Diagnosis

Shoulder Conditions

Understanding your diagnosis is the first step toward recovery.

The shoulder is the most mobile and complex joint in the body, which also makes it vulnerable to a wide range of conditions. Below is an overview of the most common shoulder problems I see and treat.

Common

Rotator Cuff Tears

The rotator cuff is a group of four muscles and tendons that stabilise the shoulder joint and enable overhead movement. Tears can develop from gradual wear over time (degenerative) or from sudden injury (traumatic). They are one of the most common causes of shoulder pain and weakness.

Common symptoms: Pain at rest and when lifting the arm, weakness in the shoulder, night pain that disturbs sleep, difficulty with overhead activities
Common

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder involves progressive stiffening of the shoulder joint capsule, leading to significant pain and restricted range of motion. It typically progresses through three stages: freezing (increasing pain), frozen (stiffness dominates), and thawing (gradual recovery). It is often misdiagnosed, making proper clinical assessment essential.

Key stages: Freezing — gradual onset of pain; Frozen — stiffness with reduced pain; Thawing — gradual return of movement
Sports Injury

Shoulder Instability & Dislocation

Shoulder instability occurs when the shoulder joint slips partially (subluxation) or fully out of place (dislocation). It is most common in young athletes participating in contact sports. Recurrent dislocations cause cumulative damage to the joint structures and can lead to long-term arthritis if untreated.

Common symptoms: Feeling of the shoulder "giving way", pain during overhead and throwing movements, visible deformity during a dislocation, apprehension with certain arm positions
Degenerative

Shoulder Arthritis

Shoulder arthritis involves the gradual loss of cartilage within the joint, leading to bone-on-bone contact. Types include osteoarthritis (wear and tear), inflammatory arthritis (rheumatoid), and post-traumatic arthritis (following a previous injury). When conservative measures fail, shoulder replacement surgery offers significant improvement.

Common symptoms: Gradual deep pain in the shoulder, stiffness and reduced range of motion, grinding or clicking sensation, pain worsening with activity
Sports Injury

SLAP Tears / Labral Injuries

The labrum is a ring of cartilage that deepens the shoulder socket and helps stabilise the joint. SLAP tears occur at the top of this ring where the biceps tendon attaches. They are common in throwing athletes and overhead sportspeople. An MRI arthrogram is usually needed for accurate diagnosis.

Common symptoms: Deep aching in the shoulder, catching or locking sensation, pain with overhead activities, decreased throwing performance in athletes
Trauma

AC Joint Injuries

The acromioclavicular (AC) joint sits at the top of the shoulder where the collarbone meets the shoulder blade. Injuries typically result from a direct fall onto the shoulder or a high-energy impact. They are graded I through VI based on severity — Grade IV and above often require surgical reconstruction.

Common symptoms: Pain and tenderness at the top of the shoulder, visible bump over the AC joint, pain when reaching across the body, difficulty with heavy lifting
Overuse

Biceps Tendon Conditions

The long head of the biceps tendon runs through the shoulder joint and is susceptible to inflammation (tendinitis), partial tears, and complete rupture. These conditions often occur alongside rotator cuff problems. Symptoms typically present as pain at the front of the shoulder.

Common symptoms: Pain at the front of the shoulder and upper arm, popping or snapping sensation, weakness when bending the elbow, visible bulge in the arm (with complete rupture)
Common

Shoulder Impingement Syndrome

Impingement occurs when the rotator cuff tendons are compressed or pinched underneath the acromion during arm elevation. It is one of the most frequently diagnosed causes of shoulder pain and often responds well to physiotherapy in early stages.

Common symptoms: Pain when lifting the arm to shoulder height, pain reaching behind the back, weakness in the shoulder, aching at rest that worsens at night
Trauma

Clavicle Fractures

Fractures of the collarbone are among the most common shoulder injuries, typically occurring after a fall on an outstretched hand or a direct blow to the shoulder. They are particularly common in cyclists, contact sport athletes, and trauma patients.

Common symptoms: Visible deformity over the collarbone, pain and swelling at the fracture site, difficulty moving the arm, bruising across the chest and shoulder
Trauma

Shoulder Fractures

Fractures of the upper arm bone (proximal humerus) near the shoulder joint, often resulting from falls, especially in older adults with osteoporosis. In younger patients, they typically result from high-energy trauma such as road traffic accidents or sports injuries.

Common symptoms: Severe pain in the shoulder, significant swelling and bruising, inability to lift the arm, tenderness around the upper arm

The information on this page is provided for general education only. It is not a substitute for a professional medical consultation. Please see a qualified surgeon for diagnosis and treatment advice specific to your condition.

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