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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Mastectomy could be cause of shoulder pain

January 28, 2010 — admin

I’m a 48-year old woman and I had a mastectomy for breast cancer three months ago. Now that I’m back to swimming, I notice I’m having trouble with my stroke. My husband says when I reach forward to stroke, the shoulder blade pops out noticeably. Could this be caused by the mastectomy?

You may be describing an injury to the long thoracic nerve that controls the serratus anterior (SA) muscle. When there is weakness in the SA the shoulder blade or scapula can’t rotate and slide like it should when the arm is lifted up. The result is called scapular winging.

Mastectomy is one possible cause for this problem. During the surgery for the mastectomy, the nerve can get stretched from the position of the arm. There are many other possible reasons such as a viral illness, working with the arms overhead, or lifting a heavy weight.

The best way to know for sure what’s going on is to have some testing done. Electromyography or EMG studies can find out for sure which muscles are involved. Nerve conduction velocity (NCV) tests can be done to see if the nerve is damaged. Talk to your doctor about these symptoms and see what he or she suggests.

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 pain traced to AC joint

November 30, 2009 — admin

I thought I had a shoulder problem. The doctor says it’s the AC joint. My shoulder still hurts. What’s the difference between these two problems?

The true shoulder joint is where the head of the upper arm bone (humerus) inserts into a shallow cup in the shoulder blade. The cup is called the glenoid cavity. It’s a ball and socket joint.

Just above the true shoulder joint is a bony projection coming around from the back of the shoulder blade. This piece of bone is called the acromion. The end of the acromion meets the collarbone to form a shelf over the shoulder.

Pain from any of the structures around or above the shoulder joint can cause pain that seems like it’s coming from the joint. A careful exam by your doctor can pinpoint the exact cause. This is helpful information so the right problem is treated.

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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Warm up does not help this baseball pitcher's shoulder. What could be wrong?

August 4, 2009 — admin

I am a collegiate baseball pitcher. Since the beginning of baseball season, the vague soreness in my shoulder has become centered in the back part of my shoulder, especially when I wind up to throw. The stiffness in my shoulder used to go away with a good warm up, but now even a warm up doesn’t seem to help. What could be wrong with my shoulder? Will my problem just keep getting worse?

This problem you describe sometimes happens in athletes who do repeated overhand motions as part of their sport. The action of throwing forces the arm out and back in order to “cock” the arm to throw. This can potentially squeeze the ball of the upper arm bone (humerus) against the underside of the rotator cuff tendons, a condition called “internal impingement.” As this condition develops, the feeling of stiffness initially goes away once you’ve warmed up, and pain felt during the wind up is generally vague. In time, the problem may worsen, causing the shoulder to feel stiff even after a longer warm up. Feelings of vague pain usually become more noticeable around the back part of the shoulder. Treatment in the early stages involves resting the shoulder for one month followed with a strengthening program for the muscles of the rotator cuff and shoulder blade. Surgery is usually reserved for athletes who’ve had the problem for at least four months and who haven’t gotten better after trying nonsurgical treatments.

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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Does your shoulder snap, crackle and pop?

July 20, 2009 — admin
Why do I sometimes feel popping and snapping in my shoulder when I move my arm?

 
It depends on where and when you feel the popping. If it is in the back part of the shoulder blade, the popping might be coming from a problem called snapping scapula. Snapping scapula causes feelings of grating, grinding, or snapping under the back part of the shoulder blade when you move your shoulder.

Popping felt during shoulder movement can also happen when a tendon rolls over a bony bump. The acromioclavicular joint is formed where the shoulder blade meets the collarbone. This joint tends to wear out earlier than other joints and can also start to pop and click with shoulder movement.

Most cases of popping or snapping in the shoulder are not serious. They often can be helped by a well-rounded exercise program designed by a physical or occupational therapist.

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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