Definition of Terms
Active range-of-motion is about moving the limb through using the limb’s own muscles.
General anesthesia is when anesthesia gas is delivered to a person through a tube inserted into their mouth or throat so they “go to sleep”. The person will not remember the procedure. They often forget the events immediately before and after the procedure. They will spend 1 to 3 hours in the recovery room while they get rid of the gas by breathing. They will usually feel groggy for 24 hours or so. A person who has undergone general anesthesia cannot drive until they feel totally normal. Typically, for procedures under 1 hour, the person should not drive for at least 24 hours.
Arthritis is the wearing out of the smooth cartilage liner of a joint. It is a problem that does not resolve on its own and usually gets worse over time. It is often painful and leads to a loss of motion and function. The x-rays shown are an example of shoulder arthritis.
A surgical procedure where several small (1/4 inch) incisions are made, and a small camera and other instruments are inserted into a joint. The word “arthroscope”, refers specifically to the camera-like instrument. The word “arthroscopy”, refers to the procedure.
The labrum is a 360 degree lip of the socket of the shoulder that acts like a “chock block” against motion of the ball. It prevents the ball from moving away from the socket (a dislocation) in any direction. When the labrum tears it can no longer prevent the ball from moving and the shoulder is likely to dislocate. A Bankart tear is a tear of the front part of the labrum of the shoulder. In order to make the shoulder stable the labrum needs to be repaired and put back into its normal position. This is done with surgery.
In the "chock block" analogy, the labrum is represented by the yellow chock blocks
The person will be told not to lift anything heavier than a small cup of water, or a cup of coffee. The person must not use their arm in any way that would “fire” the biceps muscle. If the person wants to keep their arm bent for things such as typing or eating, then they should be in a sling. These precautions typically are given for six weeks after surgery.
Bone spurs (also called osteophytes or enthesophytes) are bony growths that can stick into tissue and cause problems.
A bursa is an empty sack. It’s like a pillow-case without a pillow inside. Or a ravioli without cheese inside. One side of the empty sack is connected to the bone below and the other side of the sack is connected to the skin above. Inside the empty sack is normally a couple of drops of the body’s natural oil (lubricant). This helps the skin to slide over the bone rather than tear if the elbow has an injury.
Olecranon bursitis is when the natural deflated sack over the back side of the elbow becomes inflamed and swollen.
Continuous Passive Range of Motion Machine (CPM)
This is a machine with an electric motor, that is mounted above a person’s hospital bed. The persons will keep their arm completely relaxed, and the machine will take the persons arm through a slow and gentle motion. Most people report that the CPM helps to improve their pain. If a person is not completely relaxed, the pain will worsen and the surgical repair can be damaged.
Cortisone medication is a type of steroid medication. It is often given in the form of a shot or injection. It is used to help improve inflammation and pain. Usually cortisone is injected into a joint, including the shoulder, elbow, knee and hip. Its effects are temporary, and can last anywhere from 1 week to 3 months. It is important to remember that cortisone is helpful to reduce painful symptoms, but does usually not cure the underlying disease. It is most often used in the shoulder to reduce pain so the person can achieve more with therapy.
The removal of damaged tissue or foreign objects from a wound
When a joint becomes “out of place”- for example, a dislocating shoulder is when the shoulder bone “pops out” of its socket.
Displaced (in reference to a fracture or broken bone)
When the two ends of a broken bone move, or shift out of place, so that they are not perfectly lined up anymore.
Farther away from the body (closer to the fingertips or toes). Distal is the opposite of Proximal. Example: The elbow is more distal than the shoulder.
EMG/NCS or "nerve study"
NCS= Nerve Conduction Study
These tests are used to diagnose a variety of muscle and nerve disorders. An EMG test is used to figure out if muscles are responding the right way to nerve signals. A nerve conduction study is used to figure out if there is nerve damage or disease. When EMG tests and nerve conduction studies are done together, they can be used to help providers determine if a person’s symptoms are being caused by a muscle problem or a nerve problem.
The process of straightening, or the state of being straight.
The process of bending, or the state of being bent.
A fractured bone is a broken bone. There is no difference.
If the shoulder joint is describes as a “ball and cup” type of socket joint- the glenoid can be described as the “cup”. Technically speaking, the glenoid refers to a specific part of the scapula bone- the concave/cupped part of the bone in which the humerus interacts with.
View from the front
View from the side
The upper arm bone, which is part of both the shoulder and the elbow joint (see the humerus bone in red).
Inflammation is an important and essential part of the body’s natural healing response. Inflammation is the second of the 4 stages of healing. The more inflammation the better the healing. For this reason, the use of anti-inflammatory medications should be minimized during the first 6 weeks after an injury or a surgery.
Sometimes, however, conditions can occur that do not require healing but in which the inflammation itself becomes a problem. Examples of these conditions are, a tight or frozen shoulder, a pinched nerve, or painful olecranon bursitis. There are many more. For these conditions, taking NSAIDs to treat the pain caused by inflammation is appropriate.
A structure of the shoulder: it is the “rubber bumper” that surrounds the glenoid bone, or the “cup” of the socket joint. The labrum helps the ball stay in the socket.
Tissue that connects bone to bone (for example the ulnar collateral ligament, otherwise known as the medial collateral ligament in the elbow).
Light weight, high repetition strengthening program
This is when the person begins lifting objects or weights that are light enough that they can be lifted 30 times. If the object or weight is too heavy to be lifted 30 times, then it is too heavy and must not be lifted.
A type of brace that is placed over the elbow, which has the capability to either be locked in a fixed/non-movable position, without any movement, OR it can be adjusted so that the elbow is allowed to move. The elbow brace can be adjusted to allow for both small and large amounts of motion.
A nerve block is commonly used before or after surgery, as a method to reduce pain from the surgery. Numbing medication is injected into the body, which temporarily causes the nerves to “go to sleep”. A person who has shoulder surgery may receive a nerve block in their neck- which makes their arm temporarily numb. A person who has a nerve block may feel either no pain, or reduced pain after surgery. A person with a nerve block will also (temporarily) not likely be able to move their fingers, or arm. Nerve blocks tend to work anywhere between 6 and 36 hours and are an effective means of controlling post-surgical pain.
A group of medications, also known as “anti-inflammatory” medications. Some common NSAIDs are: aspirin, ibuprofen, Advil, Aleve, Celebrex, Motrin, Nuprin, Naprosyn, Naproxen, and Mobic. Tylenol or acetaminophen is not an NSAID.
The olecranon is the part of the forearm bone at the elbow that makes up the hinge of the elbow.
Open (surgical procedure)
An “open” surgery means the cutting of skin and tissues so that the surgeon has a full view of the structures involved. This term is often used in contrast to an “arthroscopic” surgery.
Opioid medications are also sometimes called “narcotic” medications. They are a type of pain medication. These medications require a doctor’s prescription. They should only be used for short periods of time (5 days or less). Using opioids for longer periods of time can actually INCREASE a person’s pain, rather than decrease it. These medications are best used immediately after an injury or after a surgery. Examples of commonly used prescription opioids include: oxycodone, roxicodone, codeine, TC#3, Oxycontin, Percocet, Vicodin, Norco, morphine, fentanyl, Dilaudid, and morphine sulfate.
Passive range of motion
Passive range-of-motion is when a joint is moved by forces other than the muscles of that joint. This force can be from another person, or a machine or the other arm. A therapist can provide passive range-of-motion during a visit. The CPM machine can provide passive range-of-motion during a hospital stay. And the person’s other arm can provide passive range-of-motion while the person is at home (an example of this is the 40/140 program).
This specific part of the shoulder’s labrum provides stability so that the humerus bone does not slide towards the person’s back. If the posterior labrum is torn, over time, a person can develop shoulder arthritis.
Red arrow is pointing to the posterior labrum
Closer towards the center of the body. Proximal is the opposite of Distal. Example: The shoulder is more proximal than the elbow.
The radial head refers to a specific part of the radius bone- the part of the bone that is closest to the elbow.
The radial head is circled in red in both images
One of the two bones that make up the forearm.
Immediately after surgery, a person is taken from the operating room into the recovery room. Usually a person spends one to two hours in the recovery room, and is carefully monitored as they awake from surgery. Family members and loved ones are usually not permitted to visit a person while they are in the recovery room. Another term for the Recovery Room is the “Post-Anesthesia Care Unit”, or “PACU”.
A “Reduction” is when a joint that is dislocated is put back in place. This is also called “Reduced”.
If a person is given “restrictions”, it means they are given specific instructions to NOT do a certain movement, lift more than a certain weight, or participate in a certain activity. A few examples of restrictions include:
- not moving the arm away from the body after surgery or an injury
- not putting weight on an arm or leg
- not lifting anything heaving than half a pound
- not engaging in contact sports
The rotator cuff is a group of tendons that cover the ball of the shoulder. The three main tendons are the subscapularis, the supraspinatus and the infraspinatus. They form a continuous “cuff” of tissue around the ball of the humerus. Their purpose is to help keep the ball and socket of the shoulder together.
Same Day Surgery
Same Day Surgery is when a person has surgery and goes home on the same day, and does not spend the night in the hospital. This is also called “in and out” surgery.
A SLAP tear is a tear of the shoulder socket’s labrum, or also known as a type of labral tear. It a tear of the upper part of the labrum.
A steroid or corticosteroid is class of powerful anti-inflammatory medication which can be given by mouth, in the vein, by injection into a joint, on the skin, or through an inhaler. Steroids are used to reduce inflammation and pain. When given by injection into a joint, the effect is usually temporary (1 week to 3 months). Cortisone, prednisone, medrol dose pack, prednisolone, betamethasone, dexamethasone, hydrocortisone, methylprednisolone, deflazacort are commonly used corticosteroids to name a few.
A suture anchor is a small dart-like device that has sutures or stitches attached to it. It is usually made of either metal or cloth or plastic. It is inserted into bone and “anchors” the stitches to the bone. The stitches are then used to repair soft tissue such as a ligament, a tendon or a muscle down to the bone.
The photo on the right shows what a “cloth” suture anchor looks like. The photos below shows how a metal suture anchor is inserted into bone.
A tendon is a rope made of the body’s special fibers called collagen. This rope connects the muscle to the bone so that when the muscle contracts it pulls on the rope and the rope pulls on the bone and the bone moves. There are roughly 4000 tendons in the human body.
The person will be told not to push with their upper arm, or to use their arm in any way that would “fire” the triceps muscle. This includes pushing a door closed, or using the arm to push up off from a table. These precautions typically are given for six weeks after surgery.
There are a series of ropes that connect the wrist to the elbow. When the wrist lifts up (extends), the tendons on the outside part of the elbow are firing. When the wrist moves down (flexes), the tendons on the inside part of the elbow are firing. The main function of a wrist immobilizer following elbow tendon repair surgery, is to prevent the tendons from both the inside and outside of the elbow from firing, or getting stressed. If the tendons are getting stressed immediately after surgery, that can cause the surgical repair to fail.
Another name for a “right angle”, or the angle found in the corner of a square.