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Anthony Romeo: Innovations of Shoulder Arthroplasty

Grand Rounds Video of Dr Tony Romeo Orthopaedics at Mass General Hospital, Boston, MA
Innovations of Shoulder Arthroplasty: What’s changed” What will we do about it?

Anthony Romeo, MD
Department of Orthopaedic Surgery
Rush University Medical Center, Chicago, IL
Grand Rounds presented on March 27, 2014 at the Massachusetts General Hospital, Boston, MA
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Jon JP Warner: Value-Driven Shoulder Care

Grand Rounds Video of Dr Jon JP Warner at Mass General Hospital, Boston, MAValue-Driven Shoulder Care: Alignment of Stakeholders
Jon JP Warner, MD
Department of Orthopaedic Surgery
Massachusetts General Hospital,
Boston, MA

Grand Rounds presented on October 31, 2013 at the O’Keeffe Auditorium, Massachusetts General Hospital, Boston, MA
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James Andrews: What I have Learned about the Throwing Shoulder

Grand Rounds Video of Dr James Andrews at Mass General Hospital, Boston, MAWhat I have Learned about the Throwing Shoulder
James Andrews, MD
Department of Orthopaedic Surgery,
University of Alabama Birmingham School of Medicine
Birmingham, AL

Grand Rounds presented on May 24, 2012 at the O’Keefe Auditorium, Massachusetts General Hospital, Boston, MA
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Wayne (Buz) Burkhead: Faces of Shoulder Pain

Wayne Buz Burkhead MGH Grand Rounds Faces of Shoulder PainFaces of Shoulder Pain
Wayne Z (Buz) Burkhead, MD
University of Texas Southwestern Medical School
The Carrell Clinic, Dallas, TX
Grand Rounds presented on Nov 18, 2010 at the O’Keefe Auditorium, Massachusetts General Hospital, Boston, MA
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Understanding Total Shoulder Replacement: A Patient Guide

Patients with severe shoulder arthritis are unable to move their arms through the full range of motion and consequently are unable to perform many activities of daily living. For these patients, total shoulder replacement is a proven surgical procedure relieving their pain, recovering their range of motion and allowing them to return to their active lifestyles.

In this video, Dr JP Warner from the Massachusetts General Hospital, Boston, MA, goes through the necessary examination and the surgical technique. He also points out that in 98% of the patients this is a very successful, proven procedure.

Scapular Exercises for Stronger Shoulders

Exercises for Strong and Healthy Shoulders
Shoulders permit our arms to move in a wide arc and perform elaborate activities. This mobility is due to superb coordination of muscles and soft tissues around the shoulder and shoulder blades (scapula, SKA-pew-la), and is essential for performing activities in a pain- and injury-free manner. See related article on Rotator Cuff complications impairing shoulder movement.

Conventional shoulder exercises strengthen the larger muscles but tend to overlook the mid-back muscles that stabilize the scapulas. This can often result in muscle imbalance and consequently, bad posture. Even non-shoulder exercises like running on a treadmill with shoulders slouched can lead to stiffness and pain. These conditions increase injury potential and thus the need for corrective exercises.

Michael Bento, personal trainer at the Clubs at Charles River Park, Boston, demonstrates simple exercises you can do at home to develop shoulder strength and protect them from injury. As a bonus, these exercises also help tone the all important core muscles.

These exercises can be performed on a stability ball as shown, or on a work bench. Dumbbells or additional weights are not required. And as I surprisingly found out last week, you can do these scapular exercises while standing and starting with the arms in front! Yaay!


Common Starting Position for Shoulder-Scapula Exercises
scapular exercises

  • Anchor heels to a wall, toes on the floor and slowly roll out on a stability ball.
  • Rest upper abdomen on the ball and straighten body forming a line from ears to ankles.
  • Pull your shoulder blades down, tuck your chin and look at the floor.
  • Start with arms straight, hands in front of the ball (or bench), fingers lightly curled, palms facing each other and thumbs pointing forward.
  • In this position, your core muscles including abdominal and gluteus muscles are engaged in stabilizing your body.
  • For a challenging core-muscle workout, move your heels away from the wall as demonstrated above and use as starting position.

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Rotator Cuff Disease

Primary Cause of Shoulder Pain and Treatment Options.

There are several causes of shoulder pain. In the elderly, shoulder pain is commonly associated with aging and can be traced to rotator cuff disease. In younger people, it is associated with throwing or overhead sporting activities that result in injury to the rotator cuff.

rotator cuff anatomy

The rotator cuff is a band of four muscles and tendons at the shoulder joint, which grasp the end of the upper arm or humerus (HYU-mer-us, see figure), much like four fingers holding a baseball. The rotator cuff thus stabilizes the shoulder joint and provides exceptional mobility to the arm. Pinching, irritation, or tears of the rotator cuff are common causes of shoulder pain.

shoulder rotator cuff anatomy holding baseball

Impingement
Rotator cuff tendons are separated from overlying bones by a soft tissue sac or bursa, allowing them to glide easily. According to one theory, repetitive motion of the arm causes pinching of this sac in the tight space between the acromion (a-KRO-me-un) and humerus (see figure), resulting in irritation, swelling and pain. This inflammation of the bursa and tendons is called impingement. The pain is characteristically worse when the arm is lifted and common at night.

Causes and Symptoms
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