The shoulder and elbow are among the body’s weakest joints; they are likewise among the most heavily used. As aging, overuse, trauma and orthopedic conditions take their toll on these critical components, pain, soreness and reduced mobility can emerge.
The painful symptoms of shoulder and elbow conditions can have a great impact on lifestyle. For athletes and adventurers in the Aspen area, this means an impaired ability to participate in activities, including skiing, snowboarding, mountain biking, rock climbing and more. For many professionals, it may mean an inability to perform necessary workplace tasks. And for all affected patients, shoulder and elbow symptoms severely compromise the ability to enjoy life to its fullest.
Comprehensive orthopedic issues require comprehensive solutions. At OrthoAspen, our shoulder and elbow specialists are trained to evaluate, diagnose and perform conservative as well as surgical treatment for all shoulder, elbow and upper extremity conditions. By seeking treatment in the shoulder and elbow at the first signs of pain, you can often avoid surgery. If your pain is diagnosed early, it can often be eliminated through the help of strengthening exercises and physical therapy.
Treatment plans at OrthoAspen are specialized and patient-centric, meaning each step of the shoulder and elbow treatment process is designed and adapted to address the specific conditions of your physiology and the particular symptoms you are experiencing. From osteoarthritis to shoulder dislocations and rotator cuff tears, we provide advanced care and effective solutions for the full range of orthopedic issues that affect shoulder and elbow patients.
The shoulder is the most flexible joint in the body enabling a wide range of movements including, forward flexion, abduction, adduction, external rotation, internal rotation and 360-degree circumduction.
Thus, the shoulder joint is considered the most insecure joint of the body, but the support of ligaments, muscles and tendons function to provide the required stability.
The shoulder is a ball and socket joint made up of three bones, namely the humerus, scapula and clavicle.
The end of the humerus, or upper arm bone, forms the ball of the shoulder joint. An irregular shallow cavity in the scapula called the glenoid cavity forms the socket for the head of the humerus to fit in. The two bones together form the glenohumeral joint, which is the main joint of the shoulder.
The scapula is a flat, triangular-shaped bone that forms the shoulder blade. It serves as the site of attachment for most of the muscles that provide movement and stability to the joint. The scapula has four bony processes—acromion, spine, coracoid and glenoid cavity. The acromion and coracoid processes serve as places for attachment of the ligaments and tendons.
The clavicle bone or collarbone is an S-shaped bone that connects the scapula to the sternum or breastbone. It forms two joints: the acromioclavicular joint, where it articulates with the acromion process of the scapula, and the sternoclavicular joint where it articulates with the sternum or breastbone. The clavicle also forms a protective covering for important nerves and blood vessels that pass under it from the spine to the arms.
The ends of all articulating bones are covered by smooth tissue called articular cartilage which allows the bones to slide over each other without friction enabling smooth movement. Articular cartilage reduces pressure and acts as a shock absorber during movement of the shoulder bones.
Extra stability to the glenohumeral joint is provided by the glenoid labrum, a ring of fibrous cartilage that surrounds the glenoid cavity. The glenoid labrum increases the depth and surface area of the glenoid cavity to provide a more secure fit for the half-spherical head of the humerus.
Ligaments are the thick strands of fibers that connect one bone to another. The ligaments of the shoulder joint include:
The rotator cuff is the main group of muscles in the shoulder joint and is comprised of 4 muscles. The rotator cuff forms a sleeve around the humeral head and glenoid cavity, providing additional stability to the shoulder joint while enabling a wide range of mobility.
The deltoid muscle forms the outer layer of the rotator cuff and is the largest and strongest muscle of the shoulder joint.
Tendons are strong tissues that join muscle to bone allowing the muscle to control the movement of the bone or joint. Two important groups of tendons in the shoulder joint are the bicep tendons and rotator cuff tendons.
Bicep tendons are the two tendons that join the bicep muscle of the upper arm to the shoulder. They are referred to as the long head and short head of the bicep.
Rotator cuff tendons are a group of four tendons that join the head of the humerus to the deeper muscles of the rotator cuff. These tendons provide more stability and mobility to the shoulder joint.
Nerves carry messages from the brain to muscles to direct movement (motor nerves) and send information about different sensations such as touch, temperature and pain from the muscles back to the brain (sensory nerves). The nerves of the arm pass through the shoulder joint from the neck.
These nerves form a bundle at the region of the shoulder called the brachial plexus. The main nerves of the brachial plexus are the musculocutaneous, axillary, radial, ulnar and median nerves.
Blood vessels travel along with the nerves to supply blood to the arms. Oxygenated blood is supplied to the shoulder region by the subclavian artery that runs below the collarbone. As it enters the region of the armpit, it is called the axillary artery and further down the arm, it is called the brachial artery. The main veins carrying deoxygenated blood back to the heart for purification include:
The elbow is a complex joint formed by the articulation of three bones—the humerus, radius and ulna. The elbow joint helps in bending or straightening of the arm to 180 degrees and assists in lifting or moving objects.
The bones of the elbow are supported by
The elbow joint is formed at the junction of three bones:
The elbow consists of three joints from articulation of the three bones, namely:
Articular cartilage lines the articulating regions of the humerus, radius and ulna. It is a thin, tough, flexible and slippery surface that acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables the smooth movement of the bones.
There are several muscles extending across the elbow joint that help in various movements. These include the following:
The elbow joint is supported by ligaments and tendons, which provide stability to the joint. Ligaments are a group of firm tissues that connect bones to other bones. The most important ligaments of the elbow joint are the:
Together, the medial and lateral ligaments are the main source of stability and hold the humerus and ulna tightly in place during movement of the arm.
The ligaments around a joint combine to form a joint capsule that contains synovial fluid. Any injury to these ligaments can lead to instability of the elbow joint.
Tendons are bands of connective tissue fibers that connect muscle to bone. The various tendons which surround the elbow joint include:
The main nerves of the elbow joint are the ulnar, radial and median nerves. These nerves transfer signals from the brain to the muscles that aid in elbow movements. They also carry the sensory signals like touch, pain and temperature back to the brain. Any injury or damage to these nerves causes pain, weakness or joint instability.
Arteries are blood vessels that carry oxygen-pure blood from the heart to the hand. The main artery of the elbow is the brachial artery that travels across the inside of the elbow and divides into two small branches below the elbow to form the ulnar and the radial artery.