Patient Education
Shoulder conditions
What causes each shoulder condition, how it feels, and the treatment options available. Select a condition to read more.
Shoulder Care3 min readShoulder Dislocations
The shoulder is the most mobile — and most commonly dislocated — joint in the body. Understanding why it happens and what raises the risk of it happening again.
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What happens
In a dislocation the ball of the shoulder comes completely out of the socket, usually forwards, after a fall onto an outstretched arm or a tackle with the arm out to the side. Coming out stretches or tears the labrum and capsule that hold the joint in place, and can chip bone from the socket or dent the ball.
Symptoms
Immediate severe pain with the arm held away from the body, obvious deformity, and inability to move the shoulder. After relocation, patients often describe a lasting sense of apprehension when the arm is raised and rotated outwards, and repeated 'slipping' episodes.
Treatment
The shoulder is relocated urgently, then rested in a sling for a short period followed by physiotherapy. Younger patients — especially those under 25 in contact sport — have a high chance of recurrence, and stabilisation surgery is often recommended after a first or second dislocation. Older patients are more likely to tear the rotator cuff at the same time and need an ultrasound or MRI.
Shoulder Care3 min readRotator Cuff Tears
The four rotator cuff tendons stabilise the shoulder and lift the arm. Tears are one of the most common causes of persistent shoulder pain and night pain.
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What happens
Tendons can tear suddenly with a fall or lifting injury, or wear through gradually with age and repeated overhead use. Tears range from partial thickness fraying to large tears involving several tendons.
Symptoms
Pain over the outer arm, worse at night and when lying on that side; weakness lifting, reaching or rotating; and clicking or catching with movement.
Treatment
Not every tear needs surgery. Physiotherapy, activity modification, anti-inflammatories and a targeted injection help many degenerate tears. Where weakness persists, the tear is acute, or the patient is younger and active, arthroscopic repair reattaches the tendon to bone. Irreparable tears may be treated with a balloon spacer, tendon transfer or reverse shoulder replacement.
Shoulder Care3 min readACJ Separation (Shoulder Separation)
An injury to the joint between the collarbone and the shoulder blade, typically after a fall directly onto the point of the shoulder.
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What happens
The acromioclavicular joint and, in higher grades, the coracoclavicular ligaments are torn, allowing the collarbone to rise relative to the shoulder blade and creating a visible step.
Symptoms
Pain and tenderness over the top of the shoulder, a lump or step deformity, pain when reaching across the body, and weakness lifting overhead.
Treatment
Low-grade separations settle with a sling, pain relief and physiotherapy, usually with an excellent outcome even if a bump remains. High-grade or unstable injuries — and injuries in overhead workers and athletes — may be treated with reconstruction of the coracoclavicular ligaments. Chronic painful joints can be treated with injection or excision of the joint end.
Shoulder Care3 min readShoulder Arthritis
Wear of the smooth cartilage lining the ball and socket causes deep, aching shoulder pain, grinding and progressive stiffness.
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What happens
Cartilage thins through osteoarthritis, previous fracture or dislocation, inflammatory arthritis, or long-standing rotator cuff tears (cuff tear arthropathy). Bone spurs form and movement is progressively lost.
Symptoms
Deep pain in the shoulder and upper arm, night pain and disturbed sleep, grinding or creaking with movement, and difficulty reaching behind the back or overhead.
Treatment
Activity modification, physiotherapy, simple analgesia and corticosteroid or hyaluronic injections help early disease. When pain becomes limiting and X-rays show advanced wear, shoulder replacement — anatomic where the cuff is intact, reverse where it is not — gives reliable pain relief and improved function.
Shoulder Care3 min readFractures Around the Shoulder: Clavicle & Humerus
Collarbone and upper arm fractures are common after falls, cycling accidents and sport. Many heal without surgery — some do better with fixation.
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Clavicle fractures
Most collarbone fractures heal in a sling over 6–12 weeks. Fixation is considered where the bone is markedly displaced or shortened, the skin is threatened, the fracture is open, or in athletes and manual workers wanting a faster, more reliable recovery.
Proximal humerus fractures
Fractures of the top of the upper arm bone are common in older patients with osteoporosis. Undisplaced fractures are treated in a sling with early physiotherapy. Complex or displaced fractures may need plate fixation, and in older patients with poor bone quality a reverse shoulder replacement often gives the most predictable result.
Recovery
Expect a sling for the first weeks, early gentle movement to prevent stiffness, X-rays to confirm healing, and several months before full strength returns. Stiffness is the main long-term issue after complex fractures.
Shoulder Care3 min readFrozen Shoulder (Adhesive Capsulitis)
A painful, progressively stiff shoulder that often develops without any injury — more common in diabetics and in people aged 40–60.
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What happens
The capsule surrounding the joint becomes inflamed, thickened and contracted. The condition passes through a painful freezing phase, a stiff frozen phase, and a gradual thawing phase, often over 12–24 months.
Symptoms
Severe pain, especially at night, followed by marked loss of movement in all directions — particularly rotating the arm outwards and reaching behind the back. Movement is limited whether you move the arm yourself or someone else moves it.
Treatment
Most cases resolve with time, analgesia, guided physiotherapy and a corticosteroid injection or hydrodilatation, which is most effective in the painful phase. Persistent stiffness that does not respond can be treated with arthroscopic capsular release or manipulation under anaesthetic. Good blood sugar control is important in diabetics.
Shoulder Care3 min readShoulder Impingement, Bursitis & Tendinitis
Painful pinching of the rotator cuff tendons and bursa beneath the acromion — the most common cause of shoulder pain in active adults.
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What happens
The space between the acromion and the rotator cuff narrows through bone spurs, thickening of the bursa, or altered shoulder blade mechanics. The tendons and bursa become inflamed and painful with repeated overhead activity.
Symptoms
A painful arc when raising the arm to shoulder height, pain reaching overhead or behind, night pain lying on the shoulder, and aching over the outer arm rather than the joint itself.
Treatment
Most patients improve with a structured physiotherapy programme addressing posture, shoulder blade control and cuff strength, along with anti-inflammatories and activity modification. A subacromial corticosteroid injection can break the pain cycle. Arthroscopic decompression is reserved for the minority whose symptoms persist despite good rehabilitation, and imaging is used to exclude a cuff tear.
Have questions about your condition?
These articles are for general education only. For personalised advice about your shoulder or knee concern, please contact the rooms or speak with your GP.