The shoulder is a ball and socket joint. The ball portion of the joint consists of the rounded head of the upper arm bone (humerus), and the socket portion is made up of a depression (glenoid) in the shoulder blade. The ball (humeral head) fits into the socket (glenoid). The joint is surrounded and lined by cartilage, muscles, and tendons that provide support and stability. The shoulder’s construction allows for the rotation of the arm in all directions.
Many patients seek medical attention for shoulder pain, and a common diagnosis given is “shoulder bursitis” or “shoulder tendinitis.” Shoulder bursitis and rotator cuff tendinitis are both just a way of saying that there is inflammation of a particular area within the shoulder joint that is causing pain and discomfort. Shoulder bursitis and a rotator cuff tear are different problems, and although related, the treatment is different for each condition.
Shoulder bursitis is inflammation around the rotator cuff tendons. A rotator cuff tear is an actual tear within the tendons. A sign that differentiates these problem areas is the strength of the rotator cuff muscles. Typically, these injuries have been brought about by high impact activities from contact sports like football and rugby, or from heavy use in overhead activities, such as tennis, golf, or baseball. In either case, both types of injuries produce pain and limit range of motion.
Common symptoms include:
- Pain with overhead activities (arm above head height)
- Pain while sleeping at night
- Pain over the outside of the shoulder/upper arm
In shoulder replacement surgery, the damaged shoulder is resurfaced and replaced with a prosthesis. When both sides of the joint are resurfaced, it is a total shoulder replacement. When only the ball is involved, it is a partial shoulder replacement.
The type of surgery you have and your doctor’s recommendations will determine how soon you can begin using your shoulder after surgery. If you have arthroscopic surgery, you may go home in a few hours after surgery, but you will need to arrange to have someone drive you home because the pain medications and anesthesia are likely to make you sleepy. If you have a total shoulder replacement, you could remain in the hospital for one to three days.
Physical therapy is an extremely important part of the success of shoulder surgery, and your full participation is necessary for an optimal outcome. Some degree of pain, discomfort, and stiffness can be expected during the early days of physical therapy.
The medical staff and therapist will teach you proper movements and exercises to do so that you can regain your strength and mobility in your shoulder. Continue to move the way you were taught by the physical therapist and return to activity slowly. Don’t be surprised if you feel a little stiff at first; it may take a few months to achieve a complete recovery. And remember, it is very important to keep all your scheduled follow-up visits with your surgeon.