Shoulder Common Injuries

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Acromioclavicular (AC) Joint Sprain

Acromioclavicular (AC) Joint Sprain is also referred to as a shoulder separation. This is an injury to the AC joint, which is located at the end of the collar bone on top of the shoulder. There are several ligaments which hold the AC joint together. Shoulder separations are graded depending on the degree or injury and deformity. The most common cause of a shoulder separation is landing on either the side or top of the shoulder with the arm at the side.

Symptoms include pain on top of the shoulder, pain with movement of the shoulder, with a possible new bump or prominence on top of the shoulder.

Treatment often includes a period of rest, activity modification, physical therapy, and bracing. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Biceps Tendinopathy

Biceps Tendinopathy, often referred to as tendinitis, is an irritation of the upper biceps tendon at its attachment in the shoulder. The cord-like structure connects the biceps muscle to the bones in the shoulder. As we age, our tendons slowly weaken with everyday wear and tear. Many jobs and routine chores can cause overuse damage. Repetitive overhead motion may play a part in other shoulder problems that occur with biceps tendinitis.

Symptoms include pain in the front of the shoulder with possible weakness.

Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Calcific Tendonitis

Calcific tendonitis or tendinopathy can be a very painful cause of shoulder pain. It can be found at multiple locations, the most common being the rotator cuff in the shoulder. There are several theories to why a calcification develops inside the tendon, but there is no consensus. There is a formation of crystals inside the tendon.

Symptoms include pain related to activity, loss of range of motion, and tenderness to palpation at the involved tendon. This will affect the shoulder when elevating the arm above shoulder height and pain with high-impact activities.

Treatment often includes a period of rest and activity modification. Dr. Sampson performs ultrasound diagnostics to confirm diagnosis and guided procedures to remove the calcium deposit for refractory cases.

Distal Clavicle Osteolysis

Distal clavicle osteolysis involves the end of the collarbone. The condition is typically caused by repetitive stress and micro-fracture in end of the clavicle. This is found primarily in male patients in their twenties, commonly seen in weightlifters.

Symptoms include pain located at end of clavicle, exacerbated by repetitive loading (ie. bench press or push-ups).

Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Glenohumeral Osteoarthritis

Glenohumeral Osteoarthritis (Shoulder Arthritis) is arthritis of the shoulder joint. Over time the cartilage wears down and causes the bones to rub together causing pain. There are many causes including wear and tear over time, trauma, infection, chronic rotator cuff tears, etc.

Symptoms include pain, weakness, and loss of motion. Patients may note catching, locking, or popping.

Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Labral Tear

A labral tear is an injury to the fibrous cartilage portion of the shoulder joint that helps hold the ball within the socket of the shoulder. A labral tear can occur if the shoulder is dislocated or if there is a sudden force to the shoulder. Labral tears may also occur with overuse in weightlifting, in throwing sports, and in overhead sports. While these injuries do occur in younger athletes, they most commonly occur in the older population.

Symptoms include pain with overhead movements. Patients may note catching, locking, or popping. There can also be pain at night, especially while lying on the affected shoulder.

Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Little League Shoulder

Little league shoulder is an injury to the growth plate in the shoulder of a skeletally immature (still growing) athletes. Repeated overhead throwing can lead to irritation of the growth plate closest to the shoulder. This most commonly occurs in baseball players but can occur in other athletes who do a lot of overhead arm movements, including volleyball or tennis players. This can be a result of poor mechanics, high pitch or throw count, poor technique while throwing breaking balls (curve balls, for example)

Symptoms include a gradual onset of pain in the throwing shoulder. Pain in the shoulder while throwing, particularly after an increased number of throws or while trying to increase velocity. The shoulder may remain painful for days after throwing.

Treatment often includes an extended period of rest. Athletes may not be able to throw for 2-3 months.
Followed by physical therapy and correction of throwing mechanics. Dr. Sampson uses ultrasound for accurate diagnosis and supervises a safe return to activity.

Rotator Cuff Injuries

Rotator Cuff Injuries refer to partial or full tears of one or more of the four muscles of the rotator cuff. Tendinopathy of the rotator cuff is the most common cause of shoulder pain. The most commonly torn muscle of the rotator cuff is the muscle that helps lift the arm away from the body called the supraspinatus. Rotator cuff injuries may happen with repetitive overhead use of the arm, but can also occur after suffering trauma, such as after falling on an outstretched hand.

Symptoms can include sudden onset of shoulder pain or pain that develops over time. Pain may occur at rest or at night. Location of pain is often variable, and it may radiate to the elbow. Pain is generally worse with reaching motions, especially overhead.

Treatment often includes a period of rest, activity modification, physical therapy, and bracing. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Shoulder Impingement

Shoulder Impingement is a common shoulder condition seen in active adults. Impingement is closely related to shoulder bursitis and rotator cuff tendinopathy. The rotator cuff runs between the arm bone and the top of the shoulder. The tendons of the rotator cuff and the subacromial bursa become pinched in this narrow space. This causes the tendons and bursa to become inflamed and swollen. This pinching is worse when the arm is raised overhead.

Symptoms include pain with overhead motions, difficulty reaching behind the back, and shoulder weakness.

Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Shoulder Bursitis

There is multiple bursa around the shoulder. A bursa is a sac that can be filled with fluid between tissues (bone, skin, tendons and muscle). It acts to decrease the friction and the irritation between the tissues. When a bursa is not irritated, joints move smoothly and painless. But when it becomes inflamed and swollen, they become painful. This is referred to as a bursitis. There is multiple bursa around the shoulder. Subscapular Bursa or the Scapulothoracic Bursa: between the tendon of the Subscapularis muscle and the shoulder joint capsule. Subdeltoid Bursa: between the Deltoid muscle and the shoulder joint cavity. Subacromial Bursa: below the acromion process and above the greater tubercle of the humerus. Subcoracoid Bursa: between the coracoid process of the scapula and the shoulder joint capsule.

Symptoms typically include pain with motions, difficulty reaching behind the back, and shoulder weakness.

Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections for refractory cases.

Suprascapular Nerve Entrapment

Suprascapular nerve entrapment is caused by compression of the suprascapular nerve as it passes through the suprascapular notch. The suprascapular nerve innervates the supraspinatus and infraspinatus rotator cuff muscles. This can be caused from trauma to the rotator cuff or shoulder including dislocations. Additionally, from compression of the nerve caused by cysts or tumors.

Symptoms can present as shoulder/arm weakness or heaviness, radiating/burning pain, pain that worsens with shoulder movement, or loss of shoulder function.

Treatment often includes a period of activity modification and physical therapy. Dr. Sampson uses ultrasound for accurate diagnosis and guided injections or cyst aspiration for refractory cases.