Shoulder

The rotator cuff consists of four key muscles and their tendons that stabilize the shoulder and enable arm movement. These tendons can be inflamed, strained, or torn due to overuse, trauma, or age-related degeneration.

Common causes of rotator cuff injuries:

• Repetitive overhead motion (common in athletes and laborers) 
• Sudden trauma such as a fall or heavy lifting 
• Age-related wear and tear weakening tendon integrity 

Symptoms may include:

• Persistent shoulder pain, especially at night 
• Difficulty lifting or rotating the arm 
• Weakness and reduced range of motion 
• Clicking or popping sensations 

Treatment depends on severity:

• Mild injuries may respond to physical therapy and anti-inflammatory medications 
• Moderate cases could require corticosteroid injections 
• Complete tears often need surgical repair through arthroscopy 

Timely diagnosis using MRI or ultrasound helps prevent further damage. Ignoring a rotator cuff tear can lead to shoulder dysfunction and arthritis. Rehabilitation post-treatment is critical for regaining full strength and preventing recurrence.

Shoulder dislocation occurs when the head of the humerus pops out of the glenoid socket, often due to trauma or forceful twisting. Instability refers to the recurrent or chronic tendency of the shoulder to dislocate or feel like it might “slip out.”

Causes include:

• Acute injury or fall (especially with the arm outstretched) 
• Previous dislocations that weaken the supporting structures 
• Loose ligaments or hypermobility disorders 

Symptoms can involve:

• Intense pain and visible deformity after injury 
• Swelling and muscle spasms 
• Recurrent episodes of the shoulder “giving way” 
• Limited arm movement 

Treatment options:

• Closed reduction for acute dislocations 
• Immobilization and rest for healing 
• Physical therapy to strengthen stabilizing muscles 
• Surgical stabilization in cases of chronic instability or labral tears 

If untreated, chronic shoulder instability can impair athletic performance, daily function, and lead to early-onset arthritis. Comprehensive rehabilitation programs focusing on strength, control, and flexibility are vital in restoring joint stability and preventing further injury.

Frozen shoulder, or adhesive capsulitis, is a condition characterized by stiffness, pain, and reduced mobility due to thickening and tightening of the shoulder capsule. The exact cause is not always known, but it often follows injury, surgery, or periods of immobility.

Risk factors include:

• Diabetes and thyroid disorders 
• Post-surgical immobilization 
• Shoulder trauma or inflammation 
• Age between 40–60 years 

Stages of frozen shoulder:

• Freezing phase: Increasing pain and gradual stiffness 
• Frozen phase: Pain may reduce, but mobility is highly restricted 
• Thawing phase: Slow return of movement over several months 

Management strategies:

• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain 
• Physiotherapy with passive and active stretching exercises 
• Corticosteroid injections to reduce inflammation 
• Shoulder manipulation under anesthesia or arthroscopic release in severe cases 

Recovery can be slow and may take 1–3 years, but most patients regain function with appropriate care. Early intervention and consistent physiotherapy help minimize long-term stiffness and pain.

Shoulder arthroscopy is a minimally invasive surgical technique used to diagnose and treat various shoulder conditions. It involves inserting a small camera and surgical instruments through tiny incisions to access the joint with precision and minimal disruption.

Conditions commonly treated with arthroscopy:

• Rotator cuff tears 
• Labral injuries (SLAP tears) 
• Impingement syndrome 
• Shoulder instability and recurrent dislocation 
• Bone spurs or loose fragments 

Advantages of arthroscopic surgery:

• Smaller incisions with minimal scarring 
• Less post-operative pain 
• Shorter hospital stay and faster recovery 
• High-definition visualization of the joint 

Post-operative care includes:

• Sling immobilization for a few days to weeks 
• Gradual return to activity under physiotherapy supervision 
• Avoidance of strenuous movement until complete healing 

While arthroscopy is effective for many conditions, some cases may require open surgery or shoulder replacement, especially in advanced degeneration. Surgical outcomes depend on the underlying pathology, surgical technique, and patient compliance with rehabilitation.

Rehabilitation plays a crucial role in recovering from shoulder injuries and surgeries. The goal is to restore flexibility, strength, stability, and overall function through targeted therapy and conditioning programs.

Key elements of shoulder rehabilitation:

• Pain management through ice, heat, or medications 
• Restoration of range of motion using passive stretching 
• Strength training for rotator cuff and scapular muscles 
• Proprioceptive exercises to improve joint awareness and balance 
• Postural correction to avoid recurrent strain 

Common exercises include:

• Pendulum swings 
• Wall climbs 
• Shoulder blade squeezes 
• Theraband external and internal rotations 
• Isometric holds and light resistance training 

Rehabilitation timelines vary based on the severity of injury or type of surgery. Early phases focus on mobility and pain relief, while later stages emphasize strength and functional recovery. Close monitoring by a physiotherapist ensures safe progression and reduces the risk of reinjury. A well-structured rehabilitation program is often the difference between partial and complete recovery.

The shoulder is a complex, high-functioning joint essential for both routine tasks and athletic performance. From rotator cuff tears to chronic instability and frozen shoulder, disorders of this joint can severely restrict independence and quality of life. Early diagnosis, timely intervention, and dedicated rehabilitation are essential for restoring function and preventing long-term damage.

At Kannappa Memorial Hospital, we provide comprehensive orthopedic care tailored to each patient’s needs. Our expertise spans advanced diagnostic imaging, minimally invasive arthroscopy, and structured rehabilitation programs, ensuring optimal outcomes for shoulder conditions. Whether you’re recovering from an injury or managing chronic shoulder pain, expert support and personalized treatment can help you regain strength, confidence, and comfort.