Capsular pattern of frozen shoulder explained here

February 17, 2010 — admin

The doctor and physical therapist told me I have a frozen shoulder with a capsular pattern. I understand the frozen shoulder part but what does ‘capsular pattern’ mean?

The shoulder is a very complex joint with muscles, tendons, ligaments, bursae, and fibrous cartilage helping to hold it together and give it smooth motion. Four muscles and their tendons called the rotator cuff surround the shoulder joint like an envelope. These are covered by a fibrous connective tissue called the capsule.

The head of the humerus (upper arm bone) and the shoulder socket are enclosed by the capsule. Normally the capsule is large and loose. When injury or immobility damages the capsule a frozen shoulder can develop. This means the shoulder doesn’t move smoothly in the socket. It gets stuck or frozen in place. The medical term for this is adhesive capsulitis.

With a frozen shoulder a typical pattern of movement restriction starts. This is known as the capsular pattern of the shoulder. The greatest loss of motion is in outward or external rotation of the shoulder. Moving the arm away from the body is also limited. This is called shoulder abduction. In a severe capsular pattern inward or internal shoulder motion is also stuck.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Shoulder surgery for torn rotator cuff often uses anchors

February 9, 2010 — admin

My son is going to have a rotator cuff tear repaired surgically. The doctor described a special anchor suture that will be used to hold the tendon in place until it heals. What kind of problems can come from using these anchors?

Rotator cuff tears are often repaired using some kind of anchor or suturing system. The fixation devices are called suture anchors. They work like rivets to reattach the tendon to the bone. These anchors can be made of bone, metal, or plastic.

Problems differ depending on the type of anchor material used. For example, some anchors (like the bone buttons) require a hole predrilled before insertion. This extra step makes for a longer operation. Sometimes the surgeon has trouble making and then finding and using the hole.

Anchors made of bone are usually absorbed by the surrounding bone and don’t have to be removed. Plastic anchors may also “dissolve” or get absorbed by the bone. Some metal anchors are held in place by threads or barbs. These do not resorb and can cause problems if they move or come loose.

Other problems can include breakage of the anchors, anchor pullout, infection, or rerupture of the tendon. Infection and poor wound healing are problems in a small number of cases. Usually, these patients have diabetes or some other healthy issues or they are tobacco users.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Help for baseball team plagued by shoulder injuries

January 4, 2010 — admin

As a mother of two boys on a high school baseball team, I notice there are a lot of shoulder injuries. Most seem to occur with overhead throwing. What causes this to happen?

The overhead athlete faces some unique challenges. The core muscles around the shoulder are called the rotator cuff. The rotator cuff must be strong enough to move the arm forward at high speeds without letting the shoulder coming out of the socket.

Two muscles are especially important during the overhead throw. These are the infraspinatus and teres minor, two muscles that rotate the shoulder outwardly.

Problems can occur if the joint is naturally loose or even too tight. Athletic conditioning programs often include exercises to strengthen these muscles. The idea is to: (1) increase muscle strength, (2) prevent injury, and (3) enhance performance.

Teams with high rates of injury may not be focused on exercises for all three goals.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Osteoporosis may cause rotator cuff repair to fail

December 24, 2009 — admin

I’m 78-years old and have been diagnosed with a rotator cuff tear and osteoporosis. I’ve been told the osteoporosis puts me at risk for a failed rotator cuff repair. If the muscle is the problem, what difference does it make if the bones are brittle?

The tendons attach to the bone and must be reattached after injury in order to give you back shoulder motion and strength. Some of the newer ways of repairing rotator cuff tears involve drilling holes through the bone. Then the doctor threads the sutures through the tunnel to the other side. This gives the repair strength and the shoulder stability.

The sutures may not hold if the bone is soft or brittle from osteoporosis. In cases of bone problems, they can use special anchors that look like buttons to help hold the stitches in place.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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How did I get adhesive capsulitis – a frozen shoulder?

September 25, 2009 — admin
My doctor diagnosed my tight shoulder as “adhesive capsulitis.” What is this, and how did it happen?

 
Adhesive capsulitis, also called “frozen shoulder,” is a condition in which the shoulder becomes tight and painful, making it difficult to do daily activities.

With frozen shoulder, inflammation in the joint causes the lining surrounding the joint to stick together. This causes the shoulder to “freeze” and seriously limits movement.

It’s hard to say how you got a frozen shoulder. Most cases can’t be traced to one event. One theory is that this condition is caused by an auto-immune reaction. An auto-immune reaction happens when the body’s defense system, which normally protects it from infection, mistakenly begins to attack the tissues of the body.

A frozen shoulder may arise gradually, with no injury or warning. It sometimes happens to people who’ve had past shoulder problems, such as rotator cuff tendonitis or bursitis. Others are affected after surgeries unrelated to the shoulder–even after heart attacks. The condition likely results when pain or inflammation in the shoulder causes a person to start using the shoulder less, setting the stage for a frozen shoulder.

 
The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

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Testing for tears in rotator cuff not always accurate

September 24, 2009 — admin
The arthrogram for my shoulder showed no tear in the rotator cuff. But when I went for an MRI, it showed a complete tear. Why didn’t the arthrogram show the tear?

 
The arthrogram is an older test. It is based on the idea that a special dye will leak out if the rotator cuff is torn. If a scar forms over the tear or if the dye can’t leak out for some other reason, the test will appear negative. This is known as a “false negative” result, meaning the test appears normal even though the tendon is actually torn. 

A “false positive” is when a test shows there’s a problem where there isn’t one. For example, because the MRI scan is so sensitive, it can sometimes show what looks like a tear. Yet when surgery is performed to fix the tear, the surgeon may find that the tendon is not torn.

The most accurate test of all is surgical exploration. However, because surgery is costly and has certain risks, doctors prefer to use tests like MRI first to try to confirm the presence of a tear.

 
The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

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Shoulder Impingement May Be Causing Swimmer's Pain

August 21, 2009 — admin
I am on my high-school swim team. I have been swimming competitively since I was eight years old. Last season, I started to get shoulder pain doing freestyle. The pain is the worst when my hand goes into the water. Is there any kind of stretching or exercise program I can do for this?

 
You may be describing a problem called shoulder impingement. Impingement of a tendon causes pain for swimmers at the point of hand entry into the water. In this position, the arm is rotated inward with the hand turned palm and thumb down. The supraspinatus tendon of the shoulder rotator cuff may be getting pushed up against a ligament that crosses the tendon just above it.

Before starting any kind of exercise program, it is important to find out exactly what is causing your symptoms. There are a variety of specific tests that can be done by an orthopedic doctor. Early identification of the problem can help prevent small problems from getting worse. Treatment may involve anti-inflammatory medication, physical therapy, or surgery.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

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What is a rotator cuff and how does it get torn?

July 23, 2009 — admin
I recently fell and hurt my shoulder. The doctor told me that I have a rotator cuff tear. What is the rotator cuff, and what part is usually torn?

 
There are four muscles that make up the rotator cuff. The tendons from each muscle encircle the top of the shoulder, much like the cuff of a sleeve goes around the entire wrist. The rotator cuff holds the humerus in the socket of the shoulder joint while still allowing it to turn, or rotate (hence the word “rotator”).

Usually only one or two tendons of the rotator cuff are torn. The tear commonly occurs close to where the tendon attaches to the bone. It is rare for all four tendons to be injured at the same time.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com 

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