The shoulder and elbow are made up of soft tissues, bones and joints, and problems can occur in any part of these components.
The shoulder, itself consists of three main bones; the Clavicle (collar bone) Scapular (shoulder blade) and Humerus, and two joints; the Acromioclavicular joint (ACJ) and the Glenohumeral joint (GHJ). Like the hip, the Glenohumeral joint is a ball and socket joint.
In order to provide sensation, movement, stability and function, various nerves, ligaments, tendons and muscles attach to or surround the joint to connect it to the arm, the nervous system and the main part of the body.
However, the “socket” part of the shoulder joint is much shallower and smaller in comparison to the “ball” which facilitates a greater range of movement and is vital in certain sports, for example cricket, gymnastics and tennis.
The elbow joint bends and straightens the arm, and is created by the interaction of three bones, the Humerus, Ulna and Radius. Like the shoulder, function is generated by an array of nerves, ligaments, tendons and muscles. Yet the actual movement in the elbow is more restricted, as it acts like a hinge and not a ball and socket.
However, the dynamic movement in the shoulder and elbow can cause problems, sometimes due to acute injury, such as dislocation, tears or ruptures of the tendons, or, over a prolonged period of time, degeneration and arthritis.
A consultation from our expert team will aim to establish the cause of your problems. Following an examination, further investigations may be requested and return visits can be required to confirm or exclude a diagnosis.
- X-Rays. Can confirm any problems with the bones in your shoulder or elbow
- CT scans. Look at the bony anatomy in more detail, and can be required to plan for certain types of operations.
- Ultrasound scans, can identify tears and inflammation in the joint and associated tendons.
- MRI scans, which are a more specialist method to examine the soft tissue and cartilage structures inside some of the joints. Sometimes a special dye is used to specifically identify any tears that might be present.
When investigations have been completed the Orthopaedic consultant or his team may make recommendations for treatment.
Shoulder complaints, such as, recurrent shoulder dislocation, frozen shoulder release, tendon tears, impingement, acromioclavicular (ACJ) disruption and arthritis can be treated in a variety of ways, including localised injections or surgery.
Surgery to the shoulder can include:
- Stabilisation of the shoulder joint. To repair the soft tissues inside the Glenohumeral (GHJ) joint itself or sometimes to the outer bony rim of the Glenoid (socket) if it has been damaged by traumatic dislocation.
- Stabilisation of the Acromioclavicular joint (ACJ). This is can be undertaken if the Clavicle becomes disrupted or “dislocated” from the Acromioclavicular joint due to trauma. The procedure involves re-aligning the ACJ with an artificial ligament.
- Frozen shoulder (Adhesive capsulitis) involving the release of the tightened ligament and fibrous tissues surrounding the joint, to relieve pain and restore movement.
- Rotator Cuff Repair. This involves repairing a tear in the tendons that provide movement to the shoulder.
- Shoulder Replacement surgery. To address the pain of arthritis in the shoulder.
Disorders of the elbow, such as olecranon bursitis, tennis elbow (prolonged inflammation to the tendons in the elbow which can be caused by repetitive movements), ulna nerve entrapment and mild-to-moderate arthritis, can be treated conservatively with localised injections, or in some cases surgery.
Surgery for the Elbow can include:
- Tennis Elbow release (Lateral Epicondyle release). This involves the debridement of the inflamed tendon in the elbow.
- Ulna Nerve release (Cubital nerve decompression) the space surrounding the Ulna nerve is enlarged by removing inflamed tissue, or a small part of a bone in the elbow, which in turn can reduce pain and altered sensation in the fingers commonly associated with this condition.
- Elbow debridement and removal of loose bodies. Removing some of the bony overgrowths that result from degeneration and arthritis inside the joint can improve pain, function and movement.
A high proportion of surgery can be undertaken arthroscopically, otherwise known as a “keyhole” procedure, which can facilitate a faster recovery and undertaken in our extensive Daycase Unit. The specially trained physiotherapy team can provide a structured exercise programme to achieve the best results from your surgery.
Here at Circle Nottingham Hospital, we pride ourselves on providing an holistic approach and the very best treatments for the patients we encounter.
The expert Orthopaedic consultants are supported by Extended Scope Practitioners (ESP), a Physiotherapy and Occupational therapy team specially trained in shoulder and elbow conditions, and an Orthopaedic Nurse Specialist.
We aim to gain the optimal results from your treatment and to support you in the rehabilitation process.