The shoulder is the most mobile joint in the body and is made up of a complex system of muscles, ligaments, and bones. Because the shoulder joint is so mobile it is also susceptible to various types of strains and injuries. In many cases, shoulder pain is the result of overexertion or muscle soreness and subsides within a few days with ice and rest.

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The shoulder is comprised of several bones and includes the humerus (upper arm bone), the scapula (shoulder blade) and the clavicle (collarbone). Shoulder fractures (also referred to as a “broken shoulder”) are commonly the result of an accident such as a fall onto an outstretched arm or a direct blow to the shoulder. Although fractures to any of these bones are possible, clavicle fractures are the most common.

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Osteoarthritis is a condition that causes inflammation of the bones and soft tissues of the joints which causes the bones within the shoulder to rub together. While most people have heard of knee and hip arthritis, arthritis within the shoulder is also very common and can cause pain and symptoms similar to knee and hip arthritis. Shoulder arthritis often affects the older population but can also be the result of a prior shoulder injury or repeated dislocations of the shoulder.

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Between the bones and joints of the shoulder and elbow are fluid-filled sacs, known as a bursa, that help the bones and joints glide smoothly.  When one or more of these bursa becomes impinged or inflamed it is referred to as bursitis.  Bursitis is commonly caused by a bone spur in the shoulder or elbow irritating the bursa. Bursitis is common among those whose daily activities require repetitive overhead motions or lifting.

If you have shoulder or elbow bursitis the common symptoms can include:

• Pain in the elbow or shoulder
• Difficulty lifting your arm overhead

Biceps muscle deformity

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The rotator cuff consists of four muscle tendons that attach to the top of the shoulder and the rotator cuff helps hold the shoulder in its socket and rotates and raises the arm. Rotator Cuff Tears can be caused by an accident or injury, such as a fall or direct impact onto the shoulder, or as the result of wear and tear of the shoulder.

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The biceps tendon is a long band of tissue that connects at both the elbow and the shoulder and allows for strength and flexibility in the upper arm. The biceps tendon can often become injured when lifting a heavy object or due to a fall onto an outstretched arm.  There are varying degrees of injury that can occur to the biceps tendon at either the attachment to the shoulder or the attachment to the elbow.

Biceps tendon tear.  These injuries occur when there are one or more small tears in the tendon, but the tendon is still attached to the shoulder and/or elbow.

Biceps tendon rupture. This injury is often more serious and occurs when the biceps tendon is completely torn from its attachment to the bones of the shoulder or elbow.

If you have a biceps tendon injury the common symptoms can include:

• Pain in the biceps
• Bruising
• Tenderness
• Weakness
• Biceps muscle deformity

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The shoulder joint is surrounded by a ring of cartilage, known as the labrum, that helps the shoulder joint glide smoothly within the socket.  When the larum is severely injured, it can cause what is known as a SLAP Tear.  

Many SLAP Tears occur as the result of a trauma such as an accident or forceful blow to the shoulder or if the shoulder is dislocated.  In other cases, the labrum is torn over time due to repetitive strain, repetitive overhead motions, heavy lifting or arthritis within the shoulder joint itself that frays the labrum. 

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Acromioclavicular joint injuries (also known as a separated shoulder) occur when the clavicle is forcefully dislocated from the acromion and is usually caused by a direct blow or impact to the shoulder.  There are varying degrees of severity in AC joint injuries and are classified into three categories.

• Type I – the AC ligament is slightly torn, but there’s no damage to the other ligaments
• Type II = the AC ligament is completely torn, and there’s little or no damage to other ligaments.
• Type III = both the AC and other ligaments are completely torn. In this case, the collar bone separates from the end of the shoulder blade.

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The clavicle sits between the ribcage and the shoulder blade and connects the arm to the body.  In most cases, the clavicle (also called the collarbone) is fractured due to a fall onto an outstretched arm or direct blow to the shoulder.  When the clavicle is fractured, the fracture itself is classified as either non-displaced (pieces of bone are near their normal anatomic position) or displaced (pieces of the bone are not near their normal anatomic position).  

If you have a clavicle fracture the common symptoms can include:

• Shoulder pain
• Swelling or bruising 
• A bump or lump in the shoulder
• Difficulty moving the shoulder

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Frozen Shoulder Syndrome (also known as adhesive capsulitis) occurs when the capsules that surround the shoulder joint begin to thicken and restrict motion in the shoulder. Frozen Shoulder Syndrome can be difficult because the pain may last for days or weeks at a time (freezing phase) and then resolve itself (thawing phase) only to return a few weeks or months later. Some research has shown that underlying conditions such as diabetes, hypothyroidism, and hyperthyroidism are at a higher risk to develop this condition.

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