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.

SLAP Repair

SLAP repair – arthroscopic

On Ward

Sling 4-6 weeks. Washing techniques and sling advice/management.

Day 1 on ward – scapula setting in neutral elbow, wrist and hand exercises.

Follow operation post-op instructions – usually to commence active-assisted elevation in neutral to 90° - external rotation to neutral only.

NB. No isometric medial rotation and anterior deltoid for 2 weeks. Can start external rotation in neutral 30 % Maximal Voluntary Contraction.

Can commence active external rotation from day 1 post-op if pain and muscle control allows to neutral for 2/52. No passive mobilisation into E.R. until 6/52.

2-6 weeks

2/52 can commence static rotator cuff activation in neutral.

Commence 0-90° active assisted elevation and active lateral rotation beyond neutral as pain and active control allow.

3/52 – 6/52. Progress active assisted to active elevation >90° as pain and control allow.

NB. Concentrate on quality of movement.

No resisted shoulder flexion or resisted elbow flexion and supination for 6/52-8/52.

No resisted shoulder flexion or resisted elbow flexion and supination for 6/52-8/52, avoid eccentric biceps loading until 12/52.

6 weeks

Can progress to active-assisted in all directions from 6/52.Please discuss with Catherine Howard / Debbie Prince if want to progress sooner.

Shoulder clinic review at 6/52, 3/12, 6/12 and 1 year.

Resisted light rotator cuff through range >4/52 onwards, if good control. Use free weights - one kilo and light Thera band. NB – Do not use theraband if patient still has night pain – stick to isometric contraction only.

Progress to active controlled movement > 6/52 in all ranges, esp. abduction.

Proprioceptive exercises 6/52 onwards.

12 weeks

Biceps stretches 12/52 if necessary.

Biceps strengthening 12/52 (eccentric biceps exercises with scapular control).

Aim full active ROM demonstrating dynamic stability through range.

Return to work: Sedentary 4-6 weeks (as pain allows). Physical 3-6 months (as control and strength allows).

Driving: 6 weeks (as pain and range allows) patient confirms they are able to drive safely.

Sport: Non contact 4-6 months. Contact 9-12 months.

Swimming: Gentle with modified stroke 6-8 weeks. Freestyle 12 weeks.

Andrew Cole6 November 2018

SLAP Repair

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Southampton Shoulder Clinic

Southampton Shoulder Clinic

Mr Cole’s Shoulder Clinic