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.

Frozen Shoulder Release

Arthroscopic Capsular Release and MUA of Frozen Shoulder

On ward

Sling for comfort encourage to discard once Interscalene block worn off. Aim to achieve full active ROM as achieved in theatre ASAP.

Outpatient physiotherapy appointment to be arranged within one week post-op.

Aggressive, early mobilisation but do not force into sharp pain. All ROM to include elevation, scaption, LR & MR good quality ROM with scapular control encouraged. Full unrestricted movements

2-6 weeks

Physiotherapy to continue ROM exercises in all planes. Hydrotherapy, passive and physiological stretches, accessory movements or soft tissue mobilisations to increase ROM.

Activating Rotator cuff as required from 2/52 post-op. Do not overload rotator cuff in any phase and risk inflammatory reaction = stiffness of capsule returning. Generally focus of rehab needs to concentrate on ROM GHJ as Rotator Cuff rarely weak with frozen shoulder.

6 weeks

Shoulder clinic review 6/52 and 3/12. Continuing rehabilitation – dynamic RC activation through range.

Return to work: Sedentary 2-4 weeks (as pain allows). Modified Physical 6 weeks (as guided by surgeon).

Driving: 2 weeks (as pain and range allows) patient confirms safety to drive.

Sport: Non-contact 4-6 weeks. Contact: 6 weeks.

Swimming: Gentle with modified stroke 2 weeks onwards. Freestyle: 4-6 weeks.

Andrew Cole6 November 2018

Frozen Shoulder Release

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Southampton Shoulder Clinic

Southampton Shoulder Clinic

Mr Cole’s Shoulder Clinic