The Shoulder Joint Is Prone To Problems

DANBURY — “Oh, my aching shoulder, what can I do?” is heard so often by doctors that Danbury Hospital sponsored a Medical Town Meeting on the topic and drew more than 85 people on a dreary, rainy night in October.

Shoulder problems are very common, mostly because the shoulder is such a mobile joint. Because it is so mobile, it tends to be unstable, according to a panel of orthopedic surgeons speaking at the meeting, “My Aching Shoulder, What Can I Do?”

The panel was moderated by Ronald Tietjen, MD, and included J. Albert Diaz, MD; Ross Henshaw, MD; and Michael Brand, MD, all in the Department of Surgery, Section of Orthopedic Surgery.

To illustrate the instability of the shoulder, the doctors compared the ball-and-socket joint in layman’s terms to a basketball lying on a dinner plate. To explain why shoulder problems happen, the panel spent time explaining how the joint works. The joint was likened to a seal balancing a ball on his nose — several forces are at work to keep the joint working well.

Unlike the more stable hip joint, the shoulder is prone to several common problems, including rotator cuff injuries and impingement (pressure) problems, bone spurs, tendonitis, and bursitis. Athletes can also suffer from overuse problems, especially pitchers, swimmers, and tennis players.

Injuries can also result from trauma, such as a fall, or from overuse or poor body mechanics during weight training. Dr. Diaz urged people to use lighter weights in the gym.

Most people know they have a problem when the symptoms of pain, weakness, and loss of motion set in.

Many common shoulder problems are attributed to inflammation, according to Dr. Diaz, and are best treated with rest, physical therapy, cortisone injections, and as a last resort, surgery. Many problems resolve themselves with rest.

Dr Henshaw discussed some of the problems associated with an aging shoulder, which include dislocation, rotator cuff damage, frozen shoulder, calcium deposits, and arthritis. When arthritis is stopping a person from doing things they like to do, then total shoulder replacement is a good option. “Results are excellent,” said Dr Henshaw.

Dr Brand discussed repairing rotator cuff injuries through arthroscopic surgery, a minimally invasive procedure in which small poke holes are made into the shoulder and a camera and surgical tools are inserted. The rotator cuff is comprised of four muscles and tendons that help to lift and rotate the arm and to stabilize the ball of the shoulder within the joint.

In the past few years, arthroscopic surgery has changed the way doctors approach rotator cuff repairs. While it is a difficult procedure to perform, it allows doctors to do a better repair, according to Dr Brand.

For more information on shoulder problems, see the website danburyhospital.org.