Shoulder+Problems

= = =Shoulder Problems=

Dislocation
The shoulder is a very mobile joint. It can turn in many different directions. This makes it very easy to dislocate. The shoulder can be dislocated forwards, backwards, or downwards. Also, the shoulder injury can be put into categories as to what kind of [|dislocation] it is. First, __partial dislocation__ or when the top of the humerus is partially out of the socket and then __complete dislocation__ or when the humerus is completely out of the socket. Symptoms of either kind of dislocation include swelling, bruising, weakness in the arm, numbness, and pain. If the dislocation is very severe, ligaments and nerves may be damaged. To cure the victim of these symptoms the shoulder is put back in place. This is done by relaxing the muscles in the shoulder as much as possible, pulling the humerus out and then pushing the humerus back in the socket. This is painful at first, but seconds after the shoulder is put right, the major pain stops. After the procedure is done, the shoulder is put into a sling and within a couple of days, the shoulder can be put back to use.



Rotator Cuff Tears
Before I explain this injury we need to know, ' What is the __rotator cuff__? ' Well, the [|rotator cuff] is the group of four muscles and several tendons which cover the top of the humerus. The rotator cuff holds the humerus in place by grasping it with the tendons and it helps lift the arm. The rotator cuff also enables the arm to rotate while stabilizing the arm. Now we move on to the actual injury, rotator cuff tears. Now that we know what the rotator cuff is, we can figure out what the injury is just by looking at the name. Obviously, rotator cuff tears are rips in the muscles joined together. This can be a result of a single traumatic injury (ex: fracture, dislocation, etc.), or simply gradual wear and tear of the muscles. Symptoms are usually pain lifting and lowering the arm, crepitus, and atrophy. Visual evidence is found through x-rays which are usually followed by an MRI scan due to the fact that x-rays are not as efficient at seeing soft tissue. If the doctors are sure of what they find, they will first put the patient on anti-inflammatory medication, assign physical therapy, recommend limited activity and use of a sling, and/or give steroid injections. If these treatments do not give the desired result, surgical treatment is next. There are three types of surgery that can be given, each of which depending on the patient and also on how big the tear is. First, is athroscopic repair. A fiberoptic scope and small instruments are inserted into a small incision. The surgeon looks at a TV monitor to do the surgery. Next, is mini-open repair. The procedure is very much the same as arthroscopic repair but the incision is even smaller. The incision ranges from 4-6 cm. Last, is open surgical repair. This is the traditional open surgery with a large incision. Recovery time for open surgery repair is a longer than the new operations. After the surgery the arm is immobilized and therapy begins. The exercises start out small and gradulaly move to lifting objects and pushing them. Complete recovery takes several months, even with the small incision surgeries.



Shoulder Joint Replacement
[|Shoulder replacement], although uncommon, is fast becoming widely used to relieve shoulder pain. Usually though the reasons for surgery are more serious than just pain alone. More serious reasons are because of conditions like rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, and rotator cuff tear arthrotherapy. And a more obvious reason; because a previous shoulder replacement failed. These conditions cause the shoulder to ache, make grinding sounds when moved, lock-up, and loss of motion may also occur. But before treatment can be given, the doctor giving it has to make sure that major treatment is needed. This is accomplished by taking x-rays of the shoulder. In a patient with one of the conditions above, x-rays show loss of cartilage, flattening or irregularity of the bone, and/or loose pieces of bone and cartilage. After this step, the doctor needs to decide which treatment to give. In lesser conditions medication and physical therapy may be recommended. If this treatment fails, surgery may be done. Depending on the type of condition and the severity of the pain doctor may replace the top of the humerus (ball), or part of the scapula (socket) or both with either metal or plastic replacements. After the surgery physical therapy and medication are given. The arm is also put into a sling for 4-6 weeks. The arm will be able to be used in simple tasks like eating and dressing, within 2 weeks of wearing the sling.

Lauren Smith Faith Lutheran edited: 1/07/07