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- The loss or damage of joint (articular) cartilage.

- Causes: - Osteoarthritis. - Rheumatoid arthritis

- Posttraumatic arthritis - Septic Arthritis - Avascular necrosis

- Non-surgical treatments can include: physical medicine modalities, medications and injections.

- Surgical treatments depending on the type of problem, arthroscopic or open procedure or total shoulder replacement may be recommended.

- Risks of surgery: infection, excessive bleeding or swelling, joint stiffness, blood clots.


- Usually due to a sudden fall or blow.

- Usually occurs in younger athletic people.

- Will be at higher risk for re-dislocation

- Persistent shoulder dislocations can create an unstable shoulder.

- Two types

- Dislocation resulting from injury

- Dislocation resulting from loosening of ligaments and shoulders.

- Non-surgical treatment – physical medicine modalities, immobilizatioin/sling, medications and home exercise program.

- Surgical treatments – reduction (putting ball back in socket), arthroscopic surgery or traditional open surgery.

Fractures - Usually due to a sudden blow or a fall.

- Two types

- Displaced

- When the pieces on either side of the break are out of line.

- May require surgery.

- Nondiscplaced - When the broken pieces line up on either side.

- 80% of all shoulder fractures.

- Treatment depends on the fracture type: immobilization, physical medicine modalities, medications and possibly surgery.

Frozen Shoulder (Arthrofibrosis/adhesive capsulitis)

- Occurs when there is a problem with the capsule that surrounds the shoulder joint.

- There will be difficulty is raising arm in front of you, putting your hand behind your head or back.

- Other diagnoses need to be ruled out – tendinitis, bursitis or rotator cuff tear.

- Treatment can include physical medicine modalities and medications.

- Surgery may be necessary depending on the cause of the condition

Sports Injuries

- Most frequent types are: tendinitis, rotator cuff injury and dislocation.

- Treatment can include physical medicine modalities, pain medications and injections

- Surgical options may be considered when conservative measures have failed.


- Inflammation of the inner most tissue membrane of the capsule that holds the shoulder joint together.

- Causes can be: rheumatoid arthritis, lupus, gout, injury to the joint or unknown.

- Treatment depends on the cause and can include medications or injections.

- Surgery may also be an option, if conservative measures fail.

Tendinitis, Bursitis and Impingement Syndrome

A. Tendons are fibrous cords that connect muscle to bone.

- This is inflammation of the tendon.

- Possibly the most common shoulder problem.

- Non-surgical treatment may be physical medicine modalities, medications and/or injection.

- Surgical options may be offered if conservative measures fail.

B. Bursitis often is associated with tendinitis, but can occur separately.

- This is inflammation of the bursa

- Bursa is the sac that helps cushion the rotator cuff from the acromion (front edge of the shoulder blade)

- Non-surgical treatment may consist of physical medicine modalities, medications and/or injection.

- Surgical options may be offered if conservative measures fail.

C. Impingement Syndrome

- Rotator cuff and bursae become inflamed and thickened and can be compressed/pinched under the acromion.

- Can sometimes be caused by a bone spur.

- Can become a chronic inflammatory condition that may lead to weakening of rotator cuff tendon.

- Non-surgical treatments may consist of rest, ice, physical medicine modalities and/or injection.

- Surgical options may be offered if conservative measures fail.

Torn Rotator Cuff

- One of most common causes of shoulder pain.

- Made up of four muscles – supraspinatus, infraspinatus, teres minor and subscapularis.

- Also associated with impingement syndrome.

- Causes can be: repeated lifting, overhead movements, fall on outstretched hand, or colliding with an object.

- Non-surgical treatments may consist of immobilization, physical medicine modalities, medications.

- Surgical options may be offered if conservative measures fail.

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Posture and Neck Pain

Chronic neck pain is a miserable experience. Although some cases of neck pain are caused by an injury, many are simply due to poor posture. Poor posture stresses the muscles of the neck and can cause muscle spasms, stiffness and pain. Over time, the stresses of poor posture on the neck can cause degenerative diseases to develop in the discs and bones of the neck. Forward head A very commonly seen posture that puts a lot of strain on the neck is the forward head. The individual habitually thrusts the head forward, carrying it out in front of the shoulders. In this position, the weight of the head is constantly pulling on the spine and the shoulders. Sitting for hours hunched over a desk or a computer is a common cause of forward head. Many people with this habitual forward head carriage suffer from sore shoulders as well as a sore neck. Over time, the vertebrae at the base of the neck (C5 and C6) can develop painful degenerative conditions due to the constant weight of the head pulling on them in the forward head posture. Correct posture A correct posture is one that keeps the spine in alignment. Some people call it a neutral or balanced posture. One exercise to encourage a neutral posture is to focus on opening the chest wide as you try to squeeze your shoulder blades together. Once your chest is open, bring your head into alignment. Think of a string pulling up the top of your head and lengthening the neck. When you do this, your chin will tuck in and your head will naturally shift into proper alignment with your spine. Do the open chest/ string exercise multiple times a day. Other exercises to build better posture are head nods and chin tucks. To do a head nod, slowly nod your head slightly up and down without moving your neck. To do chin tucks, tip your nose down toward the ground and move the top of your head backwards. Repeat head nods and chin tucks several times a day. These exercises strengthen the muscles on the front of the neck. Individuals with habitual forward head posture usually have very weak muscles in the front of the neck. If you've worked hard at correcting your posture and you are still suffering from neck pain, why not give us a call?

Note: The information on this Web site is provided as general health guidelines and may not be applicable to your particular health condition. Your individual health status and any required medical treatments can only be properly addressed by a professional healthcare provider of your choice. Remember: There is no adequate substitution for a personal consultation with your physician. Neither BPF Specialty Hospital, or any of their affiliates, nor any contributors shall have any liability for the content or any errors or omissions in the information provided by this Web site.