The shoulder is one of the most versatile joints in the body, providing
a wide range of motion with interaction of over 20 muscles effecting shoulder
function. Because this joint provides so much motion it is at an increased
risk of injury.
The shoulder is commonly affected by the demands of active lifestyles.
Pain and soreness caused by overuse, trauma, or degenerative conditions
(such as arthritis) can decrease activity and quality sleep.
ValleyOrtho’s physicians have decades of experience diagnosing and
treating all kinds of shoulder injuries and conditions, and utilize the
most advanced surgical and nonsurgical techniques.
Some of the Common Shoulder Conditions We Treat
Rotator cuff tears/strains
Shoulder instability/subluxations/dislocations
Shoulder arthritis
Labral (SLAP) tears
Biceps tendinitis/tears
Adhesive Capsulitis (frozen shoulder)
Impingement syndrome
Acromioclavicular (AC) separations
Fractures and dislocations – such as clavicle fractures
The rotator cuff is a group of four muscles that help provide stability
and mobility to the shoulder. The four muscles include the supraspinatus,
infraspinatus, teres minor and subscapularis.
The tendons of these four muscles come together to connect the upper arm
bone, or “humerus”, to the shoulder blade, or “scapula.”
The tendons form a “cuff” around the shoulder joint. The supraspinatus
tendon is the most frequently torn tendon in the shoulder.
The shoulder is a shallow ball-and-socket joint. The humeral head is the
ball, located at the top of the upper arm bone (humerus), the glenoid
is the shallow socket located on the shoulder blade (scapula), and the
labrum is a firm cup-like structure that helps deepen the glenoid socket.
The outside areas of the labrum are thick but the inner regions are much
thinner. The labrum expands the depth of the socket by approximately 50
percent to allow for increased motion and stability.
The glenoid labrum is divided into four sections:
Anterior: Front portion that is thicker than the rest of the labrum
Superior: Top portion that is a meniscus-like structure with a central free edge
that has no blood supply. The biceps tendon attaches to the superior labrum
at the top of the glenoid.
Posterior: Back portion that is not always attached to the glenoid, which may explain
why some people complain of more shoulder pain in the back of their shoulder
Inferior: Bottom portion that is triangular in shape and attached at the central
edge of the fossa
The term SLAP stands for Superior Labrum Anterior and Posterior and describes
the location or pattern of tearing in the labrum.
Adhesive capsulitis is a term used to describe a significant loss of motion
in all directions in the shoulder joint, which also may be referred to
as “frozen shoulder.” This is a condition where the shoulder
capsule becomes contracted and thickened.
The loss of motion is apparent when attempting to move the shoulder, as
well as when someone else attempts to move the shoulder and the muscles
are relaxed. The cause of adhesive capsulitis can be unknown or related
to an injury.
Impingement is a common overuse injury in sports such as baseball, softball,
tennis, golf and swimming. This common shoulder disorder is caused by
improper alignment of the bones and tissues in the upper arm. The rotator
cuff tendons, the biceps tendon and subacromial bursa may be inflamed
from repetitive microtrauma when the upper arm bone and tip of the shoulder
blade get “impinged” or pinched together.
If the rotator cuff becomes inflamed from overuse, the space between the
upper arm bone and tip of the shoulder blade is narrowed. This causes
the rotator cuff and its fluid-filled bursa to pinch together. This impingement
results in irritation and pain when the shoulder is raised.
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