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Shoulder Joint Problems

Bursitis

People no longer swing from lianas, they walk around erect on two legs to carry their prey home. Only gymnasts and climbers are still able to clamber up a rope as adults.

This has a price tag – the "load-bearing" muscles have become much stronger, and as soon as an arm is lifted, the space underneath the shoulder's anatomic roof becomes limited. The bursa, which is supposed to soften the friction between bones and tendons, can become inflamed when repeatedly constricted mechanically.

If the bursa swells, we talk about bursitis.

Impingement Syndrome

When an inflammation of the bursa is not treated, the shoulder develops a bottleneck syndrome, which is also known as impingement. Moving the arms above the head and raising them sideways then cause strong pain.

Postures of relief and immobilization of the arm would result in a stiff shoulder. Inflammation should be quickly treated with medication and injections, supported by physiotherapy aimed at strengthening the "traction" muscles, especially the latissimus dorsi, the broad back muscle.

Calcareous Shoulder

Chronic inflammation may cause the development of calcium deposits in the bursa and at the roots of the tendons of the rotator cuff. Resting on one's shoulder and lifting one's arm become so painful that these movements are barely possible. Injections can help relieve the pain, and the calcium deposit can successfully be dissolved by ultrasound shock waves.

Arthrosis of the Acromio-clavicular Joint

BFalling on the shoulder often injures or cracks the acromio-clavicular joint – the connection between the shoulder's summit (acromion) and the collarbone (clavicula). A trauma-induced instability of the joint must be corrected by immobilization and at times even through surgery. Progressive wear and tear result in arthrosis, putting considerable limits on the shoulder's overall mobility.

Injuries of the Rotator Cuffs

With time, the shoulder's impingement causes a degenerative abrasion of the root of the rotator muscles. Falls or frequently recurring strain can cause the tendons to tear – and then it becomes impossible to lift the arm.

In addition to ultrasonographic diagnosis, magnetic resonance tomography helps gauge the extent of the damage and, if need be, support a decision to perform surgical, minimally invasive rotor cuff reconstruction.

Shoulder Luxation

The shoulder is the human body's joint with the greatest mobility. The flat socket and the flexible articular capsule enable the joint to rotate almost 360°, stabilized by the muscles attached to it – an ingenious construct.

When the shoulder is affected by strong forces of leverage, the condyle can be dislocated. The arm's position is distorted and the arm cannot be moved. Repositioning the arm by an experienced physician becomes urgent in order to prevent further damage to the shoulder's condyle, socket and articular capsule.

Following a short period of immobilization, the shoulder joint's stability is enhanced by muscle training and physiotherapy. In cases where a feeling of instability remains or upon repeated dislocation, surgical stabilization is indicated.

Biceps Tendon Rupture

Upon exertion, even people who are in good shape can, when advancing in age (50+), experience a rupture of the long biceps tendon at the ball of the upper arm, causing some degree of pain. Often, the condition is only recognized upon the appearance of a hematoma on the upper arm and a shortening of the biceps muscle's venter. Though this results in a loss of strength (of about 40%), it rarely poses a serious impediment.


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