Shoulder
Dr. Kendall treats injuries and conditions of the shoulder
Shoulder injures and conditions
Dr. Kendall is an orthopedic surgeon who treats shoulder injuries and conditions at OrthoIndy West located in Brownsburg. Some of the most common types of shoulder injuries/conditions he treats include rotator cuff tears, impingement syndrome and shoulder instability.
Rotator Cuff Tears
The rotator cuff is a group of four muscles which originate from the scapula (shoulder blade) and then attach to the humerus at the greater tuberosity. These muscles are instrumental for overhead activities and shoulder strength. The rotator cuff, unfortunately, is susceptible to injury because of its poor blood supply. Injuries to the rotator cuff may occur traumatically with a fall or more insidiously over time. The most commonly torn portion of the rotator cuff is the supraspinatus. Damage to the rotator cuff is also a common sports injury.
Symptoms of a rotator cuff tear include shoulder pain and weakness. Patients often report difficulty putting on a coat, sleeping at night and reaching overhead. Some rotator cuff injuries may be treated nonoperatively, particularly in the elderly or sedentary population. However, in active patients, this injury often warrants repair. Generally, rotator cuff injuries are now able to be treated arthroscopically.
Impingement Syndrome
Impingement syndrome is the result of impaction of a bone on the top of the shoulder and the rotator cuff. This bone is called the acromion. The shape of the acromion is classified in three categories with 1 being relatively flat and 3 being hooked. Type 2 is the most common type and represents a medium size spur. The area where the impaction occurs is called the subacromial space.
The bursae also live in this location. Impingement syndrome results in both bursitis and tendonitis in the rotator cuff. This can be a precursor to a rotator cuff tear. It usually causes shoulder pain and some weakness. These are often less extensive than rotator cuff tear symptoms. Impingement syndrome is usually treated without surgery initially. Injections, anti-inflammatories and steroid injections may effectively reduce symptoms. Ultimately, if the symptoms do not subside, the bone spur and bursae may be removed arthroscopically.
Shoulder Instability
The shoulder naturally allows for a tremendous range of motion. It is far less constrained than the hip, for example. The common analogy of shoulder anatomy is that it is “like a golf ball on a tee.” This is because the socket is relatively shallow. It is effectively deepened by the labrum. The labrum is a cartilage structure that surrounds the articular surface.
Like that golf tee, when a corner of the labrum is damaged, the ball will “fall off.” The resulting shoulder instability is quite painful and usually has to be put back in place in the emergency room. Physical therapy and rest can improve symptoms. If the instability recurs, surgery is often indicated to repair the torn labrum. This usually performed arthroscopically.