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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Best form of surgery for torn rotator cuff depends on location

October 15, 2009 — admin
I have a moderate rotator cuff tear. I haven’t had relief from physical therapy and medications. Now we’re talking about surgery. My doctor says there are a couple of ways to approach surgery for tears like mine. What type of surgery is best?

 
There are a few ways to operate on rotator cuff tears. The most extensive surgery is open repair of the rotator cuff. With this procedure, surgeons use a large incision to operate. During surgery, they suture the tear to help the shoulder function properly. This approach is the best option for severe tears, or those that affect more than half of the rotator cuff tendon.

An alternative for minor tears is called acromioplasty. With this procedure, surgeons shave part of the acromion bone on the point of the shoulder. A ligament over the top of the shoulder is cut, and injured tissues are removed. This takes pressure off the injured rotator cuff and promotes healing. For patients with tears that affect less than half of the tendon, this procedure usually have good, lasting results.

For patients whose tears go through about 50 percent of the tendon, repair of the rotator cuff may offer better results than acromioplasty. This choice also depends on where the tear is located. Ask your doctor which surgery is best, given the size and location of your injury.

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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Too busy for physical therapy? Rethink surgery!

September 22, 2009 — admin
I recently dislocated my shoulder. I’ve heard about a new surgery available to fix it. Does that mean I won’t need to go through physical therapy? Frankly, I don’t have the time.

 
The surgery you are talking about is arthroscopy surgery, and it’s not all that new. However, it is being looked at more closely as an improvement over the traditional approach of simply placing the shoulder in a sling. Physical therapy is an integral part of the recovery process, regardless of the treatment approach. Since it’s your body, you need to have a say in how it is cared for. That said, many surgeons prefer not to operate if the plan for rehabilitation afterward can’t be agreed upon. Discuss your concerns with your surgeon.

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 snapping scapula syndrome?

September 21, 2009 — admin
What is snapping scapula syndrome?

 
Snapping scapula syndrome is a fairly rare condition where the shoulder blade thumps, grates, or snaps as it moves along the chest wall. It can happen when the bursa between the shoulder blade and chest wall becomes inflamed. (A bursa is a lubricated sac that cuts down on friction between muscles, tendons, and bones during movement.) People who have had a fractured rib or shoulder blade sometimes feel grating because the bones may have healed out of alignment. Weak muscles under the shoulder blade can increase the chances of having snapping scapula syndrome because there is less muscle padding between the shoulder blade and chest wall.

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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Does Shoulder Injury Require X-ray or MRI?

August 20, 2009 — admin

I started a weight-lifting program at home two weeks ago. When I increased to 20 pounds for shoulder movements, I felt a pop in my left shoulder. There was a twinge of pain at the time, and the next day I had extreme shoulder pain. I went to see the doctor, and she said I tore the supraspinatus tendon. There were no X-rays or other tests done. Shouldn’t I have X-rays or MRI?

X-rays have limited value in a case like this. Your doctor might have ordered an X-ray if she thought you could have fractured a bone. MRI (magnetic resonance imaging) is a useful test to identify damaged shoulder tendons. However, it is not always necessary to perform these studies. MRIs are very expensive, and most tendon tears can be accurately identified with a careful physical examination and history. An MRI is probably not necessary unless the doctor is considering surgery. If you do not get better after a program of physical therapy, the doctor may reconsider ordering an MRI. Getting a second opinion from another doctor may confirm the diagnosis at a lesser cost.

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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Sling or Surgery? What's Best for Dislocated Shoulder?

August 19, 2009 — admin
One of my rugby buddies is going to have surgery for a shoulder dislocation. My shoulder has dislocated three times since I first injured it last season. I haven’t had surgery and don’t even know if I was given the option. Should I have surgery?

 
In a recent study of people under 30 years old with a shoulder dislocation, arthroscopy surgery was compared to the more traditional approach of slinging the shoulder. Nearly everyone who chose surgery had an excellent return to strength and movement without having a future dislocation. Most of the sling-only patients had another dislocation within the year. Share your concerns with your orthopedist.

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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Frozen Shoulder Not Improving with Physical Therapy

August 18, 2009 — admin
I’ve been going to physical therapy for my frozen shoulder. The shoulder hurts a lot and doesn’t seem to be improving. What are my options for treatment?

 
Doctors generally prefer to try conservative treatments before using more aggressive forms of treatment. When symptoms don’t improve with physical therapy, doctors may recommend an injection into the shoulder joint. The injection is typically a steroid medicine, a painkiller, or both. Filling the joint with medicine helps with inflammation and pain. It also stretches the tight joint capsule. Resuming physical therapy soon after the injection enhances the benefits of the shoulder stretches you do in therapy.

If symptoms continue and shoulder motion still does not improve, your doctor may recommend a treatment called manipulation under anesthesia. This procedure is done by forcefully stretching the tight shoulder of a patient who is asleep from anesthesia.

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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