When something traumatic forces the humerus (top of the upper arm bone) out of the glenoid (your shoulder joint socket), your shoulder is considered dislocated. Heavy blows, falling hard on your shoulder or being forced to move your shoulder in unnatural ways often cause shoulder dislocations. Since your shoulder is your body’s most flexible and mobile joint, it is vulnerable to being dislocated. In fact, your shoulder is the most commonly dislocated joint in your body.

Dislocation can occur as a partial or complete dislocation and move downward, backward or forward. Your shoulder dislocation doctor may also find the fibrous tissue keeping our shoulder bones together has been stretched and torn, another frequent complication seen in shoulder dislocations.

Symptoms of a Dislocated Shoulder

• Your shoulder appears visibly deformed or your arm may hang incorrectly
• Swelling and bruising is apparent around your shoulder
• Intense, throbbing pain and muscle spasms cannot be relieved with NSAIDs or cold compresses
• You can move your shoulder a little or not at all without experiencing pain and stiffness
• You may feel tingling, weakness and numbness around the dislocated joint.
• You may feel tingling and numbness in your neck and radiating down your arm

Rotator cuff tears often cause pain and weakness, though they may not cause any symptoms at all. If pain does occur, lifting or lowering the arm can bring on the pain, though it can also occur at rest and at night, especially when sleeping on the injured shoulder. People with rotator cuff tears often experience weakness when they try to lift or rotate the arm. The rotator cuff tear doctors at iOrtho can perform physical examination tests that can diagnose rotator cuff tears. An ultrasound or MRI may be necessary to confirm the diagnosis and to plan rotator cuff tear treatment. The diagnosis of a shoulder rotator cuff injury is based on history and clinical exam. MRI is the definitive test which will demonstrate a tear. MRI examination can also show associated pathology including such things as impingement, labrum tearing, biceps tendon tearing, fatty infiltration of the rotator cuff muscles etc.

Rotator cuff tearing can be partial or complete. Partial thickness rotator cuff tearing can occur on the bursal surface, articular surface, or both.

Bursal sided tears are more often related to subacromial impingement by the direct influence of the external compression from the adjacent bone surfaces. The articular sided tears are more often related to repetitive stress and unrelated to impingement. The acronym for these tears is PASTA= partial articular sided tendon.

Full thickness tears are either non-retracted or retracted. Retracted tears can be mildly, moderately, or severely retracted. Tear patterns also include the shape of the tear and crescent tears, U shaped tears and longitudinal tears are examples of common tear patterns.

There are two categories of rotator cuff tears, acute and degenerative. An acute rotator cuff tear is caused by injury. For example, the injured person falls on an outstretched arm or tries to forcefully lift something well beyond their strength limitations. Degenerative rotator cuff tears are caused by long-standing wear and tear on the shoulder joint. They are most common in middle-aged individuals who spent a great deal of time performing the same arm motion repetitively, such as throwing a baseball, swinging a tennis racket, or rowing a boat. Bone spurs and blood supply abnormalities may also lead to degenerative rotator cuff tears.

Tendinitis, also called “Tennis Elbow” affects large tendons attached to your elbow from your forearm’s muscles. Repetitive motions cause most tendinitis conditions diagnosed. Tendinitis inflames tendons, but should not restrict your range of motion, since the inner elbow joint is not injured. For people suffering chronic tendonitis, x-rays may show development of calcium deposits within tendons or other elbow joint abnormality that may require specialized treatment.

Running from your upper arm into your palm is the median nerve, an important nerve that regulates sensation to the palm side of your fingers (minus the little and ½ ring finger) and thumb. When this nerve becomes squeezed or compressed in the carpal tunnel (a narrow, bony passage in your wrist), numbness, weakness and pain can affect your hand and wrist. Carpal tunnel pain may also radiate up your arm to the elbow. Although carpal tunnel pain may recede on its own if whatever is causing median nerve inflammation stops, the majority of carpal tunnel conditions become chronic and require specialized treatment.

Shoulder injury may cause a tear in the labrum. If you experience a deep, throbbing pain in your shoulder joint that does not go away with home treatments, pain with activity, pain while sleeping, pain often worsens if you move the shoulder, or you may hear a clicking noise and experience pain. Be aware that bicep tendinitis is often accompanied by a rotator cuff tear or superior labrum anterior to posterior lesions (SLAP), which necessitates more complex treatment methods to achieve normal function and pain relief.

Large meniscus tears, or those that interfere with the stability and function of the knee, usually require surgical meniscus tear treatment. These occur from an injury of some type as related to work or sports.  They more often require surgery. The benefit of performing surgery on a traumatic meniscus tear, especially in a younger person, is the potential opportunity to repair the tear and restore the meniscus to its pre-injury capacity to function. 

Today, all surgical meniscus tear treatments are performed arthroscopically (joint surgery performed through small incisions using very thin instruments) and at iOrtho we prefer a technique of all-inside repair. The surgery is performed through three or four small incisions in the knee. These small incisions become portals through which an arthroscope and small instruments enter the knee joint. The damaged knee meniscus may be removed in a procedure called a partial meniscectomy. In other cases, the torn meniscus may be repaired by suturing the tear in the meniscus. This allows the surgeon to place the stitches arthroscopically and all inside without the need for an open incision.

An ACL injury is one of the most common knee injuries in sports. A torn ACL is most likely to occur in movements that involve planting the foot and rotating the leg at the knee joint, such as related to soccer, basketball, gymnastics, and football.

If the goal is to return to playing sports, ACL injury treatment usually involves surgery. However, nonsurgical ACL injury treatments are available for non-athletes who want to avoid surgery and are able to modify activities to reduce stress on the knee.

ACL injuries are relatively common sports-related injuries although any mechanism which generates sufficient load within the ACL may cause it to become injured. Typically sports that involve rapid deceleration and pivoting motions are at high risk for injuring the ACL such as soccer, basketball, and football. However, a non-sports mechanism that causes tension within the ACL, typically valgus and internal rotation loads such as a fall from a height, trip and fall, MVA can injure the ACL. ACL injuries may be incomplete (partial) or complete (full) tears. Often with ACL injuries, there may be associated injuries such as meniscus tears and MCL sprains. ACL injuries can be treated non-surgically if they are incomplete or the patient has a low demand lifestyle. Complete tears are typically treated with surgical reconstruction for patients with high demand lifestyles such as athletes, policemen, firemen or other occupations where physical performance is a necessity. Surgical reconstruction is performed arthroscopically and is done on an outpatient basis.