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Treating Shoulder Pain and Stiffness in the San Fernando Valley

Dr. Daniel Silver - Silver Orthopedics October 12, 2017

Expert Orthopedic Surgeon Dr. Dan Silver explains the causes and treatments involved for those with sudden or ongoing shoulder pain.

It's very common to have shoulder pain from a variety of causes. Baseball, football, hockey, tennis and other sports are frequent sources of shoulder problems due to injury and overuse. But did you know that mothers of newborns and infants develop shoulder pain and stiffness also? This type of pain is often caused by the frequent use of shoulder muscles required when carrying infants and toddlers. Moreover, car accidents, and falls result in shoulder pain frequently.

Because shoulder problems are so prevalent in the San Fernando Valley, I thought it would be appropriate to breakdown the symptoms, causes, and treatments of shoulder injuries and conditions.

To begin, a quick anatomy lesson shows there is a humeral head that sits in a cup - known as the glenoid. Rotator cuff muscles mainly move the shoulder. There is a connection of the clavicle (collar bone) at the acromio-clavicular joint. This part of the shoulder is susceptible to injuries as is the rotator cuff and biceps tendon. See illustration.


The term "overuse" is synonymous with repetitive trauma. This can present as pain in the shoulder with stiffness and a decrease range of motion. These symptoms are the result of inflammation of the tissues which over time can lead to scarring and contractures of the capsule and bursa around the shoulder joint. Injuries to the shoulder in the San Fernando Valley can be caused by innocuous actions such as lifting a baby, vacuuming, playing a sport such as baseball or softball, and many other seemingly safe activities. However, these activities lead to stretching and often tearing of muscles and capsules, which leads to an inflamed painful shoulder.

Treatment of any inflamed and painful shoulder condition in the San Fernando Valley will include ice, anti-inflammatory pills, physical therapy, and occasional steroid injections. In severe cases - called adhesive capsulitis - scar tissue is so dense that a manipulation under anesthesia by an experienced San Fernando Valley orthopedic surgeon is required to break-up scar tissue to regain motion. Most of the time Southern California men and women respond well to these nonsurgical and surgical treatments of the shoulder.

Other common causes of shoulder pain arising in men, women, and children in the San Fernando Valley include injuries from auto, bicycle, and slip and fall accidents. The shoulder is vulnerable in all these situations. There can be strain of the muscles or sprains of the ligaments that support and move the shoulder. Drivers involved in car accidents in the San Fernando Valley often get tossed around in their vehicles, often bumping into the door or gripping onto the steering wheel which may twist violently on impact. It's also frequent in bicycle and motorcycle accidents to be launched over the handlebars striking the shoulder on the ground. These injuries can result in contusions, sprains of the acromio-clavicular (A-C) joint as well as fractures of the bones of the shoulder.

Minor bumps and bruising of the shoulder can be treated with ice, anti-inflammatory pills, physical therapy, and time. Abrasions will obviously need cleansing, topical antibiotic cream or ointment, and sterile bandages.

However, forces in high velocity car accidents can cause severe damage to the shoulder and require urgent treatment. Many times, orthopedic surgery is needed to fix bones with plates and screws, rods or pins. If possible, repairs should be done through the arthroscope, because it is less invasive; but this may not always be possible.

It's important to note that injuries to the rotator cuff may not immediately be recognized. When pain and weakness in the shoulder persists for months or years, an MRI of the shoulder is medically indicated. This imaging technology will likely show a tear of the rotator cuff and other structures that probably can be fixed arthroscopically. Special sutures and anchors are used in this type of orthopedic surgery.

Unfortunately, the A-C joint will frequently develop a painful arthritic joint in the years following any type of trauma. After conservative treatment fails, a procedure called a Mumford procedure (removing 2 cm. of distal clavicle) is often necessary. Instead of the arthritic painful bones touching, a gap is created between the end of the clavicle and the acromion bone. In most cases, this makes the shoulder pain go away or lessen.

Another commonly painful injury involves damage to the structure of the biceps tendon. A portion of this tendon is in the shoulder joint. This tendon can become inflamed and painful from overuse and a single trauma. Conservative treatments including ice, anti-inflammatory pills, physical therapy, and trigger point injections are used. Occasionally, surgery is indicated.

If you're suffering from shoulder pain, without a known cause, or as the result of overuse, or an accident, it is important to see an experienced San Fernando Valley orthopedic surgeon as soon as possible. This way, you can begin treatment immediately to alleviate pain, and prevent further injury to the shoulder.

To schedule an appointment with Dr. Dan Silver at Silver Orthopedics in Encino, please call 818-784-9593