Shoulder

Treating Shoulder Conditions Efficiently

Your shoulder is designed to help you swing, lift, push, and press. An injury or other condition in this area can limit movement throughout your upper body, induce pain, and decrease your quality of life. Dr. Cobb also uses minimally invasive technique to treat many shoulder problems such as bursitis, impingement, tendon tears, rotator cuff injuries, and fractures. He can help to reduce or eliminate pain and get you back to work, life, and your favorite off-hours activities faster and with better results.

Frozen Shoulder (Adhesive Capsulitis)

Adhesive Capsulitis, also known as frozen shoulder, is the result of the capsule surrounding the shoulder joint contracting and thickening, making movement difficult. Patients with this condition typically have previously had long periods of joint immobilization, or have been diagnosed with diabetes. Anti-inflammatory medications, therapy, or steroid injections are recommended non-surgical treatments, but some cases may require surgery for improvement. Frozen shoulder arthroscopy is a minimally-invasive procedure in which the tight tissue causing the restriction is divided. Recovery is shorter than that of open surgery, and physical therapy is required for best postsurgical results.

Rotator Cuff Tears (Partial or Complete)

Rotator cuff tears may occur to one or more of the four muscle tendons attached to the upper arm. These are typically caused by repetitive movements, throwing or pitching injuries, weightlifting injuries, or traumatic injuries. Symptoms include the shoulder feeling tender or sore during activity, difficulty raising the arm above the head, and nighttime pain in the shoulder. In mild cases, rest, anti-inflammatory medications, therapy, or cortisone injections may be utilized for treatment. In more severe injuries, surgery is required, but may be done using minimally-invasive arthroscopic rotator cuff repair. Special instrumentation is inserted through a small incision to suture the torn tendon(s) to the correct location. Patients experience less scarring, less pain, and faster recovery time than traditional surgery.

Shoulder Arthritis

As with any arthritis, shoulder arthritis is the result of a loss of cartilage between bones that may be caused by wear and tear or a previous injury to the joint. However, if occurring in both shoulders, it may be due to Rheumatoid Arthritis. Symptoms may include deep, achy shoulder pain; grinding, clicking or snapping in the shoulder joint; limited range of motion; pain when moving the shoulder; or pain at night within the shoulder. Mild cases may be treated by avoiding certain activities, using anti-inflammatory medications, undergoing therapy, using moist heat, icing, or corticosteroid injections. If symptoms worsen, surgery may be necessary, which could include reverse total shoulder replacement.

Shoulder Instability (Dislocation or Separation)

Shoulder instability is essentially a loose shoulder joint caused by dislocation or complete separation that overstretches and damages surrounding tendons and ligaments. Symptoms include feeling like it may easily slip out of place, quick bursts of shoulder pain, history of previous shoulder injury, numbness on the outside of the arm, swelling or bruising around the shoulder, or visible abnormalities. Mild cases may be treated by splinting, resting, utilizing stretching or strengthening exercises, avoiding certain activities, anti-inflammatory medications, or corticosteroid injections. If the instability is more severe, minimally-invasive arthroscopic shoulder instability repair may be required. Small incisions are made and the damaged tendons are ligaments are reattached to help stabilize the joint. This procedure provides patients with a faster recovery than typical surgery.

Proximal Biceps Tendon Rupture (Partial or Complete)

Proximal biceps tendon rupture occurs when the long head of the biceps tendon in the shoulder is frayed. Symptoms include a sudden pop or tearing sensation followed by severe elbow pain, and significant bruising and swelling around the shoulder. Partial ruptures may be treated with rest, avoidance of activities, anti-inflammatories, or therapy. However, non-surgical treatments typically result in some loss of shoulder strength, so many patients may require surgery, whether complete or partial rupture. Minimally-invasive arthroscopic proximal biceps tendon rupture repair is done using a small incision where special instrumentation is used to reattach the tendon resulting in less scarring, less pain, and a faster recovery. Mini-open biceps tenodesis is another option for both partial and complete tears. A small incision is again used, but the tendon is detached from the injured area and reattached to the humeral head, helping relieve pain, weakness, and visible muscle deformities.

Chronic Shoulder Pain

Patients experiencing chronic shoulder pain are often enduring a slow degenerative process before a tendon tears known as tendinosis. For many, this ongoing pain is actually worse than when the tendon finally does tear. It is possible to treat chronic shoulder pain non-surgically through therapy, activity avoidance, anti-inflammatory medications, and cortisone, but for those whose symptoms do not respond, the minimally-invasive TENEX Health TX® procedure may be utilized. This technique uses the process of phacoemulsification – originally developed for cataract removal in the eyes – to remove the abnormal tendon and promote healing, leaving the surrounding healthy tissue undisturbed.
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