Shoulder Problems

The most common cause of acromioclavicular joint arthritis is wear and tear through over use. For this reason it is most common in people who are aged 50 or older and in athletes who place a lot of stress on the joint.

Bicep Problems

The most common shoulder conditions affecting the biceps are injuries to the cartilage and tendons that attach the biceps muscle to the shoulder bones. These include SLAP lesions, tendonitis, and tendon rupture.

Calcific Tendonitis

Calcific tendonitis is a build-up of calcium deposits within one or more of the four tendons that meet at the top of the shoulder joint. Together these four tendons are known as the rotator cuff.

Frozen Shoulder

Frozen shoulder is a condition where the ball and socket joint of the shoulder appears to "freeze". This causes loss of motion with stiffness in all directions. Typically the shoulder joint is stiff and initially painful.

Shoulder Arthritis

Glenohumeral arthritis is also known as shoulder arthritis. It is a progressive type of arthritis that is normally caused by damage to the cartilage surfaces of the shoulder's glenohumeral (ball and socket) joint.

Shoulder Instability

This is when the ball of your shoulder slips in certain position or completely comes out of joint (dislocates). There are a number of types of instability and it can get worse with time.

Rotator Cuff Injuries

The rotator cuff is the group of four tendons that surround the shoulder joint and control its movement. The tendons can become inflamed, degenerate or tear and can lead to pain and weakness, particularly with sudden movements.

Snapping Scapula

Snapping scapula is a general term applied to a range of disorders that can result in a painful clicking or snapping sensation in the shoulder blade (scapula).

Subacromial Impingement

Subacromial impingement is a condition that causes pain in the shoulder and upper arm. It happens when the tendons of the shoulder joint are strained or injured.

Winging Scapula

Winging scapula is the description for a condition where the shoulder blade protrudes from your back, giving the impression of a wing. In most cases, only one shoulder blade is affected.

Subacromial Decompression

Arthroscopic Sub-Acromial Decompression

On Ward

Wear sling as needed for rest and pain relief for approx. 1 week. May remove for washing, dressing and exercises as comfort allows, ideally in the first 1-2 days.

Exercises and advice sheet given by physio i.e. active assisted exercises, GHJ – elevation and lateral rotation, posture, scapula setting.

Commence low effort isometric contractions for 5 sec hold – initially ant/post deltoid then med rotation and lateral rotation if pain free.

No limitations in range of movement. Active exercises dependant on pain limitation and muscle control of movement.

Care of sling and washing techniques.

Removal of sling for gentle exercises advised 4 times/day.

2-6 weeks

Shoulder active-assisted movements can be progressed to active exercises, from approximately 10/7 to 2/52, pain dependant (particularly abduction through scaption, elevation & lateral rotation) concentrating on quality as well as ROM.

DO NOT UNDERESTIMATE WEIGHT OF ARM

Continue isometric ant/post deltoid, MR & LR 5 sec hold thro range.

Light Resisted cuff exercises can be introduced through range ensuring good quality of scapula and gleno-humeral joint remains centred thro range. Only introduce light resistance once full pain free ROM regained. N.B. Care with resisted concentric lateral rotation, ensuring pain is not reproduced (If painful you could try eccentric lateral rotation). Free weights of one kilo to perform short lever scaption exercises (W exercise) with high repetition is excellent for activation of rotator cuff..

6 weeks +

Functional and sports specific rotator cuff and scapular training through range, to include proprioception. No restriction but still guided by pain and control of rotator cuff to maintain humeral head centring through the movement.

Return to work: Sedentary 2-3 weeks (as pain allows). Physical 6-8 weeks (as pain allows).

Driving: From 2 weeks (as pain and range allows) patient confirms they are able to drive safely.

Sport: Non contact 2-3 months. Contact 3-6 months

Swimming: Gentle with modified stroke 3-4 weeks. Freestyle 8-12 weeks

General Goals: FROM by 6/52 Cuff strength regained by 3/12

Summit Digital6 November 2018

Subacromial Decompression

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Southampton Shoulder Clinic

Southampton Shoulder Clinic

Mr Cole’s Shoulder Clinic