Shoulder
Epworth has a team of highly skilled orthopaedic surgeons and physical therapists who specialise in treating shoulder conditions.
Overview
Orthopaedic units at Epworth have dedicated teams of nursing, medical and allied health staff to expertly manage all orthopaedic conditions and are supported by radiology facilities, including MRI and CT scans, pharmacology and pathology services.
What is the shoulder joint?
The shoulder has two joints, the glenohumeral joint and the acromioclavicular joint. The glenohumeral joint allows for a wide range of movement in the shoulder. The shoulder is also made up of several key structures, such as the rotator cuff and deltoid. The three shoulder bones include the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle).
Can surgery treat shoulder pain?
There are several minimally invasive surgeries that can treat shoulder pain. If you are experiencing chronic shoulder pain, we recommend you speak with your doctor and evaluate the possible benefits you could achieve from shoulder surgery.
When should I have shoulder surgery?
If you’ve recently suffered a shoulder injury, you may experience pain or weakness that requires immediate surgery. Alternatively, you may also require surgery if you have recurrent pain from a shoulder condition and are finding it difficult to do everyday activities such carry items or raising your arm. In that case, our orthopaedic surgeons may recommend surgical treatment to increase mobility and reduce pain.
Conditions
Below is a list of common shoulder injuries and conditions. Most shoulder problems involve the ligaments, tendons, and muscles rather than the bones.
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Torn rotator cuffA torn rotator cuff is when one or more of the four tendons become partially or entirely detached from your shoulder bone, limiting your ability to raise or rotate your impacted arm. A torn rotator cuff might have occurred during a bad fall or caused by normal ageing wear and tear.
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Dislocated shoulder and hyperlaxityA dislocated shoulder is when the head of the upper arm bone dislocates from the socket. A dislocated shoulder can happen during a traumatic event such as a sporting injury, fall or road accident. A condition called hyperlaxity (shoulder instability), where the ball of the joint can move excessively on the socket and may lead to repeated shoulder dislocations.
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Frozen shoulderFrozen shoulder is a condition that causes stiffness and pain in your shoulder joint and may be caused following an extended time without shoulder movement, such as a broken arm. A frozen shoulder can improve with rest and steroid injections. If your frozen shoulder persists past 18 months, your doctor may recommend surgical intervention.
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Clavicle fractureA clavicle fracture, also known as a fractured collarbone, typically occurs after a high-impact fall. A clavicle fracture can often heal with rest, medication, physiotherapy, and a sling. However, surgery may be required if the bones are drastically misaligned.
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Arthritis of the shoulderFive types of arthritis typically affect the shoulder. Osteoarthritis is the most common form and occurs when the cartilage in the shoulder joint gradually wears away over time. This can lead to pain as the joint can’t move as easily.
Diagnosis
Evaluation for shoulder surgery
Once you have received a referral from your GP, you will be able to book an appointment with an Epworth specialist. Your specialist will then assess your X-rays, medical history and physical exam to provide personalised treatment options.
Medical imaging
- During the early stages of investigation, your doctor will likely arrange X-rays or Magnetic Resonance Images (MRIs) images to examine your bones and cartilage.
Medical history
- Your specialist will ask you questions about your symptoms, ability to perform everyday activities, pain level and general health.
Physical exam
- During your consultation, your doctor will perform a physical exam to assess your shoulder mobility and strength.
Shoulder arthroscopy
- To formally diagnose a shoulder joint condition, your doctor may arrange shoulder arthroscopy surgery. Learn more about this procedure on our treatment section below.
Fees
When booking an appointment with your specialist, you can speak with their administrative team to understand the fee for the consultation. We then recommend speaking with your insurance company to determine your out-of-pocket costs.
Treatment
Depending on a range of factors, your doctor will advise which type of shoulder treatment is best for you.
Shoulder treatment examples:
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Non-surgical treatmentDepending on your injury or condition, you may be recommended to make lifestyle changes or non-surgical interventions such as pain medication or steroid injections. Physical therapy and rehabilitation may also be suitable to help you manage the symptoms associated with your condition. If non-surgical options are no longer reducing your symptoms, we encourage you to speak with your doctor about alternative treatment.
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Shoulder replacementThere are many conditions or injuries which may require a shoulder reconstruction. The most common is long-term arthritis which has impacted your quality of life. Shoulder replacement, also known as shoulder reconstruction surgery, aims to improve movement, quality of life and reduce pain by replacing damaged bones or cartilage with artificial parts.
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Total shoulder replacementTotal replacement surgery is recommended for patients with extensive shoulder damage or pain. This surgery will replace both sides of the shoulder joint, ball, and socket.
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Reverse shoulder replacementA reverse should replacement may be recommended if you have specific types of injuries, such as a completely torn rotator cuff. Reverse shoulder replacement aims to maintain the shoulder joint by placing the ball portion of the shoulder where the socket used to be and the socket where the ball head used to be.
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Revision shoulder replacementAll joint replacements will need to be replaced eventually; this is known as revision surgery. Unless your shoulder replacement is failing, your shoulder replacement will typically last around 15 years before revision surgery is needed.
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Shoulder arthroscopyShoulder arthroscopy surgery is a specific surgical technique used for certain surgeries, such as treating rotator cuff injuries (not complete tears). During this procedure, the orthopaedic surgeon will inspect the shoulder joint by inserting a small camera (arthroscope) into your shoulder joint via a small incision. This camera guides your surgeon to perform surgery or to diagnose a shoulder joint problem.
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Bankart repair surgery and capsular shift surgeryBankart repair and capsular shift surgery may be recommended if you experience recurrent shoulder instability. Bankart repair aims to repair a torn labrum and ligament and restore stability to the shoulder joint, while capsular shift surgery is sued to decrease and tighten the joint socket. Both these surgeries can often be performed through arthroscopy (see above), and you may require both or only one of these surgeries, depending on your injury.
Deciding whether surgery is right for you
The decision to undergo surgery is a collaborative one. We encourage you to speak with your family, GP and orthopaedic surgeon and always ask questions. The more you know, the easier it will be to decide whether this surgery is right for you.
Fees and private health
Once you speak with your specialist, you’ll be provided with the relevant information to give your insurance company. Your insurer will provide you with the breakdown of treatment fees.
Find your Epworth specialist
Shoulder treatment locations:
Preparing for surgery
We are here to support patients and their families in preparing for surgery.
To learn more about your anaesthetist's role during the surgery and what to expect beforehand, watch the video below.
Home preparation
Occupational therapists recommend you review your home environment and implement simple modifications, moving trip hazards such as rugs and cords from walkways to ensure your home is safe following your surgery.
Rehabilitation
Epworth Rehabilitation programs aren’t just something to consider after surgery. Our rehabilitation programs can also support people preparing for joint replacement or ligament surgery.
Ordering assistive aids
Recovery
Our aim is to provide you with comprehensive and compassionate recovery care that will help you return to an independent and functional lifestyle as possible.
The day after your surgery
We are here to support you to get back to your life as soon and as safely as possible. Your care team will often try to get you moving the day after your operation. This will support your recovery and reduce the likelihood of complications, so you can book your next holiday, get back to playing sport, or return to work sooner.
Physiotherapy
Your physiotherapist will assist you in completing a daily walking and exercise program. The planned exercises aim to restore the range of shoulder movement and muscle strength.
Pain management
It is normal to have some pain following major surgery. By controlling your pain as best we can, you are likely to recover faster. The team caring for you will offer you medications to manage your pain, enabling you to participate in your walking and exercise program. It is important to be proactive in asking for pain relief. As your pain improves, you will gradually require less pain medication. You will be supplied with pain relief medication on discharge.
Rehabilitation
Depending on your personal needs and your GP or your surgeon’s recommendations, you may be referred to a rehabilitation program.
How rehabilitation supports your recovery
Guided by Epworth physiotherapists and occupational therapists, rehabilitation will help you to feel stronger, safer and more confident to participate in everyday life activities.
To learn more about what you can expect from your rehabilitation program, please watch the video below.
Rehab after your joint replacement surgery
Achieve your post-surgery goals
Our rehabilitation team will assess and develop a specific rehabilitation program based on individual needs and goals. Your program will consider factors such as pain, arthritis, movement, and personal goals such as returning to work or sport.
Rehabilitation programs
There are a few ways you can access our rehabilitation programs. Your surgeon and care team will work with you to identify the best option:
Rehabilitation at home
- A physiotherapist will visit you at home and develop a program you can complete in your local area. Our team will also connect you to local services such as gyms and pools if it benefits your recovery. The team will also recommend equipment you may like to purchase or hire to support recovery and long-term health.
Outpatient program
- Outpatient program involves visiting the hospital a few times a week to complete your rehabilitation program.
Inpatient program
- If you are recommended an inpatient program, you will stay in our rehabilitation hospital for about 5-7 days after your surgical admission.
Why choose Epworth for rehabilitation?
Epworth Rehabilitation offers patients access to an expert team of rehabilitation clinicians with purpose-built gymnasiums, hydrotherapy pools and other specialised rehabilitation equipment to support you.
Fees and health insurance
Depending on the level of your private health insurance, our rehabilitation services may be covered by your health fund. You can also choose to self-fund if you prefer. Whichever option you choose, we will provide you with the financial information when you are referred to Epworth Rehabilitation.