Shoulder injuries

Shoulder injury and shoulder disorder. This is a review of the most common causes of shoulder pain or shoulder problems.

Rotator cuff lesion

This is a common shoulder injury with a tear of some of the lifting tendons of the smaller shoulder muscles. Your injury could be caused by a fall or a sudden movement in the shoulder. Your tendon(s) can be partially or completely torn by bone attached to the humerus. You will often experience pain at night and your arm strength will be reduced when lifting your arm forward and outward.  

Surgery for rotator cuff injury

The Danish Health Authority’s recommendations are that you should have your tendon(s) repaired within 3 months of the injury. Your ruptured tendon(s) are sutured to the bone with tiny anchors using a telescopic technique. Your diagnosis is made by a UL scan or MRI scan (arthrography). After surgery, you’ll need to keep your arm at rest until the tendon has healed back onto the bone, and then you’ll have a lengthy rehabilitation program.  

Rotator cuff suture

Here is an example of how such a tendon can be sewn – the so-called Speed Bridge technique. It’s a very solid technique, without the use of knots. Unfortunately, it’s also a costly technique, which is why some departments have chosen to say they won’t pay for it. Thankfully, my employers are tolerant and understanding and I have the opportunity to use this technique when deemed appropriate. Watch a video of the fantastic technique –  here

Loose shoulder – dislocated shoulder

When your shoulder dislocates, it will usually also cause your joint lip to tear away from the front of your joint socket. Your shoulder’s joint capsule and ligaments attach to your joint lip, which means that when your shoulder dislocates, your joint lip is usually pulled off. Unfortunately, the pull of the ligaments causes your joint lip to subsequently heal in the wrong place (Bankart lesion). Your shoulder will therefore tend to become too loose and may dislocate again. The younger you are, the higher the risk, and if you are under 30, the risk of experiencing a new dislocation is up to 80%, and the more times it has been dislocated, the higher your risk.

Loose shoulder – dislocated shoulder

When your shoulder dislocates, it will usually also cause your joint lip to tear away from the front of your joint socket. Your shoulder’s joint capsule and ligaments attach to your joint lip, which means that when your shoulder dislocates, your joint lip is usually pulled off. Unfortunately, the pull of the ligaments causes your joint lip to subsequently heal in the wrong place (Bankart lesion). Your shoulder will therefore tend to become too loose and may dislocate again. The younger you are, the higher the risk, and if you are under 30, the risk of experiencing a new dislocation is up to 80%, and the more times it has been dislocated, the higher your risk.  

Treatment for a loose shoulder

The treatment involves loosening and reattaching your joint lip in the right place through a telescopic operation, which automatically tightens your loose ligaments – this is called arthroscopic Bankart surgery and is a simple and less standard operation. As always, there are exceptions, and in some cases, there are completely different things that apply, and it’s too complicated to go into here. However, it’s worth mentioning that if you’ve broken bone in your joint socket, you should undergo an operation called Latarjet surgery.

About loose shoulder by the way

It can be important in this shoulder injury that the correct cause is diagnosed so that the right treatment can be initiated. Causes such as osseous Bankart, posterior Bankart, hypermobility and HAGL lesions are something I have years of experience with, as well as surgeries such as Latarjet surgery and plication, but it would be too extensive to explain about these types of shoulder injuries here.  

SLAP lesion – Joint lip injury

SLAP lesion is an abbreviation for a labral tear in the shoulder; some people refer to it as a meniscus tear of the shoulder. There is a separate website dedicated to SLAP injuries

Dislocation in AC joint/AC joint dislocation

A fall on the shoulder can result in an unfortunate dislocation of the acromioclavicular joint. This is a common shoulder injury in mountain biking, motorcross and skiing etc. What happens is that 1-3 ligaments are torn and the collarbone jumps up in relation to the shoulder blade. The damage usually looks pretty severe. Many patients go home from the emergency room somewhat shocked to be told that – somewhat surprisingly – they don’t need surgery. The vast majority of people suffer only very limited damage over time. However, some people continue to have discomfort and if you are one of them, you should be offered an operation, and here I recommend a Weaver-Dunn’s operation and where some ligaments are reconstructed etc.

Here you can see that the collarbone has jumped upwards 

Above you can see the AC joint slipping and shoulder drooping

Same patient 3 months after Weaver-Dunn surgery.