscles: the supraspinatus, subscapularis, infraspinatus, and teres minor. The rotator cuff is attached to the humeral head and adheres to the glenohumeral capsule.

The shoulder joint is where the humerus fits into the scapula. The relatively loose fit of the humerus allows for a wide range of motion but also makes the area more susceptible to injury than other joints.

Symptoms of Shoulder Conditions

Common shoulder injury symptoms include:

  • Deep pain in one or several parts of the shoulder (back, front, or upper arm). The type of pain sensation and where it is being felt can indicate which part of the shoulder has suffered an injury, either suddenly or through wear and tear.
  • Reduced ability to move arm due to pain and stiffness in the shoulder. Movement can be greatly impacted due to shoulder pain, often caused by a partial or complete tear of rotator cuff tendons.
  • Feelings of weakness in the shoulder, sometimes accompanied by a feeling of the humerus slipping in and out of the scapula. If the humerus is completely separated from the joint, it means the shoulder is dislocated.
  • Tingling or burning sensation (or pins and needles). Is often associated with nerve damage in the neck rather than an issue with the shoulder joint.

Common Shoulder Conditions

Rotator Cuff Syndrome

Rotator cuff syndrome refers to issues experienced by the four muscles that move and control the shoulder socket joint. There are several specific injury types, including rotator cuff tendonitis, rotator cuff impingement, and complete rotator cuff tears.

Rotator cuff injuries can run the gamut from mild inflammation to partial and full tears. This is a common shoulder injury for athletes who perform throwing exercises, and surgery may be required for the most severe issues.

Common symptoms of rotator cuff syndrome include:

  • Pain or clicking sensation when raising the arm to or above shoulder height.
  • Pain running from the peak of the shoulder down to the elbow.
  • Pain when resting against the shoulder.
  • Weakness and pain when attempting to use the shoulder.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform rotator cuff surgery to help alleviate symptoms and return joint function.

Frozen Shoulder

Frozen shoulder (adhesive capsulitis) is a common shoulder problem. While often confused with a rotator cuff injury, adhesive capsulitis has distinct symptoms that are caused when the shoulder capsule becomes inflamed (capsulitis).

Adhesive capsulitis is most often the result of inflammation (swelling, pain, and irritation) of the soft tissues surrounding the joint. This issue can develop as a result of any shoulder injury.

Adhesive capsulitis symptoms typically occur in three stages:

  1. Freezing – pain and loss of movement in the shoulder.
  2. Frozen – extreme stiffness of the shoulder.
  3. Thawing – movement gradually returns, and some interventions like physiotherapy can help increase the speed of recovery.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform frozen shoulder release surgery to help alleviate symptoms and return joint function.

Bicep Tendonitis

Bicep tendonitis occurs when there is irritation or inflammation of the upper biceps tendon. As the condition progresses, the tendon becomes thicker and more inflamed which can eventually cause it to split or tear. Bicep tendonitis typically occurs with wear and tear that comes with age, although it can also be caused by repetitive shoulder motions, such as those performed by certain atheletes.

Symptoms of bicep tendonitis include:

  • Pain in the front area of the shoulder that may get worse with overhead activity.
  • Aching pain that can travel down the arm.
  • Weakness in the shoulder and loss of function.
  • Deformity in the arm if tendon is partially or fully torn (ruptured).

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform bicep tendonitis surgery to help alleviate symptoms and return joint function.

Shoulder Impingement

Shoulder impingement occurs when elevating the shoulder leads to the tendons rubbing against the shoulder blade (scapula). This issue is most often caused by overuse and is common in athletes like swimmers (which is why it is also known as swimmer’s shoulder).

The common symptoms of this condition include:

  • Sudden acute pain when lifting the arm backwards or overhead.
  • Minimal yet constant pain sensation in the arm.
  • Pain travelling from the front part of the shoulder to the side of the arm.
  • Pain that worsens at night.
  • Weakness in the shoulder.

Supraspinatus Tear

A supraspinatus tear is when the supraspinatus muscle (part of the rotator cuff) is torn or entirely ruptured (detached from the bone). This issue typically accompanies another rotator cuff tear and can develop due to sudden injury or overuse.

The common symptoms of a supraspinatus tear include:

  • Pain when moving the arm.
  • Pain at rest or night, particularly when laying against the affected shoulder.
  • Loss in movement.
  • Weakness in the shoulder.

Subacromial Bursitis Impingement

Shoulder bursitis impingement is inflammation of the large bursa that sits at the top of the shoulder (bursa are small fluid-filled sacs that allow for smooth movement between muscles and bones). It normally accompanies shoulder impingement syndrome and is commonly caused by repetitive motion or overuse of the shoulder.

Common symptoms of subacromial bursitis impingement include:

  • Pain when lifting arms overhead which may worsen over time.
  • Pain that worsens after repetitive activity.
  • Tenderness.
  • Muscle weakness (which can worsen when shoulder use is avoided because of pain).

Deltoid Pain

Deltoid pain is a common shoulder problem that occurs when the deltoid muscle is injured by overuse or tendon tearing. This issue is most commonly caused by a strain, which is graded based on its severity.

  • Grade 1 strains are mild in nature and are accompanied by tightness and swelling.
  • Grade 2 strains have increased pain and swelling, with movement being impacted.
  • Grade 3 strains are the most severe and can lead to a bulge or gap in the muscle alongside pain and swelling. Movement is often severely limited.

Calcific Tendinitis

Calcific tendinitis is a relatively common shoulder condition wherein calcium forms inside the rotator cuff tendons. There are several potential causes for this condition, including genetic predisposition, abrnomal thyroid gland activity, and metabolic diseases like diabetes.

This condition is sometimes painless and is often only detected in x-rays performed to diagnose another issue. However, if symptomatic calcific tendinitis can cause:

  • Pain and inflammation surrounding the shoulder tendon.
  • Throbbing pain at rest.
  • Pain that increases when the eblow is moved away from the body.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform calcific tendinitis surgery to help alleviate symptoms and return joint function.

 

Shoulder Bone Spurs

Bone spurs (osteophytes) that develop under the acromion of the shoulder are typically a result of arthritis, but they can also affect those who play sports or conduct work with repetitive shoulder motion. Shoulder bone spurs can be very painful because the space within the joint is narrowed, leading to irritation of the rotator cuff tendons.

Common symptoms of shoulder bone spurs include:

  • Pain and stiffness in the shoulder joint, causing limited range of motion.
  • Numbness and tingling if the bone spur is pressing against nerves.
  • Weakness, cramps, and muscle spasms.

Proximal Humerus Fracture

A proximal humerus fracture is one of the most common types of shoulder fracture and is often the result of a fall onto an outstretched arm. Treatment options depend on the nature and severity of the fracture.

Common symptoms of a proximal humerus fracture include:

  • Pain, swelling, and bruising.
  • Severely limited movement of the arm.
  • Numbness and tingling sensations.
  • Unusual appearance (deformity) of the upper arm.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon help you with shoulder fracture treatment to help alleviate symptoms and return joint function.

Shoulder Instability

Shoulder instability often occurs when structures surrounding the shoulder joint fail to keep the ball within the socket. This can cause partial shoulder dislocation (shoulder subluxation).

Common symptoms of shoulder instability include:

  • General shoulder pain or soreness.
  • Frequent dislocation of the shoulder.
  • Frequent instances of the shoulder ‘giving out’.
  • A constant sense of the shoulder feeling loose or barely ‘hanging on’ to the rest of the body.

Shoulder Subluxation

Shoulder subluxation is a partial dislocation of the shoulder that typically occurs due to a change in the joint’s integrity. Trauma to the shoulder or weakness in the rotator cuff causes humeral head to slip out of its socket.

Shoulder subluxation symptoms can include:

  • Shoulder appears deformed or out-of-place
  • Pain and swelling
  • Numbness and tingling sensation
  • Difficulty moving the joint

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon help you with shoulder dislocation surgery to help alleviate symptoms and return joint function.

Multidirectional Shoulder Instability

While typical shoulder instability can often be caused by a sudden injury like dislocation, multidirectional shoulder instability tends to occur due to many smaller injuries incurred through overuse.

Common symptoms of multidirectional shoulder instability include:

  • Pain and instability when using the shoulder.
  • A sensation of the shoulder ‘slipping out’ of its socket.
  • General weakness and reluctance to use the affected shoulder.

Acromio-Clavicular Joint Separation

Also known as a shoulder separation, acromio-clavicular joint separation occurs when the clavicle is dislocated from the acromion. This type of shoulder injury normally occurs as the result of a fall where the patient has landed on an outstretched arm or directly onto the shoulder.

Common symptoms of shoulder separation include:

  • Intense pain at the moment of injury.
  • Reduced movement because of pain.
  • Bruising and swelling.
  • Tenderness of the acromioclavicular joint.
  • Deformity or unusual appearance of the shoulder.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon help you with AC joint separation surgery to help alleviate symptoms and return joint function.

Shoulder Blade Pain

Shoulder blade pain (also known as interscapular pain) is a common type of shoulder pain that is typically caused by an injury to a muscle or tendon. Heavy lifting, poor posture, and overuse during sport or exercise are common causes.

Shoulder blade pain is typically characterised as a shooting, sore, dull, or aching pain in the upper part of the back between the shoulder blades.

Anterior Shoulder Pain

Anterior shoulder pain occurs at the front of the shoulder (as opposed to posterior pain at the back of the shoulder). This type of shoulder pain is typically caused by an injury like a rotator cuff tear that leads to inflammation of the tendons surrounding the joint.

Several different conditions may be responsible for anterior shoulder pain, including:

  • Biceps tendonitis
  • Frozen shoulder
  • Arthritis in the shoulder
  • Labral tear
  • Rotator cuff tear
  • Shoulder separation

Shoulder Arthritis

Shoulder arthritis occurs when the cartiliage that separate bones in the shoulder breaks down, causing bones to rub against eachother can cause severe pain and discomfort. Shoulder arthritis can be caused by oestheoarthritis or rheumatoid arthirits, and while there is no cure there are treatment options available.

Symptoms of shoulder arthritis include:

  • Pain when performing motions with the shoulder
  • Reduced range of motion
  • Joint stiffness and swelling
  • Tenderness around the shoulder
  • A gridning or catching sensation within the shoulder

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon help you with shoulder arthritis surgery to help alleviate symptoms and return joint function.

Shoulder Popping

Shoulder popping or cracking shoulder is when moving the shoulder causes a popping or clicking sound coming from the shoulder joint. The popping sensation is known as crepitus. There are a wide range of potential causes for shoulder popping, including labral tears, osteochondroma, cavitation, and osteoarthritis.

The most obvious symptom of shoulder popping is the popping sensation. If pain accompanies the popping or clicking sounds, it may indicate that a more serious shoulder injury is the underlying cause.

Double-Jointed Shoulder

A double-jointed shoulder or hypermobile shoulder is when the soft tissues that hold the shoulder together are too loose, allowing for a wider range of motion than normal. While a double-jointed shoulder can be seen as advantageous in some contexts, it can also make the area more susceptible to injuries and chronic joint pain.

Experiencing Shoulder Pain?

If you are suffering from any of the conditions listed above, you should seek medical diagnosis and treatment from an orthopaedic specialist. Contact Melbourne Arm Clinic to book an appointment or ask any questions about your issue and the treatment options available (such as shoulder arthroscopy and shoulder replacement surgery).

Devinder Garewal
SHOULDER SPECIALIST

Mr. Devinder Garewal

MBBS, BMedSci, FRACS (Orth), FAOrthA

Devinder completed his medical qualifications from the University of Melbourne and is a Fellow of the Royal Australiasian College of Surgeons and the Australian Orthopaedic Association.

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