Whatever the cause, successful treatment often relies upon early detection. Here, we’ll look at how shoulder instability is typically managed and treated.

Shoulder instability treatment

There are several treatment options which can be used to treat shoulder instability. Patients who have never suffered a dislocation of the shoulder joint, will typically find physical therapy offers the best course of treatment.

• Regular physical therapy sessions will focus on strengthening up the girdle; providing stability to the joint. In addition, electrical and ultrasound stimulation, along with massage can also be used to minimise the pain.
• Placing ice over the affected area twice daily will also help to reduce pain and limit inflammation. In severe cases, the patient may also be given corticosteroid injections to manage the pain and inflammation.
• If the shoulder has become dislocated, physical therapy alone will not always be enough to repair the problem. Just one dislocation could be treated without the need for surgery, but if multiple dislocations are identified, an arthroscopy may be needed.
• The arthroscopy can usually be done as an outpatient procedure. It’s minimally invasive and has shown great success in the treatment of shoulder instability.

It’s worth pointing out, treatment can vary depending upon the age of the patient. Below you’ll discover more about age-related treatment options.

Shoulder instability treatment for older patients

The majority of older patients who present with shoulder instability, have developed the condition after a fall or traumatic incident.

If a patient is over the age of 40, treatment will usually be done non-operatively. A sling will need to be worn, ensuring the joint is immobilised for a set time period. This gives it plenty of time to heal. Once it has been rested, usually within a couple of weeks, physiotherapy will be used to help the patient regain motion and strengthen the shoulder joint to prevent future injury.

Interestingly, the re-occurrence rate of shoulder instability in older patients is very low. A full recovery is also expected within three to six months.

Shoulder instability treatment for younger patients

Younger patients are generally more prone to shoulder instability issues; particularly young athletes. In sports which require frequent overarm movements such as tennis, there’s an especially high chance of shoulder instability.

If the shoulder is dislocated, it is likely to end with future instability in the joint. It’s estimated that 80% of young patients who experience a dislocation, go on to experience recurring instability issues.

Treatment will very much depend upon the severity of the instability. If the shoulder has been dislocated fully, it will need to be reset. However, it’s worth noting that this doesn’t treat the actual instability issue.

The instability is most commonly treated with physiotherapy to start. To address the pain, anti-inflammatory medications may also be prescribed. If very little improvement is seen after physiotherapy, surgery may be the only other option.

Overall, shoulder instability can be treated, though the method and recovery period will depend upon several factors, including the age of the patient. As with any shoulder injury, the earlier instability is detected and managed, the easier it will be to treat.

All strenuous physical activities should be stopped until the shoulder is strengthened and the pain is gone.

London Shoulder Specialist Ms Susan Alexander of the Fortius Clinic reiterated in a recent presentation on shoulder instability “the importance of a close working relationship, with good, open and regular communication between surgeon, physiotherapist and general practitioner to optimise the treatment of this complex condition.

A recent study has shown that age may not necessarily be a factor in determining shoulder replacement success. This result has surprised researchers, as up until now, age has always been associated with a decreased chance of success.

What’s more, older patients tend to experience far less complications and gain an increased level of shoulder function after the procedure compared to younger patients.

Understanding the study

The recent study was conducted by the Henry Ford Hospital in Detroit and it followed two different aged patient groups. The first included 262 patients under the age of 65, while the second followed 103 patients who were over 75. Each patient had undergone surgery due to osteoarthritis.

The older group were found to have less function in the shoulder than the younger group before they had surgery. However, once the replacement surgery had been performed, the older group experienced more improvement than the younger group.

While the study determined there was no real link between age and the outcome of shoulder replacement surgery, it was quite a small study. Therefore, more in-depth research would need to be done in order to determine just how factual these results are.

What causes a patient to require shoulder replacement?

Shoulder replacement surgery may not be performed as much as knee and hip replacement surgery, but it’s still surprisingly common. There are numerous things that can lead to a patient requiring this type of surgery including:

Osteoarthritis and rheumatoid arthritis – Arthritis in the shoulder joint is by far one of the most common causes of shoulder pain; particularly osteoarthritis. This occurs over time and largely affects patients aged 50 or over. The pain results from the cartilage being worn away and the bones then begin to rub against each other. Eventually the joint becomes painful and stiff.

Rotator cuff tear arthropathy – If you have a large rotator cuff tear that’s been there a while, it can lead to rotator cuff arthropathy. Because of the tear, changes can start to appear within the joint, which in turn can lead to damage to the cartilage and arthritis.

Serious fractures – If the bone in the upper arm becomes shattered, it could prove very difficult to have them placed back together. Therefore, a shoulder replacement may be recommended.

Understanding shoulder replacement surgery

Shoulder replacement surgery has proven really successful at eliminating shoulder joint pain. It’s one of the few surgical procedures that has been carried out since the 1950s. However, the techniques and equipment used have certainly improved over time.

While it is an effective treatment option, surgery is only ever considered as a last resort. The first thing patients are usually given to ease the pain is medication and recommended changes in activity. If these initial treatments don’t work, that’s when surgery could be more effective.

The procedure involves removing any damaged sections of the shoulder joint and replacing them with artificial components. The head of the joint alone could simply be removed, or the ball and socket may need to be replaced depending upon the severity of the problem.

Overall, shoulder replacement surgery is common and it does have a high success rate. In the past, patients have been put off due to their age, but this new study proves surgery could actually be more effective in older patients.

A new discovery made by Uconn Health researchers, could revolutionise the way rotator cuff tears are treated forever. Using stem cells, the researchers found that they could regenerate the tendons, completely repairing the tear without surgery. This exciting discovery provides hope, particularly for athletes, that this common shoulder issue could be treated quickly and almost painlessly.

How would stem cell rotator cuff repair work?

In order to regenerate the tendons, it requires a nano-textured fabric seed complete with stem cells. It is the introduction of the nano-textured fabric along with the stem cells that’s important in the effectiveness of the stem cell rotator cuff repair treatment. Surgeons have already used stem cells occasionally in the past, injecting them in the tear of the rotator cuff. However, on their own, they haven’t proven to be very successful.

The nano-textured fabric seed appears to significantly increase the success of the treatment. With the seeds help, the stem cells found it much easier to attach to the bone. This resulted in regrown tendons that weren’t just repaired, but they were stronger afterwards too. The cell structure appeared to look just like undamaged and natural tissue. This contrasts to current surgical treatment which often leaves an unorganised cell structure, causing the tendons to grow back weaker.

It’s worth noting that this stem cell rotator cuff repair treatment has only been tested on animals. So, human trials would need to be conducted in order to establish whether it presents the same benefits.

Understanding rotator cuff tears

Rotator cuff tears are extremely common, and they’re typically caused by repetitive micro-trauma. That means, they develop over time, whether it be weeks or even years. Once the tendon becomes torn, it causes the shoulder to weaken, which ultimately leads to pain when you try to carry out normal, everyday activities such as brushing your hair.

A lot of the time, torn tendons actually start out by fraying. Then, often after lifting a heavy object, and after a period of time where the damage becomes worse, the tendon finally tears.

Rotator cuff tears are categorised as partial and full-thickness tears. With the partial tear, the tendon becomes damaged, but it doesn’t completely tear. A full-thickness tear on the other hand, occurs when the tendon comes completely away from the bone.

These tears often result in extreme pain, even when the patient is resting, or lying in bed at night. So, the fact these common tears could soon be repaired by stem cells is definitely welcome news for patients. However, until these stem cells can be used as a mainstream treatment, what options do patients have in the meantime?

Current rotator cuff treatment options

There are numerous treatment options available right now, including injections, surgery and physical therapy. The treatment that’s right for you will depend upon the severity of the tear. Surgery tends to be used for the most severe, painful rotator cuff tears, and there’s many different methods that can be used.

If you suspect you have a rotator cuff tear, it’s best to get it diagnosed as soon as possible. The earlier it is detected, the less invasive the treatment will be. For example, a minor tear could repair itself with physiotherapy. So, if you want to avoid surgery, always get your shoulder pain checked out as quickly as possible.

Shoulder replacement surgery is often considered as a last resort for severe shoulder injuries. However, a new study has shown that the majority of shoulder replacement patients under the age of 55, find they can return to sports, often in as little as seven months.

This proves promising for recreational athletes who worry they’ll never be able to play sports again after the surgery. So, what does shoulder replacement involve and which sports will patients still be able to partake in after the surgery?

Understanding shoulder replacements

A lot like hip and knee replacements, a shoulder replacement involves replacing the damaged components with artificial ones, or more commonly referred to as a prosthesis.

Younger athletes can develop early osteoarthritis due to the repetitive motions performed in various sports. Once the joint develops arthritis, a total shoulder replacement is often required. This involves removing the joint surfaces, and then replacing them with a metal ball which has been highly-polished, that is then attached via a stem, along with a plastic socket.

Once healed, the prosthesis should allow the patient to move the shoulder freely and painlessly; allowing them to get back to the tasks they were unable to perform prior to the surgery. Of course, the results and success of the replacement vary between patients.

However, the study which was published in the World Journal of Orthopaedics, showed in patients under the age of 55, return to sport after shoulder replacement wasn’t only possible, but probable.

Which sports can shoulder replacement patients go back to?

One thing that is worth noting, is that there are limits as to which sports a shoulder replacement patient can go back to. The study questioned 61 patients, and found over 90% were able to return to a high demand sport.

The exact sports patients returned to included:

• Fitness sports – 97.2% of patients went back to fitness-related sports
• Golf – 93.3% of patients went back to playing golf
• Tennis and swimming – One of the more surprising statistics presented by the study, 87.5% of patients could return to both singles tennis and swimming
• Basketball – 75% of patients found they could return to basketball
• Flag football – 66.7% of patients returned to flag football

You’ll notice none of the above sports are contact sports. You may find you cannot return to sports such as rugby, for example, once you’ve undergone a total shoulder replacement.

Why are the results of the study important?

The reason why this study is important to shoulder specialists and young athletes is because it shows a shoulder replacement could be a viable choice for young patients suffering from early osteoarthritis.

It proves the treatment doesn’t eliminate the chances of a return to sport after shoulder replacement. Overall, as with any type of shoulder injury, it is important to seek treatment if you’re experiencing any pain as early as possible. This reduces the risk of the problem getting worse and provides a much more optimistic outcome.

Swimmers are more vulnerable to developing shoulder pain than athletes who aren’t involved in overhead sports, according to a new study published in The American Journal of Sports Medicine.

Researchers studied a cohort of competitive swimmers over the course of an intensive 12-week training season and found that swimmers experience a 15% increase in forward shoulder posture compared to an approximately 1% increase in those that participate in non-overhead sports. There was also a substantial decrease in subacromial space distance in comparison.

“Swimmers have a lot of pain during training season and this [study] validates some of where that pain is coming from,” Elizabeth E. Hibberd, assistant professor at the University of Alabama and the Director of Athletic Training Research Laboratory, explains. “Over the course of the training season, they are getting these adaptions in their physical characteristics, predisposing them to injury.”

Swimmer’s shoulder is a common injury experienced by professional swimmers, affecting both men and women alike. Here we’ll look at why swimmers are more vulnerable to developing shoulder pain and the types of injuries which can occur.

Why are swimmers more vulnerable?

Unlike other sports, swimmers require a high endurance level of the upper extremity. The upper body is responsible for approximately 90% of the propulsive force involved in swimming, with the shoulders absorbing the majority of the pressure.

Shoulder pain and injury typically develops due to a combination of the overuse of the shoulders and leaving little rest time for the muscles to recover. It’s thought that competitive swimmers can swim six to eight miles each day, sometimes up to seven days a week. The constant movement of the muscles and joint, along with the mechanical characteristics involved in swimming, put an enormous amount of pressure onto the shoulders.

The shoulder joint is also particularly prone to instability and it isn’t difficult to see why shoulder injuries are the most common orthopaedic injury reported by competitive swimmers. In a recent review of published literature on musculoskeletal injuries in swimmers, the prevalence of shoulder injuries runs from between 40% and a staggering 91%.

Injuries can occur due to one or a combination of the following:

• Over training
• Hypermobility
• Tightness of the joint
• Poor technique
• Fatigue
• Weakness
• The use of hand paddles
• Previous shoulder injury

Professional swimmers therefore, are much more likely to develop shoulder injuries due to the amount of time they spend training.

Majority of swimmers believe mild to moderate shoulder pain is normal

Due to the amount of time swimmers spend in the water, most believe mild to moderate shoulder pain is normal. However, this mindset can prevent the swimmer from seeking help quickly enough when they’ve suffered an injury.

As they don’t recognise that they do have a shoulder injury, many swimmers also try to treat the pain themselves using pain medication. The trouble with this is, as the injury is left untreated, it will become worse the longer it is left undiagnosed. This leads to more time out of the pool and can seriously damage a professional swimmer’s career.

Can swimmer’s shoulder be prevented?

Further research is required to establish which intervention methods would be most effective for swimmers. While you can never completely eliminate the risk of shoulder injury, there are ways you can reduce the risk. These include:

• Building up the muscles of the shoulder to make the joint more stable and less prone to injury.
• Always use the correct stroke technique.
• Ensure you seek a diagnosis quickly if you experience any form of shoulder pain.

What is known is that it is really important to have the injury diagnosed as soon as possible. If you wait before seeking help, it’s likely inflammation will have developed and the pain will be more widespread, making it difficult to make a precise diagnosis. Inflammation masks the symptoms, making it more difficult to pinpoint the exact injury. That’s when a broad ‘swimmer’s shoulder’ diagnosis is made.

Overall, swimmers shoulder is a common injury which plagues professional swimmers. It is vital that proper techniques and training are undertaken to prevent the risk and a fast diagnosis is made if injury does occur.