Shoulder & Elbow

Shoulder and elbow joints allow us to bend, flex, reach, and rotate our arms. However, repetitive overhead movements that are common to some sports and jobs frequently overstress the elbow and shoulder joints resulting in injury. When problems related to tendon tears, instability, fractures, arthritis and other conditions impede movement, both surgical and non-surgical treatments are considered to ease pain and help restore movement.

Our Services

• Arthritis Surgery in the Shoulder and Elbow
• Arthroscopy
• Distal Biceps and Triceps Ruptures
• Elbow Arthroscopy
• Elbow Fractures/Dislocations
• Elbow Replacement
• Elbow Sports Injuries
• Elbow Surgery
• Rotator Cuff Injuries
• Shoulder Fractures
• Shoulder Instabilities
• Shoulder Replacement
• Shoulder Sports Injuries
• Shoulder Surgery
• Tendonitis

Why the Rothman Orthopaedic Institute Shoulder & Elbow Team?

Considered one of the top programs for shoulder surgery in Philadelphia and nationally, Rothman Orthopaedic Institute's Shoulder and Elbow program provides highly specialized care to those experiencing arm pain in Philadelphia. Patients of the program benefit from the expertise of specialists who perform more than 3,000 procedures each year and pioneer advances in shoulder repair and replacement.

Tips for Healthy Elbows

Injuries are the most common cause of elbow pain. Some people may not recall having had a specific injury, especially if symptoms began gradually or during everyday activities.

Elbow injuries occur most commonly during:

• Sports or recreational activities
• Work-related tasks
• Work or projects around the home
• Falls

Older adults have a higher risk for injuries and fractures because they lose muscle mass and bone strength (osteoporosis) as they age. They also have more problems with vision and balance, which increase their risk for accidental injury. If you are looking for relief from arm pain, the experts at Rothman Orthopaedic Institute are equipped to take care of any shoulder and elbow conditions.

Tips for Healthy Shoulders

Although Rothman specialists can offer the best shoulder surgery Philadelphia physicians can provide, it is best to avoid surgery altogether if possible. To avoid experiencing shoulder pain, Philadelphia patients should keep physically fit with a balanced program of aerobics, stretching and strengthening all body parts to help to prevent shoulder injuries. If you think you have injured your shoulder, consult a physician or physical therapist before starting an exercise program. Here are some specific tips for the shoulders:

• Apply heat to shoulder muscles before exercise. Heat prepares muscles and tendons for exercise.
• Keep your arm below shoulder height while doing stretches for the shoulder.
• Gradually increase movements—big circles, across-body movements, trunk twists, shoulder blade rolls and forward and backward squeezes—during shoulder warm-up.
• Pendulum stretching exercises relieve pressure on the rotator cuff. While sitting or standing, keep arm vertical and close to the body. Allow arm to swing back and forth in a small diameter (about 1 inch). As symptoms improve, the diameter of swing may be increased. Initially perform the exercise with just the weight of your arm. As shoulder pain improves, progressively add more weight—5 to 10 pounds (a filled gallon container weighs 8 pounds). Perform exercise for 5 minutes once or twice a day.
• Muscle-strengthening exercises can be performed about 1 to 2 weeks after doing pendulum stretching exercises. Use elastic exercise bands for a variety of arm exercises. For example, attach band to a doorknob. Then hold your elbow close to your side at a 90 degree angle, grasp the band and pull toward your waist. Hold for 5 seconds. Do 15 to 20 repetitions each day.

Shoulder Anatomy

The shoulder is a ball and socket joint. The ball is called the head of the humerus and the socket is called the glenoid (it's part of your shoulder blade, also known as the scapula). Sometimes, arthritis can form here. On top of this ball and socket joint is another bone known as the acromion. This is a frequent place for bone spurs to form. Right next door to the acromion is the acromioclavicular joint or "AC joint" for short. This is a common place for shoulder separations.

A group of 4 muscles helps to move your shoulder joint; they are called the rotator cuff. These muscles work together to help get your arm up over your head, as well as rotate it in and out. That's why rotator cuff injuries usually result in weakness, especially in trying to raise the arm overhead. One of the 4 muscles is injured much more frequently than the others; it is known as the supraspinatus muscle.

In addition, these rotator cuff muscles function to help keep your shoulder "in socket", or "located" (when the shoulder comes out of socket, it's called "dis-located"). You have several ligaments in your shoulder that help to keep it in place. Finally, there's an "O-ring" around the socket, called the labrum, which also helps keep your shoulder in socket and causes pain and popping when it's torn.

Elbow Anatomy

The elbow is an example of a hinge joint or a joint moving in one direction permitting only flexion and extension. The elbow joint is formed by 3 bones ¾ the humerus of the upper arm, and the bones of the forearm: the radius laterally and the ulna medially. The joint is actually formed by the trochlea of the humerus articulating with the ulna and the capitulum of the humerus articulating with the head of the radius. Although there are two sets of articulations, there is only one joint capsule and a large bursa to lubricate the joint. An extensive network of ligaments helps the elbow joint maintain its stability.

The ligaments of the elbow joint include the ulnar collateral, and the radial collateral ligaments and the annular ligaments. Because so many muscles originate or insert near the elbow, it is a common site for injury. One common injury is lateral epicondylitis or "tennis elbow", which means inflammation surrounding the lateral epicondyle of the humerus. Six muscles that control backward movement (extension) of the hand and fingers originate on the lateral epicondyle.

Repeated strenuous striking while the muscles are contracted and against force such as that occurring with the backhand stroke in tennis causes strain on the tendinous muscle attachments and can produce pain around the epicondyle. Resting these muscles will usually bring about recovery.