Last weekend, I was pedaling my bike along State Highway 131 in Wisconsin, between Viola and LaFarge, when I was reminded by a warning sign of the number of recent requests from patients regarding their shoulder symptoms and limitations. After the year-long hibernation, people are waking from their slumber to swim, play golf, play tennis, return to a fitness routine, sail, fly fish, etc., all dependent on a functioning shoulder.
The shoulder is a unique joint in that it enjoys the widest range of motion in the body. Actually, two joints are at the shoulder. The glenohumeral joint is the ball and socket junction of the top of the arm bone and the socket of the shoulder blade. A second joint is the junction of the collar bone with the shoulder blade, called the acromioclavicular joint. Owing to the relative degrees of freedom at the glenohumeral joint, evolution resulted in the rotator cuff, shoulder capsule, shoulder labrum, and shoulder muscles to provide stability and function. All was going well with phylogeny until humans starting walking on two legs. As a result of ontogeny, I now am faced with determining if a shoulder impairment is related to the joint, the rotator cuff, the capsule, the labrum, the bone, or the muscle and tendons. In addition, referred pain from your cervical spine and related nerves is not uncommon.
Shoulder Pain | Altered Function
Let us assume that you present with a chief complaint of shoulder pain and altered function. After completing the medical history including symptom onset and chronicity while learning of any co-morbidities, a physical examination is completed. What follows is a routine X-ray and an MRI if indicated. Once the diagnosis is established, treatment options are addressed by an informed consent process. The three major categories of care fall under operative, biologic, and non-intervention depending on the diagnosis and patient preference.
Space in this Blog does not allow me to address each and every shoulder abnormality; for the purpose of discussion, assume that you are presenting with shoulder symptoms and altered function of longer than six weeks duration. In the aforementioned setting, treatment is mostly elective based on the diagnosis. In some, surgery might be indicated; in others, especially when the problem is in a non-dominant extremity, no intervention may be the patient’s choice other than a course of Physical Therapy and NSAIDs.
Over the last several years, the needle rather than the knife has become a very viable therapeutic option allowing for treatment with Platelet Rich Plasma, Growth Factors, and Bone Marrow Concentrate containing PRP, Growth factors, Precursor Cells, and Adult Mesenchymal Stem Cells. Biologics are safe, effective and yours providing both anti-inflammatory and regenerative potential.
Cell-Based Therapies | Using a Needle and NOT a Knife
Don’t pass up the opportunity to be rendered symptom-free and enjoy the restoration of shoulder function with a relatively short-term rehabilitation. Call (847) 390-7666 to schedule your consultation. You may continue learning more at my website: www.sheinkopmd.com.