• Western Orthpaedic Clinic

Shoulder Conditions

Impingement Syndrome

At the shoulder the tendons of the rotator cuff pass underneath the bone of the acromion. Between the bone and the tendon is a bursa, which acts as a lubricant. If the space between the tendon and the bone narrows, the bone can rub on the tendon. In young people, this can happen if the bone has a curved shape leaving less space. In older patients, it can occur due to a bone spur forming. This results in impingement syndrome. The tendon is impinging upon the bone. At the same time the bursa becomes irritated causing subacromial bursitis. The tendon becomes inflamed causing rotator cuff tendonitis.



Shoulder Instability and Dislocation

Shoulder instability or dislocation occurs in two common ways. Firstly, some people, particularly young women, can be very loose-jointed and this allows the shoulder to slip out or sublux. In these people the shoulder can dislocate with relatively little force.

A second group of patients have dislocations as a result of a severe injury such as a football tackle. Usually the arm is wrenched up and out resulting in the ball dislocating out the front of the shoulder joint.


Rotator Cuff Tear

The rotator cuff is made up of four tendons which all merge to form a sheath or cuff over the ball of the shoulder joint. The tendons of the shoulder can tear as a result of injury or degeneration. The tendons usually tear away from the bone. This is often associated with a bone spur rubbing on the tendon and gradually producing a tear over time. Some tendon tears do not cause symptoms but for other people this condition can be very painful and restrict their ability to lift the arm above their head.



Acromioclavicular Joint Conditions

Often called the AC joint, the acromioclavicular joint is at risk of dislocation (separation) from a fall onto the shoulder. Minor sprains of the AC joint recover quickly. Severe dislocation can produce a very unsightly bump at the end of the collarbone.

The AC joint is also a common site for arthritis. A tender, painful bump at the end of the collarbone can form slowly over many years. AC joint arthritis can restrict lifting and overhead work.


Clavicle Fracture

Clavicle fractures commonly occur as a result of contact sport or cycling. The clavicle functions as an important strut for the function of the shoulder joint. The fractures are often quite displaced and fragmented. This can result in a very dramatic looking x-ray. Despite this, the clavicle has an excellent capacity to heal.