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.

Shoulder Replacement

Total Shoulder Replacement (Ascend Flex)

On Ward

Sling for 4/52. Can remove sling at night after 4/52 if comfortable. Remain in sling if has night pain or arm moves a lot in bed at night for 6 weeks.

Day 1 on ward – commence active-assisted elevation, external rotation to neutral, short lever scaption and elevation in neutral. Patient may find ball rolling on lap or table most comfortable. Can commence active external rotation as pain allows. Will normally only achieve LR to neutral in first 2-3 weeks. Exercises may be taught to relative as appropriate. May find squeezing a soft ball makes early shoulder movements more comfortable.

Maintenance elbow, wrist, hand and neck exercises, sling care + washing techniques.

Scapula setting and posture.

N.B. AVOID axial loading for 3/12

2-6 weeks

3/52. Active ROM can be commenced in all movement planes. Hydrotherapy or use of gentle stretches or soft tissue mobilisations to increase ROM. Aim 90 degrees elevation by 6 weeks.

Commence early static isometric cuff exercises at week two, CARE NOT TO OVERLOAD SUBCSAPULARIS REPAIR WITH FORCED OR LOADED MED ROTATION. Start with ant and post deltoid deltoid activation in sagittal plane before moving to LR and MR Progress light rotator cuff and deltoid activation through range after 6/52 as able. Use free weights – half to one kilo as well as light Thera band. Keep in sagittal plane with rehabilitation or ‘in line of vision’ or in an imaginary rectangle box in front of person – ie) Avoid end range ADB with LR movements or end range HBB until 12 weeks.

6 weeks

Clinic review at 6/52, 6/12 and 1 year.

If all well, full active functional ROM exercises as tolerated. Progress overall functional activation of rotator cuff and deltoid and concentrate on functional rehabilitation.

Aim to regain pre-operative movement by 12 weeks.

Return to work: Sedentary 6 weeks (as pain allows). Modified Physical 3-4 months (as guided by surgeon).

Driving: 6 weeks (as pain and range allows). Patient confirms safety to drive.

Sport: 3-4 months dependent on activity (as guided by surgeon)

Swimming: Gentle with modified stroke 6 weeks onwards.

Andrew Cole6 November 2018

Shoulder Replacement

Testimonials

Opening Hours

Southampton Shoulder Clinic

Southampton Shoulder Clinic

Mr Cole’s Shoulder Clinic