A dislocated shoulder is a traumatic and painful injury, typically caused due to a fall or during contact sports. In a dislocated shoulder condition, the upper arm bone will move away from its normal position along with damage to the surrounding muscles, tendons and ligaments.

A shoulder dislocated requires prompt medical attention. A full rehabilitation program is essential if the athlete is to avoid re-injuring the shoulder. Profound, dedicated, and board certified orthopedic surgeons at the Bigler Knee & Shoulder Institute provide treatments for dislocated shoulder to patients in Las Vegas, Nevada, and surrounding communities.

Symptoms

The patient will experience sudden severe pain at the time of injury. Bruising and swelling will develop later. The patient may feel the shoulder is popping out of the joint and the injured side will often look different or slightly lower than the other side. The patient will typically avoid moving or turning the arm outwards. If any nerve or blood vessel damage has occurred, the patient may experience a sensation of pins and needles, numbness or discoloration through the arm to the hand.

Causes

A dislocated shoulder is often caused by a fall onto an outstretched arm, twisting or impact to the shoulder. The dislocation takes place when the head of the humerus bone pops out of the shoulder joint.

They are usually either posterior where the head of the upper arm bone or humerus dislocates out of the back of the joint or more commonly anterior where it pops out forwards. The large range of movement available in the shoulder joint makes it particularly vulnerable to injury.

Treatment

To protect the shoulder joint from further damage, once an injury occurs, the patient should not move the shoulder joint. If possible, the shoulder should be immobilized in a sling. Ice packs can be used to improve pain and swelling. Ice therapy can be repeated every hour initially.

Reduction

Reduction is a form of treatment that involves putting the dislocated humerus bone back into the joint. Reduction should only be performed by a fully trained medical professional. The orthopedic surgeon may seek an x-ray before reduction to rule out any small fractures. For active adults below the age of 30, reduction can be a very effective solution for shoulder dislocation.

Immobilization

The shoulder is typically immobilized in a sling in medial rotation with the arm across the body until the tissues have healed. Mobility and strength of the shoulder will be restored after a comprehensive rehab process. The shoulder may be immobilized in a string for a week following a reduction. In case of severe tissue damage, the duration of immobilization may be longer.

Surgery

If the shoulder dislocation recurs, or if the bones are fractured, the patient may require surgery. Surgery should ideally be performed as soon as possible after the injury. Several surgical techniques can be used to treat shoulder dislocation. The choice of technique will depend primarily on the patient’s lifestyle and activity.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide shoulder dislocation treatments to patients in Las Vegas, Nevada, and other cities and towns in The Battle Born State.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.

The glenoid labrum is a fibrous ring of tissue that is attached to the rim of the glenoid which is the shallow depression of the scapula or shoulder blade where the ball of the humerus or arm bone sits. The glenoid labrum increases the depth of the shoulder cavity, which helps improve the stability of the shoulder joint.

The glenohumeral ligaments, which secure the upper arm to the shoulder and shoulder capsule, attach to the glenoid labrum. If a tear in the glenoid labrum occurs due to an injury or repetitive use, it must be treated in a timely manner to prevent worsening of the injury.

Board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide treatments for glenoid labrum tear to patients in Las Vegas, Nevada and other neighborhoods and communities in this part of southwest.

Nature of Injury

The glenoid labrum tears typically occur due to repetitive overhead throwing, lifting or catching heavy objects below shoulder level. This injury may also occur when a person falls onto an outstretched arm. These tears can be categorized as either superior, towards to the upper end of the glenoid socket, or inferor towards to the lower end of the socket.

A superior injury is known as a SLAP lesion (superior labrum, anterior to posterior). It involves a tear of the rim above the middle of the socket that may also involve the biceps tendon.

A tear of the rim beneath the middle of the glenoid socket is called a Bankart lesion, which also involves the inferior glenohumeral ligament. In many cases, glenoid labrum tears may occur with other shoulder injuries, such as a shoulder dislocation.

Symptoms

Symptoms of a glenoid labrum tear include pain in the shoulder that is not localized to a particular point. Overhead activities tend to worsen this pain. If the arm is held behind the back, it may increase the pain.

Many patients will complain of instability and weakness in the shoulder with specific tenderness above the front of the shoulder. Pain may be reproduced on resisted flexion of the biceps or bending the elbow against resistance

Treatment

PRICE therapy is the first line of treatment for glenoid labrum injuries. The patient should give adequate rest to the injured site, and apply ice therapy to improve pain and inflammation. It is important to see an orthopedic surgeon, who may prescribe NSAIDs such as ibuprofen after assessing the patient’s condition as well as their health factors.

Most patients will require a comprehensive and gradual rehabilitation program to restore full function. It is important address any underlying causes that may have contributed to the injury, such as shoulder instability.

Surgery

If the injury is severe, causing instability, a surgery may have to be performed to restore full shoulder health. The surgery will aim to re-attach the labrum to the glenoid. Surgery is often necessary in case of Bankart lesions.

Following the surgery, the shoulder will have to be placed in a sling for about a month. Percipient, wonderful, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and other suburbs and cities in this region of the nation for shoulder injuries.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.

A tear to any of the four rotator cuff muscles in the shoulder is called a rotator cuff strain or tear. The injury is common in throwing and racket sports, and may range from mild to severe. The job of the rotator cuff is to rotate the arm at the shoulder and provider support around the joint.

Treatment in case of rotator cuff tears will begin by reducing pain and inflammation, followed by a comprehensive rehabilitation program including mobility and specific exercises to strength the muscles. Salient, dependable, and board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide treatments for rotator cuff tears to patients in Las Vegas, Nevada and surrounding locations in this area of the southwest.

Symptoms

Symptoms of a rotator cuff tear will include sudden pain in the shoulder, which may be accompanied by a feeling of tearing. The pain may radiate down into the arm.

Signs of shoulder impingement may occur where the tendon pinches between the ball and socket of the shoulder joint when moving the arm out over head height. Pain may worsen over time and weakness in the shoulder may progress to a point where the patient is unable to lift the arm up to the side.

PRICE Therapy

The basic first aid for a rotator cuff tear in the muscle or tendon involves rest and application of PRICE principles – protection, rest, ice, compression, and elevation. Ice or cold therapy should be applied quickly to stop the swelling, inflammation and pain from worsening. The patient can use ice therapy for 10 minutes every hour, reducing it to three to four times a day as pain mitigates.

For more severe rotator cuff injuries, a sling can sometimes be more useful. Once the acute phase has passed, the patient can begin mobility and strengthening exercises as long as no pain occurs. If the PRICE efforts do not help to eliminate the pain and restore the shoulder movement, the patient will require professional medical treatment.

Orthopedic Treatment

To start with, an orthopedic surgeon may prescribe pain relief and anti-inflammatory drugs to address a rotator cuff tear. The surgeon may order imaging studies such as x-rays or MRI to determine the exact diagnosis and rule out a fracture. Some patients may have to receive a steroid injection directly into the site of the problem to help improve inflammation and enable the patient to proceed with rehabilitation.

Once the pain is eliminated, the surgeon will recommend a full rehabilitation program including stretching and strengthening exercises. Shoulder massage, including cross friction massage, to the rotator cuff tendon can break the injury down to its acute stage to allow correct healing of the injury to occur.

Range of motion and mobility exercises in the shoulder joint should start as soon as these can be performed without any pain. The first priority is pendulum exercises, particularly if it is a severe tear or following surgery. Stellar, committed, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas in this part of southeast Nevada for rotator cuff injury treatments and surgery.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.

A shoulder injury may be acute or chronic depending on when it is diagnosed and the duration for which the shoulder pain has persisted. An acute shoulder injury may occur by way of direct impact, overstretching of a muscle, tendon or ligament, overuse of a muscle or tendon, or twisting of the shoulder joint.

Outstanding, dedicated, and board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide treatments for shoulder pain to patients in Las Vegas, Nevada, and surrounding communities and cities in this part of The Silver State.

Glenoid Labrum Tear

The glenoid labrum refers to a fibrous ring of tissue that is attached to the rim of the glenoid shallow hole or socket of the shoulder blade where the ball of the humerus or arm bone sits.

Dislocated Shoulder

A dislocated shoulder is a common injury that is typically painful and traumatic. Contact sports or a fall are the common causes of this condition.

AC Joint Separation

An AC joint sprain or AC joint separation refers to an injury occurring in the ligament that holds the acromioclavicular joint together at the top of the shoulder. A fall onto an outstretched arm will often cause this injury.

Frozen Shoulder

Frozen shoulder, clinically known as adhesive capsulitis, refers to a condition that causes pain and restricts movement in the shoulder joint.

Shoulder Impingement Syndrome

Impingement syndrome is sometimes called swimmer’s shoulder or thrower’s shoulder. If the tendons of the rotator cuff become impinged as they pass through the shoulder joint, this condition may occur.

Winged Scapula

This is not an injury itself, but a symptom of another condition. It is where the shoulder blade protrudes out on the back, rather than laying flat against the back of the chest wall.

Deltoid Muscle Strain

An injured deltoid muscle can cause pain at the front, side or back of the shoulder.

Bruised Collarbone

A clavicle contusion, commonly known as a bruised collarbone, may occur due to a direct impact to the collar bone at the front of the chest or shoulder.

Shoulder Subluxation

Shoulder subluxation or shoulder instability is caused when partial dislocation of the shoulder occurs. The shoulder joint by its nature allows a large range of movement which means it is likely to be less stable.

Subscapularis Inflammation

The subscapularis is a strong muscle that rotates the arm inwards and is part of the rotator cuff group of muscles. A thrower may typically sustain this injury, which can be stubborn to treat.

Shoulder Tendonitis

This is a degenerative condition of any of the tendons surrounding the shoulder joint. It often occurs in the rotator cuff tendons, but may sometimes occur in the biceps and triceps tendons.

Posterior Shoulder Dislocation

This is a rare shoulder injury as most shoulder dislocations are anterior. A posterior dislocation of the shoulder occurs when the head of the humerus moves backwards out of the socket.

Shoulder Sprain

Damage to the shoulder ligaments or capsule that support the shoulder joint is called a shoulder sprain. It may be stretching of the fibers or partial to full tears of the ligaments or joint capsule.

Poignant, reliable, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas across the horizon for shoulder pain.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.

Lateral knee pain refers to the pain that occurs on the outside of the knee. It develops gradually, unlike an acute knee joint or ligament injury. Iliotibial band friction syndrome and lateral cartilage injuries are two of the most common causes of outside knee pain.

Iliotibial Band Syndrome

Iliotibial band syndrome refers to inflammation of the Iliotibial band on the outside of the knee when it rubs against the outside of the knee joint. Symptoms include pain occurring on the outside of the knee, which can get progressively worse. The athlete will be required to rest for a period of time until the symptoms dissipate.

Lateral Meniscus Tear

Lateral meniscus tear refers to an injury to the semi circular cartilage on the outside of the knee joint. Pain and tenderness around the outside surface of the knee will occur in this case. The knee joint is cushioned and supported by two crescent shaped cartilage menisci. These can be injured due to a traumatic injury or twisting as well as gradual degeneration.

Peroneal Nerve Contusion

The peroneal nerve is a branch of the sciatic nerve which runs down the outside of the lower leg, serving the peroneal muscles which help pull the foot upwards and inwards. Tingling and numbness in the lower leg is a common symptom, and it is often caused by a blow to the outside of the knee.

Proximal Tibiofibular Joint Dislocation

In many cases, dislocation of the proximal tibiofibular joint occurs when the athlete sustains an impact or falls with their knee in a fully bent position. It is an injury to the joint at the top of the shin where the two shin bones meet at the knee.

Less Common Causes of the Lateral Knee Pain

Osteoarthritis

Osteoarthritis of the knee refers to the wear and tear on the knee joint. In a case where this condition occurs in the lateral compartment or outside of the knee, the patient may experience a deep aching pain in the inner knee that worsens after exercise.

In the morning, the patient may often suffer from stiffness in the knee joint. But this can reduce with movement as the joint produces lubricating synovial fluid. The patient may experience knee swelling or a cracking or clicking sound when moving the knee.

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome typically causes pain at the front of the knee. However, it may also cause pain on the outside of the knee as the outside of the patella rubs on the bone underneath. The knee will often have swelling, and pain will emerge gradually over time.

Biceps Femoris Tendonitis

Biceps femoris tendonitis refers to inflammation of one of the hamstring muscles at its point of attachment at the back and outside of the knee. It is marked by swelling and tenderness at the point where the bone and tendon attach. The patient may experience pain when bending the knee against resistance with stiffness after exercise and in the mornings.

Astute, marvelous, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and other neighborhoods and suburbs in The Sagebrush State for outside knee injuries.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.

Patella, or kneecap, may fully or partially dislocate outside of its regular position, usually around the outside of the knee. The patient will experience pain and swelling in the knee joint along with an obvious displacement of the kneecap.

Outstanding and salient board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide advanced treatments for patella dislocation to patients in Las Vegas, Nevada and other towns and communities in this area of the southwest.

How the Dislocation Occurs

The patella typically lies within the patella-femoral groove. It is designed only to slide vertically within the groove. However, when the patella moves or is moved to the outside of this groove, a dislocation takes place. With the dislocation, the patella moves onto the bony head of the femur, which is clinically called the lateral femoral condyle.

In some cases, the patella may not fully dislocate, but may sublux, which means it moves partially out of its normal position. Patients should note that a patella dislocation is different from the dislocation of the knee joint itself, which is a significantly more severe and traumatic injury.  

Conservative Treatment of Patella Dislocation

Following a patella dislocation, the surgeon may recommend application of the RICE principles to the injured knee. This involves rest, ice, compression and elevation. The patient can apply ice for about 10 to 15 minutes every hour in the beginning, and reduce it to two or three times a day as the symptoms and swelling subside.

The patient must take a rest break from any sporting activity. An athlete who has experienced one episode of patella dislocation is usually vulnerable to another dislocation. A knee support can be used to protect the joint. The patient may use patella stabilizing braces that are specially designed to support the kneecap.

Once the acute symptoms have been resolved, the patient will require a full knee strengthening rehabilitation program to help avoid future recurrence. This will include specific exercises for the vastus medialis muscle on the inside of the quadriceps.

Treatment for Severe Cases

An orthopedic surgeon specializing in sports medicine will first confirm the diagnosis of patella dislocation. The symptoms of this condition can sometimes be similar to an ACL injury due to an audible crack or pop up sound, and the feeling of the knee giving away.

The surgeon will address the pain by prescribing anesthetic medication and repositioning the patella if it has not already relocated. NSAIDs such as ibuprofen may be prescribed to mitigate pain, swelling and inflammation.

Patella-femoral taping techniques may be used in some cases to provide additional support for the patella. This becomes particularly useful if the patient wants to be mobile and there is a risk of further dislocations. The surgeon may order diagnostic imaging tests such as an x-ray or MRI, or perform an arthroscopy to determine the precise extent of the injury.

Surgery may be recommended in a situation if there are loose fragments of the bone or other serious structural damage to the knee. Sterling and astute board certified orthopedic surgeons at Thomas & Bigler Knee & Shoulder Institute receive patients from Las Vegas, Nevada and other neighborhoods and communities in The Battle Born State for the treatment of patella dislocation.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. call (702) 933-9393; Physical Therapy (702) 933-9393.