Joint Preservation Blog

January 11, 2009

Shoulder Ligament Injuries

Ligament Tear Symptoms

Ligament Tear Symptoms

MY OWN TORN SHOULDER LIGAMENT TREATMENT: As a very young young doctor many years ago, I thought I knew how to ride a motorcycle (or a donor cycle as my mother called it) and ended up with my right shoulder finding the road. This began my first-hand education of my own shoulder ligament injury. First, an anatomy lesson on shoulder ligaments simplified for non-physicians. The most commonly torn shoulder ligaments in a “separated shoulder” are those that hold the collar bone (clavicle) and top of the shoulder blade (acromion) together. There is an actual joint here, known as the “AC” joint or acromio-clavicular joint. When you injure this joint and the ligaments that hold this top shoulder joint together, it can be a grade 1 (just stretched ligaments, but the joint is still together), grade 2 (stretched ligaments that allow the joint to come apart a bit, but are still intact), or a grade 3 (completely torn-up ligaments that no longer hold the joint together or connect). If you have a grade 3 torn ligament in your shoulder, you’ll know it by the huge step off (often 1/2-1 inch) between the collar bone and the acromion (top of shoulder). If you have a grade 3, then the only long-term solution is to either leave it alone or have an orthopedic surgeon perform a shoulder repair using cadaver ligaments, a tendon graft, or similar to bring it back together. The grade 1’s and 2’s are really the focus of this post. What to do if this continues to pop, click, get sore, and generally hurt? How do you heal these torn ligaments in the shoulder? After a few years of not being able to go back to weight lifting, I tried prolotherapy on mine, and it worked reasonaly well (not a complete fix, but better). This is where the doctor injects substances that cause a brief inflammatory healing reaction in the ligaments. What would I do if I injured it today and it wasn’t getting better, no doubt I’d try some of the adult stem cell procedures where we can take your own stem cells and inject them into the ligaments to reapir the damage. In addition, if you have a partial rotator cuff tear (not uncommon), the same can be done to heal that as well. I have posted videos at the end of this discussion on a shoulder rotator cuff tear and ankle ligaments healed this way. What would I stay away from? The knife and shoulder ligament surgery! For a grade 1 and grade 2 shoulder ligament injury, in my opinion, there is no rationale for surgical repair, given these other treatment options. There are various links above for more information. Why do you want to get the ligaments fixed in some way? because if you don’t, the AC joint will develop arthritis and start pressing on the rotator cuff muscles leading to a chronic shoulder problem that will need surgery one day.

My shoulder? No perfect, but since I went back to lift very heavy weights as a weight lifter, you can guess it’s much much better than it was prior to treatment. I have never had surgery and am doing fine some 20 years after the injury.


December 15, 2008

torn shoulder ligaments cures

There are many ligaments that help to support the shoulder.  The shoulder ligaments are the duct tape that hold the bones together.  These include the coraco-acromial ligaments (the duct tape that holds the collar bone to the front of the shoulder blade).  Other ligaments include the joint capsule of the AC joint (duct tape that holds the AC joint together) and the shoulder joint capsule (the duct tape that holds the shoulder ball in the socket).  An injury that stretches these ligaments can cause instability, meaning that the duct tape can be stretched an lose it’s ability to hold these shoulder bones together as they move and as you use the shoulder.  This can cause many problems, including early arthritis and pain.  Torn shoulder ligament cures have traditionally been surgical.  However, newer non-surgical torn shoulder ligament cures are now available. 

Surgery for this area usually means sewing the torn ligament together or back to it’s attachment to the bone.  While for a complete tear of one of these ligaments this may the only way to get the two ends back together, for partial tears, this is an older method of repair that may have more problems than benefits.  For example, sewing a partially torn ligament often over tightens the ligament.  In addition, this surgical approach carries more risk of infection.  Newer treatments are all injection based.  This means that stem cells can be injected into the ligament to help it mend, rather than needing surgery.  The newer stem cell based treatments (links above) also mean much less down-time and immobilization for the patient. 

As an example, a patient with an AC joint injury often has chronic and painful popping and cracking in this joint between the front of the should blade and the collar bone.  The shoulder muscles underneath can become sore.  The surgical option is to sew a cadaver ligament or synthetic material around the injured ligaments to try and stabilize the joint.  However, there is huge down-time, with the patient being unable to use the area for months.  In addition, over tightening is common, and this leads to more arthritis.  The newer technique of injecting stem cells into the ligament requires no or little down-time and likely results in a more physiologic repair (without the over tightening) because the goal with this procedure is to get the ligament to heal back to it’s pre-injured state (or as close to it as possible).

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