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Shoulder

schulter_schmerzAn extraordinarily complex interplay of joints, tendons, muscles and ligaments gives the shoulder joint the greatest range of motion of all the joints in the human body. The soft tissues that surround the bony structures of the shoulder play a vital role in driving and harnessing the joint. An array of muscles, tendons and ligaments give the joint static and dynamic stability and permit it to execute powerful and precise movements.

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Shoulder Pain

Shoulder pain Shoulder Pain

Shoulder pain can be intense, prolonged and disabling. Together with a reduction in the shoulder joint's range of motion, shoulder pain is a very common symptom that leads many patients to visit our clinic. The incidence of chronic shoulder pain has increased significantly in recent years, with nearly 10% of all adults affected. However, shoulder pain is not a condition that affects only older individuals. It occurs quite commonly among men and women of all age brackets. Patients are advised to take shoulder pain seriously because many shoulder disorders can be effectively treated when diagnosed at an early stage.

 

 

 

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Muscle and Tendon Injuries

rotatoren.jpgA rotator cuff is made of the tendons of four muscles. It surrounds the head of the humerus like a cuff. One part of these muscle attachments is located below the top of the shoulder. So these parts lie between two opposite, movable bones and are therefore endangered. The tendons keep the head of the humerus within the joint and centre it in the shoulder socket when moved. If the centering of the head is disturbed or if the space is constricted various pain syndromes and shoulder disorders may result from it. Inflammations of the bursa, tendon irritations or premature wear of the tendon can be the result. Sometimes the tendon tears after a fall or strenuous work. However the tendon has to have suffered a prior disorder. A healthy tendon will seldomly tear during an accident.
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Calcification

verkalkung.jpgCalcific tendonitis (shoulder calcification, shoulder pain) is a condition situated in the area within the tendons of the rotator cuff, particularly around the supraspinatus tendon. It is caused by insufficient blood supply to the rotator cuff, leading to reactive calcium deposits on the tendon insertions.
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Impingement Syndrome

Rotator Cuff glossary termImpingement

rotatorenmanscheltte_213x195The rotator cuff - the group of muscles and their accompanying tendons that act to stabilize the shoulder joint - occupies a very tight space between the acromion (the rigid bony arch of the shoulder blade) and the humeral head (top of the upper arm bone). The rotator cuff's limited space and its role as a dynamic stabilizer of the shoulder joint, which is itself designed to accommodate the upper arm's tremendous range of motion, leaves it susceptible to becoming pinched or trapped between the bony surfaces surrounding it, a condition referred to as impingement.

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Shoulder Instability

The shoulder joint consists of the head of the humerus and the joint socket. It is surrounded by a capsule, strengthening ligaments and muscles that contribute to the mobility of the joint. A shoulder instability can be caused by a natural disposition (e.g. with a capsule ligament deficiency) or it is the consequence of an injury. With the instability caused by an injury (shoulder glossary termLuxation ) the so-called joint lip ( glossary termLabrum ), joint ligaments and capsule can be ruptured or a fracture of the joint socket or of the head of the humerus could have occured additionally. A shoulder instability causes repetitive painful dislocations of the head of the humerus out of its socket, e.g. after heavy falls, sports that involve upside-down postures or even after simple twisting movements. Sometimes the shoulder can only be reposed with help. Sometimes incomplete, painful "subluxations" can occur.
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Shoulder Arthritis

We distinguish between a primary and secondary type of glossary termArthritis of the shoulder joint (omarthritis). In both cases it is due to a growing wear and tear of the joint which eventually leads to complete destruction of the cartilage in the gleno-humeral joint. Very often, this degenerative joint disease is the consequence of mechanical surcharge, of lesions in the rotator cuff, inflammations or accidents.

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Acromioclavicular Joint Osteoarthritis

Die AC- glossary termArthrose Acromio-Clavicular-Arthrose ist die Abnützung des Schultereckgelenkes (Abnützung des Gelenkes zwischen Schlüsselbein und Schulterdach). Dieses kleine Gelenk ist großen Belastungen ausgesetzt, fixiert es doch das Schulterblatt gegenüber dem Brustkorb. Das gesamte Armgewicht wird ebenso wie die über den Arm eingeleitete Kräfte von diesem Gelenk aufgenommen. Besonderen Belastungen ist dieses Gelenk bei Überkopf-Sportarten und bei Gewichthebern ausgesetzt (Fitness-Sport). Diese Belastungen können auch bei Jugendlichen zu sehr schmerzhaften Irritationen des Gelenkes führen. Operationen sind nur selten notwendig, denn die Abnützung in diesem Gelenk verläuft langsam und wenig schmerzhaft. Die Veränderungen können (wie bei jeder Abnützung) zu einer Verbreiterung der Gelenkspartner kommen. Der Körper versucht also, das verschlissene Gelenk mittels einer Vergrößerung der Kontaktflächen, den Druck der Gelenkspartner zu reduzieren. Dies kann sich aber bei den engen Platzverhältnissen an der Schulter fatal auswirken. Randzacken können in den Raum unter dem Schulterdach vorstehen. Die Folge ist ein mechanisches Impingementsyndrom, das ohne rechtzeitige Diagnose und entsprechender Behandlung zur Rotatorenmanschettenruptur führt.

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Biceps Tendon Injuries

Not available
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Rotator Cuff Rupture

The detection and treatment of Rotatorenmanschettenruptur lead us in a joint clinic by. The far-reaching significance of this injury, the possibilities and risks of treatment after the diagnosis and assessment of damage extent essential task of the treating physician.
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Shoulder Bursitis

Wie kommt es zur Schleimbeutelentzündung der Schulter?

Die Schleimbeutelentzündung der Schulter stellt eine der häufigsten Ursachen für akute Schulterschmerzen dar. Die akute Bursitis subacromialis ist eine Schleimbeutelentzündung (Bursitis) (lat. bursa = Schleimbeutel) unter einem Knochen des Schultergelenks (Acromion). Meist geht eine mechanische Überbelastung voran zum Beispiel durch Überkopfarbeiten. Dabei kommt es zu Bildung von Mikroverletzungen und Ausfallen von Kristallen, die dann eine aseptische (bakterienfreie) Entzündung auslöst. In Einzelfällen kann es zur Auskristallisation auch bei Ernährungsumstellung, Diäten oder ähnlichem kommen.

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