What bones make up the shoulder and how exactly does the shoulder work?

The shoulder is made up of three bones: The shoulder blade (Scapula), the collar bone (Clavicle), and the upper arm bone (Humerus).  There are  two joints that facilitate the movement of the shoulder. The acromioclavicular joint is located between the acromion and clavicle. The glenohumeral joint called the shoulder joint, is a ball and socket type joint that helps move the shoulder forward and backward and allows the arm to rotate in a circular fashion or hinge out and up away from the body. The “ball” is the top, rounded portion of the upper arm bone or humerus; the “socket”, or gleniod, is a dishshaped part of the outer edge of the scapula into which the ball fits. The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane. The bones in the shoulder are all held together by tendons, which are cords of tissue that attach the shoulder muscles to bone and assist the muscles in movement of the shoulder. They are also held by ligaments which connect the shoulder bones together.

What causes people to have shoulder problems?

Shoulder problems exist because of the range of motion allowed.  It is the most movable joint in the entire body and is subject to injury because the “ball” of your shoulder is larger than the shoulder socket that holds it. Other shoulder problems may arise from injury, overuse of the joint, not using the joint enough, from degenerative processes like arthritis or from disease in the body.

How can I get my shoulder problem diagnosed?

In order to diagnose a shoulder problem, we must look at several things.  We will look at your medical history to see how long you have had the pain/problem, where it is localized, what you are doing when it bothers you the most.  I will also do a physical examination to feel for an injury and to test your range of motion and points of pain.  Next, some tests may be performed.  We will most likely obtain an x-ray to look at the shoulder joint/bones.  Further testing may include, but is not limited to an MRI or arthrogram.

I was told that I have a shoulder dislocation. What is the difference between that and a shoulder separation?

A shoulder dislocation occurs when the ball of the humerus pops out of the shoulder socket.  A strong force that pulls the shoulder outward, extreme rotation, or a backward pull on the arm can cause the shoulder dislocation.  A shoulder separation occurs where the collarbone meets the shoulder blade.  The outer end of the collarbone slips out of place and does not meet up with the shoulder blade properly.  This is caused by a blunt blow to the shoulder or by falling on an outstretched hand.

I was recently told that I have tendonitis and bursitis. What are some non-surgical ways to treat this?

The best way to non-surgically treat these conditions is to reduce the inflammation and pain with rest, ice, and NSAIDS (non-steroidal anti-inflammatories).

Also, home exercise programs or physical therapy may help. Lastly, a shot in the shoulder joint of a steroid may also help relieve the pain and reduce inflammation.

A friend told me that “RICE” could help with shoulder injuries. She could only remember that the “R” stood for rest. What does it stand for and can it really help?

Yes “RICE” can help with shoulder injuries. Rest- rest the injured area for at least 24 hours. Ice- ice the area for 20 minutes at a time several times a day.  You can use an icepack, or put ice in a plastic bag and wrap it in a towel. Compression- compressing the injured area may help with swelling. Use an ace wrap or bandage to help. Elevation- elevate the injured area by keeping it above the level of your heart. You may use pillows to help prop it up.  This is a great acronym to remember and to practice.