Injuries – At any time or at any age musculoskeletal injuries can occur
  1. Sprains – ligament injury/tears (glenohumeral joint capsule, shoulder separations, Frozen Shoulder)
  2. Strains – Muscle/Tendon tears/ruptures (rotator cuff biceps tendon)
  3. Fractures – Humerus, clavicle, scapula, growth plate Dislocations or instability
Signs & Symptoms:
  1. Pain – constant or intermittent
  2. Swelling – immediate or gradual
  3. Instability – “going out” of place
  4. Weakness
  5. Catching or snapping – either constant or positional
  6. Limited range of motion
Treatment options:
  1. Conservative –
    1. Medications to reduce pain and swelling
    2. Physical therapy – improve motion, strengthen & relieve symptoms
    3. Sling/Splints – to rest injured area and to allow proper healing
  2. Surgical – most procedures performed using minimally invasive arthroscopic techniques when possible
    1. Repair tendons to improve function and decrease symptoms
    2. Labrum and/or capsule repair to improve joint stability
    3. Fractures re-aligned and fixed in place using specialized plates and screws
    4. Shoulder decompression where bony spurs are removed to decrease pain and improve function
Osteoarthritis or Rheumatoid Arthritis
This can be extremely painful and has many possible explanations.


  1. Overuse – which wears out the cartilage cushion of the joint and or causes irritation to the surrounding soft tissue.
  2. Injuries sustained from involvement in sports/recreational activities or those secondary to accidental fall causing damage to the articular cartilage
  3. Genetics or family history which leaves individuals predisposed to arthritis
  4. Autoimmune disease that attacks the joint causing damage to the cartilage and bone.

Signs & Symptoms

  1. Pain with movement or at rest. Many times pain is experienced at night causing sleep disruption
  2. Loss of function, to include strength and or range of motion
  3. Swelling which may be chronic and increase with activity
  4. Stiffness which may be partially alleviated with stretching or activity
  5. Joint noise caused by irregular joint surfaces

Treatment options

  1. Conservative
    1. Medications – variety of medications, from oral to topical, to manage pain and swelling
    2. Physical therapy – stretches and exercises to reduce symptoms and maximize function
    3. Steroid injections- for longer relief and occasional acute flare ups
    4. Supplementation for joint health
  2. Surgical
    1. Total shoulder replacement using the latest technology and components
    2. Reverse total shoulder replacement – an alternative to conventional joint replacement for those with chronic rotator cuff tears in addition to severe arthritis
    3. Arthroscopic cartilage smoothing to remove loosened flaps of damaged or frayed cartilage
    4. Partial joint replacement (Hemiarthroplasty) to reduce pain in those who are not candidates for total joint replacement