• What is the anatomy of the shoulder?
  • What can go wrong with a shoulder joint?
  • What kinds of surgeries can repair your shoulder?
  • What is recovery like after shoulder surgery?

Ashley P. is a professional pilot. When operating planes started causing her shoulder to hurt, she knew something was seriously wrong. The dull ache had evolved into a debilitating pain when she sought the help of Michael D. Riggenbach, M.D., board-certified orthopaedic surgeon at Orlando Orthopaedic Center. 

Ashley experienced pain, weakness, and issues with shoulder mobility. She’s not alone—the shoulder is a complex joint that is easy to tear, strain, or wear out from overuse. Each year, approximately two million Americans tear the delicate structures inside their shoulders. Still, others experience sprains, dislocations, or fractures to the bones.

Ashley damaged not one but both shoulders. When her daily activities—which ranged from working out to flying a plane—brought her more pain than joy, she contacted Dr. Riggenbach and his team. Today, Ashley says, “I’ve had these shoulder issues for six years. Dr. Riggenbach fixed my shoulders perfectly. It feels good to have normal shoulders that don’t hurt anymore.”

What Is the Anatomy of the Shoulder?

Anatomically, the shoulder joint comprises a ball and socket structure. It brings together three primary bones:

  • Collarbone (clavicle)
  • Shoulder Blade (scapula)
  • Upper Arm Bone (humerus)

Under the skin, the end of the humerus bone forms a ball that rests within the scapula’s shallow socket. A bursa sac between these parts lubricates the socket to help things glide smoothly. Normally, these parts stay together and rotate freely thanks to a four-muscle group of tendons that form around the humerus head. These four tendons are known as the rotator cuff and consist of these four muscles:

  • Infraspinatus 
  • Subscapularis
  • Supraspinatus
  • Teres Minor

The rotator cuff supports shoulder movements, keeping the joint from accidentally dislocating. Their job is to facilitate the movements we take for granted, from lifting your morning coffee cup to flying a plane (in Ashley’s case). Because the shoulder is so complex, however, there is a lot that can go wrong. Ashley says, “Flying takes a toll on the shoulders, believe it or not. You’re picking up the airplane pretty much. So that, and I used to wakeboard and wake surf. All that stuff I wasn’t able to do.”

What Can Go Wrong with a Shoulder Joint?

There is a lot that can go wrong with a shoulder joint. Some of the more acute issues include:

  • Dislocation (the head of the humerus comes out of the scapula)
  • Bone fractures
  • Sprains of ligaments inside the joint
  • Torn rotator cuff (one or more of the four major tendons separate from the arm bone)

Chronic instability and inflammation can also occur in these joints as well, including:

  • Arthritis (inflammation that causes joint pain and stiffness)
  • Bursitis (inflammation in the bursa causes pain)
  • Frozen shoulder (limited mobility of the joint)
  • Tendinitis of the rotator cuff tendons (tiny tears in its structure become sore and painful)

Like a lot of orthopaedic patients, Ashley’s joint problems took years to develop. She says, “Six years ago, I was working out doing lat pulldown exercises and I tore my right shoulder.” Also, like a lot of patients, Ashley waited until the pain and stiffness in both shoulders began to affect even the most basic tasks in her life. It was then that she began to look for a way to restore her strength and mobility and return to the active lifestyle she once enjoyed.

Fortunately, Ashley sought the help of Dr. Riggenbach and the Orlando Orthopaedic Center. Together, they formulated a surgical and therapeutic approach to get her back to health.

What Kinds of Surgeries Can Repair Your Shoulder?

The surgical approaches necessary to repair a shoulder joint are complex and improving constantly. Some of the most common surgeries available to repair a broken, injured, unstable, or worn-out shoulder include:

  • Arthroscopy – increases mobility in frozen shoulders
  • AC Joint Repair – alleviates arthritic conditions
  • Rotator Cuff Repair – reattaches the tendons to the bone
  • SLAP (Superior Labrum Anterior and Posterior) – repairs cartilage
  • Total Shoulder Replacement – removes the entire joint and replaces it with a prosthetic

In Ashley’s case, Dr. Riggenbach recommended the following surgeries:

  • Left shoulder arthroscopic capsular application, with possible biceps tenodesis
  • Right shoulder arthroscopic superior/posterior labral repair and capsulorrhaphy

What does this mean in layman’s terms? 

On October 21, 2021, Dr. Riggenbach worked on Ashley’s left shoulder to perform an arthroscopic capsular procedure to relieve her shoulder mobility issues.

On April 6, 2021, Dr. Riggenbach repaired Ashley’s right shoulder, using a non-invasive (arthroscopic) procedure that worked on the front (superior) and back (posterior) labrum, which a cartilaginous cup that cushions the humerus from grinding against the scapula. He then performed a shoulder capsulorrhaphy, which repairs the connective shoulder tissue by tightening it, allowing everything to fit snugly together again.

These complex surgeries were an excellent experience for Ashley. She says, “I drive three hours just for Dr. Riggenbach. I expect the best. The staff was amazing. They’re super sweet, caring, and understanding.” Today, Ashley is back to flying and has resumed her normal exercises and activities.