The Shoulder & Elbow Institute

Whether you are an athlete suffering from an injury to your shoulder or elbow, or if the wear and tear of life has left you with a painful or arthritic joint, you want to get back to an active and pain-free life.

For different people that means different things – for a competitive baseball player or a professional athlete, that’s having a shoulder or elbow that is functioning at a level that allows them to be competitive in their sport. For others, they may want to get back to all the activities they love – snowboarding, skiing, hiking, weightlifting, golf or tennis. And yet for others, shoulder or elbow pain has gotten in the way of daily activities. For these individuals, simply getting dressed in the morning, washing their hair, unloading the dishwasher or playing with their children or grandchildren has become difficult.

The shoulder and elbow are parts of the body that are often treated by different types of doctors and surgeons, making it difficult for patients to find the right doctor to treat their problem. Often patients with shoulder and elbow problems are not sure where to start – is it a sports medicine doctor, a joint replacement surgeon or a physical therapist who specializes in shoulders?

For elbows, it can be just as difficult – some hand surgeons treat the elbow and some do not. Do you need a pain management doctor or a sports medicine doctor? At the Panorama Shoulder and Elbow Institute, we can help you find the right doctors and care providers to treat your problem – the first time.

The Shoulder & Elbow Institute at Panorama Orthopedics & Spine Center is the first of its kind in the Rocky Mountain region. The Shoulder & Elbow Institute brings together specialists who are experienced in shoulder and elbow care — from sports medicine and shoulder surgeons to physical therapists, return-to-sport athletic trainers and highly specialized orthopedic imaging technologists. Together we specifically serve patients with shoulder or elbow injuries, pain, or arthritis.

We treat more patients with shoulder and elbow problems than any other orthopedic practice in the region.

The Shoulder & Elbow Institute brings together specialists who are experienced in shoulder and elbow care — from sports medicine and shoulder surgeons to physical therapists, return-to-sport athletic trainers and highly specialized orthopedic imaging technologists. Together they specifically serve patients with shoulder or elbow injuries, pain, or arthritis. Together they treat more patients with shoulder and elbow problems than any other orthopedic practice in the region.

A Specialized Shoulder and Elbow Team

At the Shoulder & Elbow Institute, our experts assess each individual patient and create a treatment plan based on your specific condition, lifestyle and expectations. Our entire team has special expertise in shoulder and elbow conditions and includes specialists from the following medical areas:

  • Sports Medicine Specialists
  • Trauma Surgeons
  • Hand Surgeons (Including Nerve Specialists)
  • Shoulder surgeons
  • Pain Management doctors
  • Physical therapists
  • Athletic Trainers
  • Specially Trained Radiologists

Our trauma team treats hundreds of shoulder and elbow emergencies each year and specializes in treating dislocated and traumatized elbows and fractured or dislocated shoulders.

Specialized Shoulder Care

Shoulder pain and stiffness can be caused by a variety of conditions – shoulder arthritis, soft tissue damage, or a rotator cuff injury. Not every shoulder injury needs surgery. In fact, with our comprehensive team of shoulder experts we have the resources needed to give you the best chance of getting better without surgery. Some of the most common conditions that cause shoulder pain that we treat every day include:

Soft tissue injuries in the shoulder – These are often seen in athletes or individuals who have injured their shoulder by falling on an outstretched arm, or have fallen victim to repetitive use injuries, such as shoulder injuries in throwing athletes. . Soft tissue injuries such as ligament tears or labral tears (also know as SLAP tears), can create pain and shoulder instability. Our team of experts always uses a variety of conservative treatments to minimize pain and aid in healing. When surgery is necessary to repair a soft tissue injury in the shoulder, minimally invasive surgery is typically all that is needed. Specialized physical therapy, rehabilitation and return-to-sport training are used to achieve the best possible outcome for these patients following surgery.

Soft tissue injuries can lead to shoulder instability.  It is important for people who have sustained multiple shoulder dislocations to find a highly skilled and specialized shoulder surgeon. Repairing a shoulder that has suffered from instability or multiple dislocations will likely require more complex surgical techniques.

Rotator cuff tears are fairly common injuries that can limit your daily activities, making it difficult and painful to reach overhead into a cupboard or put on a shirt. Your rotator cuff is made up of four muscles that come together to help you lift and rotate your arm.

 

Treatments for rotator cuff tears have come a long way. In some cases if you have a partial or small tear it can be managed with conservative treatments. Individuals with more extensive tears or a full thickness tear will need to have the injury surgically repaired. Orthopedic imaging technologists are critical in getting the diagnosis correct.

A skilled surgeon can often repair the cuff tear with an arthoscope, meaning smaller incisions and a quicker recovery. While the surgical repair is important, proper rehabilitation and therapy, by shoulder experts is critical to a successful recovery when you have a rotator cuff tear.              

Impingement or rotator cuff tendonitis is another common problem that can lead to pain in the shoulder. In this case the rotator cuff is not torn, but the alignment of the shoulder has created inflammation in the bursa or the rotator cuff and now the shoulder is not moving freely without pain. Injections and physicai therapy can often work wonders to correct this problem and help individuals get past the pain and to a place where their shoulder can move freely again. If impingement issues are left untreated they can lead to a rotator cuff tear, so it is important that people who have pain when moving their shoulder are evaluated by a shoulder specialist.

Frozen Shoulder or adhesive capsulitis is a condition that usually affects middle age individuals, more often women than men. Sometimes the shoulder can get “stuck,” leading to decreased movement in the joint capsule.  Over time the shoulder joint becomes inflamed and difficult to move.   Sometimes, an injury to the shoulder can preceed the “freezing” of the joint capsule, but oftentimes individuals with this problem do not know when or how it even started. Typically they have pain when moving the shoulder and difficulty getting dressed or performing the daily activities of life. People with this condition are often helped with physical therapy. If that is unsuccessful, a manipulation of the joint while under anesthesia can often free the joint and being the path to healing.

 

Our Sports Medicine Team - Shoulder Specialists

Professional Athlete Steve Hess Tells His Story of Recovering from Shoulder Surgery

Shoulder Replacement Experts at Panorama

Shoulder arthritis can cause pain and limit a person’s ability to move their shoulder. We offer a variety of treatments for shoulder arthritis, from physical therapy to joint injections and cellular treatments. When conservative treatment options fail to relieve the pain we offer options for shoulder replacement. In a total shoulder replacement we can replace your entire shoulder joint leaving you with a new shoulder. For individuals who are older and may have had a shoulder replacement that was not successful, we also offer complex revision shoulder surgeries and reverse total shoulder replacements.

Dr. Charles Gottlob, Dr. Daniel Haber, Dr. James Johnson and Dr. David Schneider are experts in shoulder replacement and reverse total shoulder replacements. Together they perform more of these complex surgeries than any where else in the Region.

Our Team of Shoulder Replacement Specialists

Elbow Expertise

Who cares for elbows? That’s a common question people ask when they are suffering with elbow pain. Many times it is a sports medicine specialist, but when nerve or tendons are involved, often a specially trained hand surgeon is called onto the case. Orthopedic trauma surgeons often repair complicated elbow fractures and a joint replacement surgeon may be necessary if you have elbow arthritis. At the Shoulder and Elbow Institute we have brought specialists from across many orthopedic specialties into one area where it is easy to find the right care for your elbow.

For many elbow injuries, physical therapy, stretching and strengthening are all that is needed to get better. Sometimes a pain management specialist can provide an injection to help eliminate pain. When you have a more serious problem it may require a specialized surgeon or a team approach. Some of the common elbow conditions we treat at the the Shoulder and Elbow Institute include: elbow arthritis, ligament injuries, and elbow injuries for athletes in throwing sports.

Elbow Ligament Tears

The ulnar collateral ligament (UCL) and the lateral ulnar collateral ligament (LUCL) are the primary structures that keep the elbow stable. In the case of a dislocated elbow or other injury, they can tear — and without proper healing, that can lead to further instability later.

Repetitive stress or overuse, such as with a throwing motion, can cause damage to the UCL. You might associate UCL injuries with baseball pitchers.  A Tommy John surgery (named for the first baseball pitcher to have the surgery) is another name for a UCL reconstruction surgery. During this procedure, the UCL is replaced with a tendon graft taken from elsewhere in the body. The percentage of players who are able to return to pre-injury level of play is very high.

Elbow Arthritis

Like arthritis in other joints, arthritis in the elbow can cause pain and a loss of range of motion. Some people describe it as a “locking” sensation in the joint. And as the arthritis progresses, you may start to notice numbness in your ring and pinky fingers. To help relieve the pain of elbow arthritis, our experienced elbow surgeons may offer arthroscopic surgery to remove damaged tissue and smooth out rough surfaces in the joint via small incisions around the elbow. If arthritis is severe, elbow replacement surgery (termed “total elbow arthroplasty) is typically recommended. This replaces the natural elbow joint with an artificial joint. Although elbow replacement surgery is rare (only about 3,000 Americans get it each year), it is extremely effective at relieving pain caused by elbow arthritis. Every year the surgeons at the Panorama Shoulder & Elbow Institute perform more elbow replacement operations than any other group in the Rocky Mountains.

Tennis Elbow - A common Problem You Can Treat At Home

Tennis elbow is common. For people suffering with this condition, it can affect your daily life — causing pain or a burning sensation on the outside of the elbow. This is due to an inflammation of the tendons in the joint. Tennis elbow can also can lead to weak grip strength and it typically gets worse when you use your forearm, such as when you swing a tennis racquet or use a wrench.

But while it can be quite painful early on, the good news, says orthopedic surgeon Dr David Schneider, head of the Shoulder & Elbow Institute at Panorama, is that it can typically be managed at home and will rarely need surgery.

Try these things at home:

  • Apply a cold pack for 10 to 15 minutes several times a day when you feel the pain coming on.
  • Rest the area.
  • Try anti-inflammatory medication such as aspirin or ibuprofen.
  • Rub a pain-relieving cream into the joint.
  • Wear a counterforce brace when you do anything that involves grasping or twisting the arm.
  • Work with a physical therapist to ease back into activity the right way.

 

  • The most important treatment for tennis elbow is a regular program of arm stretching and strengthening.
  • See a sports medicine physician to make sure your recovery is on track.

If you are not getting better despite your good efforts at home, there are other options available. Tenex is a newer procedure that is used to treat tennis elbow. Our pain management specialists, can talk with you more about this injection that is helping people who have been suffering with tennis elbow, feel better again.

 

Tips and Tricks for Recovering from Shoulder Surgery

Recovering from shoulder surgery can be tough. Whether you have had rotator cuff surgery or any type of procedure that leaves you with a shoulder sling for a few weeks, these tips and tricks are meant to help you.  It’s important when you have a sling that you are properly protecting the shoulder and reducing any stress on the injured area. Learning how to wear the sling so that it is providing proper support and taking the sling on and off are especially important. In addition, simple things like getting dressed or sleeping comfortably may be challenging in the beginning. Please use the series of videos with tips and tricks from our physical therapy team to get acquainted with the do’s and don’ts to make your recovery easier.