Shoulder & Elbow: Injuries & Treatment

Key Takeaways

• Shoulder and elbow pain can come from many sources. The most common cause is tendonitis.
• Shoulder instability, rotator cuff tears and labral tears are among the most common conditions we treat — and often respond well to minimally invasive surgery.
• We prioritize nonsurgical care first. When surgery is needed, our orthopaedic specialists offer the full range of arthroscopic (minimally invasive) and open procedures.
• Our team works closely with physical and occupational therapists before, during and after treatment to help you regain full function and return to sports or daily activities as soon as possible.

When shoulder or elbow pain limits your movement, the University of Chicago Medicine offers advanced treatment options tailored to your needs. Our orthopaedic specialists treat the full range of shoulder and elbow conditions — from sports injuries like rotator cuff tears and shoulder instability to arthritis and complex reconstruction surgery.

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What Causes Shoulder and Elbow Pain?

Shoulder and elbow pain usually comes from injury or wear and tear on your bones, muscles or tendons. This can limit how well your arm moves and functions. The most common cause is tendonitis — when tendons become irritated or inflamed, often from overuse or repetitive motion.

Sports Medicine and Common Shoulder Conditions

• Shoulder instability: When the shoulder joint slips out of place (dislocates) or feels loose. This is one of the most common conditions we treat surgically, especially in active patients and athletes.
• Rotator cuff tears: The rotator cuff is a group of 4 muscles and tendons that hold your shoulder in place and help you lift and rotate your arm. A tear can happen suddenly (from a fall or injury) or gradually from overuse.
• Labral tears: The labrum is a ring of cartilage that helps keep your shoulder joint stable. Tears can happen from a dislocation or repetitive overhead activity. A SLAP tear is a specific type that occurs at the top of the labrum.
• Sports-related shoulder and elbow injuries: Including those from throwing, overhead sports, contact sports and other athletic activities.

Other Shoulder and Elbow Conditions We Treat

• Bone spurs (small bony growths that form along the edges of joints) in the shoulder or elbow — small bony growths that form along the edges of joints over time; they can rub against nearby tissue and cause pain or limited movement
• Frozen shoulder — stiffness and pain that limits how far you can move your arm
• Fractures (broken bones) in the shoulder or elbow
• Nerve damage in the shoulder or elbow
• Repetitive motion injuries
• Scapula winging — abnormal movement of the shoulder blade
• Shoulder and elbow arthritis — joint breakdown that causes pain and stiffness
• Tendinitis and bursitis — inflammation of tendons or the fluid-filled sacs (bursae) that cushion your joint
• Tennis elbow — pain on the outside of the elbow from overuse of the forearm muscles
• Shoulder muscle injury

If you have pain when lifting your arm or moving it forward or behind your back, our orthopaedic specialists can assess your symptoms, diagnose your condition and create a treatment plan.

Shoulder and Elbow Treatment and Surgery

We always start with nonsurgical options. Many shoulder and elbow conditions can be treated without surgery using:

• Rest, ice, compression and elevation (RICE)
• Physical therapy
• Anti-inflammatory medications and injections to reduce pain and swelling

When surgery is needed, we work with you to choose the right approach. Our goal is always to get you back to the activities you love as quickly and safely as possible.

Arthroscopic (Minimally Invasive) Surgery

Arthroscopic surgery uses a tiny camera and small tools inserted through very small cuts. Because it is minimally invasive, most patients have less pain, a shorter hospital stay and faster recovery than with open surgery. We strongly emphasize arthroscopic techniques for sports medicine conditions.

Arthroscopic procedures we offer include:

• Arthroscopic rotator cuff repair: Reattaching torn tendons using small instruments through tiny incisions
• Arthroscopic instability surgery: Tightening the ligaments to stabilize the shoulder joint and prevent future dislocations
• Labral repair: Reattaching the torn labrum (cartilage) to restore shoulder stability
• Shoulder arthroscopy for biceps, bone spurs and other injuries: Using a small camera and instruments to diagnose and treat damage inside the joint

Additional Surgical Options

• Latarjet procedure: Surgery that adds bone to the front of the shoulder socket to prevent repeat dislocations; often used for severe instability
• Tendon transfers: Moving a tendon from one place to another to restore movement when a tendon is too damaged to repair directly
• Elbow replacement surgery: Replacing the damaged elbow joint with an artificial implant to relieve pain and restore movement
• Revision surgery: Correcting or replacing a prior shoulder or elbow procedure that did not heal as expected
• Total shoulder replacement: Replacing both the ball and socket of the shoulder joint with artificial parts; a partial replacement (hemiarthroplasty) replaces only the ball
• Reverse shoulder replacement: Switching the position of the ball and socket so the deltoid muscle can lift the arm when the rotator cuff is severely torn

Shoulder Replacement: What You Should Know

Shoulder replacement is typically recommended for patients with severe arthritis, rotator cuff damage or a failed prior shoulder surgery. We offer several types, including:

Total Shoulder Replacement

Your shoulder is a ball-and-socket joint. The rounded end of the arm bone (the ball) fits into a cup-shaped opening in the shoulder blade (the socket). In a total shoulder replacement, the ball is replaced with a metal head on an artificial stem, and the socket is lined with a smooth plastic shell held in place with cement.

If only one part of the joint needs replacing, this is called a partial shoulder replacement (hemiarthroplasty). This may be an option if you have bone-on-bone osteoarthritis with healthy rotator cuff tendons.

Reverse Shoulder Replacement

In a reverse shoulder replacement, the ball and socket are switched: a metal ball is attached to the shoulder blade, and a plastic socket is attached to the upper arm bone. This allows you to use your deltoid muscle — instead of a torn rotator cuff — to lift your arm.

This procedure is typically used for patients who have a completely torn rotator cuff with severe weakness, severe arthritis combined with a torn rotator cuff, or a failed prior shoulder replacement.

The Copeland Shoulder

The Copeland Shoulder is a bone-preserving option for patients in the earlier stages of arthritis who have been told they are not yet candidates for a full shoulder replacement. Unlike a total shoulder replacement, it caps only the top of the arm bone (humerus), removing much less bone. It allows new bone to grow into the implant over time. This is often considered for younger patients who have had multiple prior shoulder surgeries.