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General information about Orthopedics Shoulder

The shoulder joint has the widest range of motion of any joint in the human body, which makes it particularly vulnerable to sports injuries, inflammatory wear and mechanical damage. Shoulder pain can dramatically affect daily routine, from difficulty raising the arm or getting dressed to severe pain that prevents uninterrupted sleep at night. An orthopedic specialist in shoulder surgery has completed a subspecialty fellowship devoted entirely to the diagnosis and the conservative and surgical treatment of the tendons, ligaments, bones and cartilage of the shoulder.

What conditions do shoulder orthopedic specialists treat?

Tendon injuries: diagnosis and treatment of rotator cuff tears, tendinitis and calcifications.
Restricted movement: treatment of "frozen shoulder" (adhesive capsulitis), accompanied by sharp pain and loss of range of motion.
Instability and trauma: treatment of recurrent shoulder dislocations, labral injuries, clavicle fractures and fractures of the humeral head following falls or accidents.
Cartilage wear: advanced solutions for treating shoulder joint wear, from biologic injections to total or reverse shoulder replacement surgery.

Frequently asked questions about Orthopedics Shoulder

Does every rotator cuff tear require surgery, or is physiotherapy enough?

Not every tear requires surgical intervention; the decision depends on the patient's age, activity level and the size of the tear. According to the guidelines of the American Academy of Orthopaedic Surgeons (AAOS), for small to medium tears (full- or partial-thickness), there is research evidence that conservative treatment including physiotherapy can significantly improve symptoms and restore shoulder function to an extent comparable to surgery. However, in cases of large tears that do not respond to conservative treatment, or a traumatic injury in a young, active person, surgery (usually arthroscopic) will be recommended to prevent muscle atrophy and enlargement of the tear over time.

How long does it take for a “frozen shoulder” to go away?

Frozen shoulder is a condition in which the joint capsule thickens and contracts, and it develops in three distinct stages: the freezing stage (increasing pain and loss of movement), the frozen stage (pain decreases but stiffness peaks), and the thawing stage (gradual return of movement). Although the condition tends to resolve on its own, full recovery can take between one and three years. Early treatment with targeted physiotherapy, anti-inflammatory medications or cortisone injections into the joint can significantly relieve pain and speed up the restoration of movement.

I was diagnosed with shoulder calcification (Calcific Tendinitis). Is shock wave therapy considered an effective treatment?

Shoulder calcification is caused by a buildup of calcium deposits within the tendons, leading to sharp pain and inflammation. Today, extracorporeal shock wave therapy (ESWT) is considered one of the best non-invasive alternatives before turning to surgery or more invasive procedures. The shock waves are high-frequency acoustic waves that promote the breakdown of the calcium deposits, stimulate blood flow to the area, and encourage healing and remodeling of the tendon tissue, without the need for a long recovery period.

Why does my shoulder make “clicking” sounds when I move my arm?

Clicking, grinding or “popping” in the shoulder (a phenomenon known as crepitus) is very common. If the click is not accompanied by pain, it is usually a completely natural phenomenon caused by the release of small gas bubbles in the joint fluid, or by a tendon that “snaps” over the bone during movement. However, if the sounds are accompanied by pain, a catching sensation or weakness in the arm, it is advisable to be examined by an orthopedist.

Does a shoulder orthopedist also treat problems with the collarbone or shoulder blade?

Absolutely. Contrary to popular belief, the shoulder joint is not made up of a single bone, but of the synchronized mechanics of three main bones: the upper arm bone (Humerus), the shoulder blade (Scapula), and the collarbone (Clavicle). Therefore, specialist shoulder surgeons are trained to treat this entire anatomical system. Their areas of treatment also include collarbone fractures following falls, dislocations of the acromioclavicular joint (known as the AC joint), and problems with the position or mobility of the shoulder blades that affect the function of the entire arm.

When is it customary and legitimate to request a second opinion from a specialist orthopedist?

Seeking a second opinion is a very common consumer and medical step, and the medical community encourages patients to be active partners in decisions concerning their bodies. It is customary to seek an additional consultation with a specialist surgeon especially before deciding on surgery (such as tendon repair or joint replacement), when the conservative treatment you are receiving is not leading to the hoped-for improvement, or when you are offered several different treatment options for the same problem and want to thoroughly understand the advantages and disadvantages of each approach before making a final decision.