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Shoulder

Rotator Cuff Tear

What is a Rotator Cuff Tear?

The rotator cuff is a collection of muscles and tendons that work with the joint to keep the shoulder joint in position. Rotator cuff injuries are common and can occur during sports, from a fall, from repetitive overhead motion, or from degeneration of the tendon. Tears occur when the tendon fibers are damaged. The tear can involve the whole tendon (complete tear) or only some of the fibers (partial tear).

How do you know if you have a Rotator Cuff Tear?

Patients typically experience pain over the outside of the shoulder or arm. To confirm the diagnosis of a rotator cuff injury you may require x-rays, ultrasound and/or MRI.

What are rotator cuff treatments?

In many cases, rotator cuff injuries will heal without surgery. In some cases, rotator cuff tears do not heel. In the past, when traditional non-operative treatments failed, surgery was the only option recommended to patients. Dr. Sussman now offers alternatives to shoulder surgery for partial rotator cuff tears, including platelet rich plasma (PRP) injections and stem cell injections.

PRP and stem cell injections for Rotator Cuff Tears uses a patient’s own platelets or stem cells to help accelerate healing and promote tissue regeneration. Learn more about PRP or stem cell injections here.



Calcific Rotator Cuff Tendinopathy (Tendonitis)

Shoulder x-rays showing rotator cuff calcification (image A),
and resolution of the calcification (image B) after a Tenex
percutaneous barbotage procedure.

What is Calcific Rotator Cuff Disease?

Calcific tendinitis is due to hydroxyapatite (crystalline calcium phosphate) in the rotator cuff, causing pain and inflammation. No one knows what causes the calcifications to form, but calcifications are found in 5% of asymptomatic healthy adults.

How do you know if you have Calcific Rotator Cuff Disease?

While the calcium deposit is forming, you may only feel a mild to moderate pain, or no pain at all. The calcification can result in severe pain and cause you to lose motion in your shoulder, resulting in frozen shoulder (adhesive capsulitis). Pain can be severe and lifting your arm may be painful. An X-ray will usually confirm the presence of calcium deposits.

What are treatment for Calcific Rotator Cuff Disease?

The goal of treatment is to control pain and common treatments including medication, therapy and cortisone injections are prescribed. In the past, when traditional non-operative treatments failed, surgery was the only option recommended to patients. Dr. Sussman now offers minimally invasive alternatives to surgery.

Percutaneous ultrasonic needle tenotomy (Tenex) can help remove the calcium despite by inserting a needle into the calcium deposit and rinsing the calcium away with sterile saline. Learn more about Tenex here.



Shoulder Arthritis

What is Shoulder Arthritis?

Approximately 20% of the adult population is affected by shoulder arthritis. Shoulder arthritis is caused by wear and tear of the articular cartilage, the white tissue lining the ends of the bone. This is known as degenerative arthritis or osteoarthritis.

Two joints within the shoulder can be affected by arthritis:

  • The acromioclavicular (AC) joint, located where the clavicle (collarbone) meets the acromion (roof of the shoulder joint).
  • The glenohumeral joint, located where the ball of the humerus (arm bone) meets the glenoid (socket).

How do you know if you have Shoulder Arthritis?

Shoulder arthritis can cause symptoms of joint pain, stiffness and weakness. During the clinical examination, Dr. Sussman localizes the source of pain using a number of tests such as x-rays and MRI to confirm the diagnosis.

What are the treatments for Shoulder Arthritis?

The goal of treatment is to control the pain using medication and a cortisone injection. In the past when traditional non-operative treatments failed, surgery was the only option recommended to patients. Dr. Sussman now offers minimally invasive alternatives to surgery.

PRP and stem cell injections for shoulder arthritis use a patient’s own platelets or stem cells to help accelerate healing and promote tissue regeneration. Learn more about PRP or stem cell injections here.

Viscosupplementation injections for Shoulder Arthritis can help with pain. Commonly used to treat knee pain, viscosupplementation injections were approved for treatment of the ankle and should in Europe in 2007. While the US Food and Drug Administration (FDA) has not yet approved viscosupplementation for the shoulder, Dr. Sussman does offer these injections for Shoulder Arthritis. Learn more about viscosupplementation here.


Frozen Shoulder/Adhesive Capsulitis

What is a Frozen Shoulder?

A frozen shoulder, or adhesive capsulitis, is a condition that causes pain and limits movement in the shoulder joint. Scar tissue or adhesions restrict the joint capsule causing it to become thickened a restricts shoulder motion.

Frozen shoulder is poorly understood. Anyone can get a frozen shoulder, but various triggers have been associated with adhesive capsulitis. Learn more here.

How do you know if you have a Frozen Shoulder?

A frozen shoulder can cause symptoms of joint pain and stiffness. This diagnosis is often missed early in the process. During the clinical examination, Dr. Sussman localizes the source of pain using a number of tests, and often the diagnosis can be made on clinical examination alone. X-rays and MRI can rule out alternative causes of shoulder pain.

What are the treatments for a Frozen Shoulder?

The goal of treatment is to control the pain and improve range of motion. Traditionally, treatments have included medication and cortisone injections. In the past when traditional non-operative treatments failed, surgery was the only option recommended to patients.

Dr. Sussman now offers minimally invasive alternatives to surgery, including platelet rich plasma/PRP injections and high volume dilation treatments. Learn more about adhesive capsulitis and alternatives to surgery here.