Shoulder

frozen-shoulder

Anatomy of the shoulder joint

The shoulder is a very complex joint. It consists of several joints that act together. This way, they ensure the large range of movement of the arm. Other parts of the shoulder consist of three bones (bone of the upper arm, shoulder blade and collarbone), three muscle groups as well as numerous tendons and ligaments for the joint capsule.

What is frozen shoulder?​

Frozen shoulder is marked by adhesions or hardening of the joint capsule. The shoulder joint muscles can also be affected.

A problem with the shoulder joint demands a lot of patience. With a frozen shoulder, for instance, the shoulder stays stiff for a very long time. It can be caused by rheumatic disease, osteoarthritis, injuries overuse. The good news though is that it will “thaw out” eventually.

Signs and symptoms​

The first symptom is shoulder pain, which is most noticeable at night. It is typical for the pain to get better on its own in time. By contrast, however, the shoulder constantly grows stiffer and less moveable. Sometimes it can’t even be moved passively anymore. A stabbing pain shoots through the shoulder during everyday movements such as bathing or getting dressed. Frozen shoulder resolves with time, but it can take up to three years as the arm gradually loosens up again.

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What causes frozen shoulder?

Frozen shoulder usually occurs as a result (secondary form) of injury. Rheumatic diseases, infections, inflammation or osteoarthritis can also lead to frozen shoulder. Particularly the long-term immobilization of the shoulder joint after operative procedures or accidents can trigger frozen shoulder.

The causes of spontaneous onset frozen shoulder (primary form) are unclear. A number of doctors suspect that metabolic diseases such as diabetes or hyperactivity of the thyroid gland could play a part.

Prevention

In certain cases, it is very important to immobilize the shoulder after an injury or an operation. We have special immobilization orthoses for this. However, always ask your doctor whether you might be able to start gentle physiotherapy at an early stage.

Early mobilization helps prevent secondary frozen shoulder. Good posture is another preventive measure. Perform all everyday activities as carefully as possible. You should not expect your shoulder joint to bear any one-sided stresses at work or when playing sports. If you suffer from arthritis, get early treatment.

dislocation

Dislocation

What Is A Joint Dislocation?

In comparison to the other joints, the shoulder can be dislocated relatively easily. The joint’s socket is small in relation to the head of the humerus. Although this makes the joint enormously mobile, it also makes it unstable.

When we dislocate something – called luxation by the experts – the surfaces of the joint are separated from each other. You will certainly be aware of the term dislocation. The dislocated bone jumps, so to speak, out of its socket. The articular surfaces shift relative to one another and jam in an unnatural position.

Dislocations occur particularly often in the shoulder, the elbow or the fingers. The good news is that a dislocated bone can usually be “reduced” quickly and gently. Sometimes a (sub-)luxation spontaneously reduces itself if it hasn’t been dislocated completely.

Anatomy And Function Of The Joints​

There are various types of joints in the human body. They generally consist of a joint head and a socket. These are separated by a layer of cartilage. The joint capsule surrounds the joint and, together with ligaments, tendons and muscles, forms a protective outer envelope. In comparison to the other joints, the shoulder can be dislocated relatively easily. The joint’s socket is small in relation to the head of the humerus. Although this makes the joint enormously mobile, it also makes it unstable.

Dislocated Shoulder Symptoms

A dislocation is very painful. The affected joint cannot be moved and is often swollen. If nerves have also been injured, it is accompanied by pins and needles and numbness.

The doctor can usually find out whether the socket is empty just by palpation. They will usually takes X-rays to rule out secondary injuries such as a tear in the joint capsule or ligaments or broken bones.

Risk Factors and Causes

Everybody automatically tries to break their fall with their arms and hands. The impact not only forces the bone out of the shoulder joint, but ligaments, tendons and muscles are also inevitably stretched. This is why the chance of dislocating the shoulder is higher if it has already been dislocated before.

Patients with chronic instability, i.e. if the joint has not formed properly or if the ligamentous apparatus of the shoulder joint has become lax, may suffer spontaneous dislocation (habitual dislocation) without any external influence.

Prevention​

We cannot specifically prevent dislocations. But well-trained muscles and coordination training can help keep the joints healthy. In sports, the proper equipment and defensive behavior protects against falls and collisions.

How Can Dislocations Be Treated?​

The immediate first aid measure is to hold the joint as still as possible and cool it. Dislocated joints may only be reduced by a doctor – and as quickly as possible.

Depending on the patient’s sensitivity to pain, local anesthesia may be used for minor dislocations. If the shoulder joint has been dislocated, the patient is usually given a short general anesthetic (dissociative anesthesia).

There are various ways of reducing dislocated shoulders. They are all based on the same principle – pulling on the upper arm. The arm is turned outwards at the same time. The head of the humerus clicks back into the socket and the shoulder is then back in its old position.

If it isn’t possible to reduce the joint in this way, surgical reduction (repositioning) is performed. General anesthesia is necessary for this. The shoulder is then immobilized for eight to ten days using elastic supports, splints, slings or a plaster cast. The shoulder support Omomed from medi® offers the patient as much freedom of movement as possible. It is easy to put on without help from others. Since the capsule may shrink if the arm is immobilized for a long time, careful mobilization should be started as soon as possible.

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