Arthroscopic Shoulder Surgery

Rotator Cuff Tears
A rotator cuff tear is a tear of one or more of the tendons of the four rotator cuff muscles. A rotator cuff injury can include any type of irritation or damage to the rotator cuff muscles or tendons.
There are two main causes of rotator cuff tears: injury & degeneration. You can tear your rotator cuff if you fall down on your outstretched arm or lift something too heavy with a jerking motion. Or this type of tear can occur with other shoulder injuries, such as broken collarbone or dislocated shoulder.
Chronic tears however, are the result of a wearing down of the tendon slowly over time, usually occurring as we age. You have a greater chance of degenerative rotator cuff tears when the same shoulder motion is repeated again and again in a job, routine chores, or most frequently in sports activities. Lack of blood supply as we age can ultimately lead to a tendon tear.

The pain with a sudden tear after a fall or injury is intense and is often accompanied by weakness of the shoulder and arm. Chronic rotator cuff tears include a gradual worsening of pain, weakness and stiffness or loss of motions. Over time, the pain and other symptoms become much worse.

Impingement
Shoulder impingement syndrome is a condition where your shoulders rotator cuff tendons are intermittently trapped and compressed during shoulder movements This causes injury to the shoulder tendons and bursa resulting in painful shoulder movements.

Impingement (impact on bone into rotator cuff tendon or bursa) should not occur during normal shoulder function. When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis. Likewise if the bursa becomes inflamed, shoulder bursitis will develop.

Both these conditions can co-exist or be present independently.

While a traumatic injury can occur eg fall, it is repeated movement of your arm into the impingement zone overhead that most frequently causes the rotator cuff to contact the outer end of the shoulder blade (acromion). When this repeatedly occurs, the swollen rotator cuff is trapped and pinched under the acromion.

Injuries vary from mild tendon inflammation (tendonitis), bursitis (inflamed bursa), calcific tendonitis (bone forming within the tendon) through to partial and full thickness rotator cuff tendon tears, which may require surgery.

What are the Symptoms of Shoulder Impingement?

  • Commonly rotator cuff impingement has the following symptoms:
  • An arc of shoulder pain approximately when your arm is at shoulder height and/or when your arm is overhead.
  • Shoulder pain that can extend from the top of the shoulder to the elbow.
  • Pain when lying on the sore shoulder.
  • Shoulder pain at rest as your condition deteriorates.
  • Muscle weakness or pain when attempting to reach or lift.
  • Pain when putting your hand behind your back or head.
  • Pain reaching for the seat-belt.

Frozen Shoulder
Frozen shoulder is a condition characterized by stiffness and pain in the shoulder joint. Signs and symptoms typically begin gradually and worsen over time and then resolve, usually within one to three years.

Symptoms of Frozen Shoulder
Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months

  • Freezing stage: Any movement of your shoulder causes pain, and your shoulder’s range of motion starts to become limited.
  • Frozen stage: Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult.
  • Thawing stage:The range of motion in your shoulder begins to improve.

Causes of Frozen Shoulder
The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.