Dr. Philipp Heuberer – Shoulder Specialist Vienna

  • Fast appointments – short waiting times – rapid assistance
  • Broad spectrum of therapy forms – gentle and effective
  • Minimally invasive shoulder surgery at the highest level

Do you have pain in your shoulder? Do you suffer from calcific tendonitis, dislocated shoulder, tendon rupture or other shoulder complaints? Then, as a shoulder specialist I can definitely help you! Then, as a shoulder specialist I can definitely help you!

During a detailed examination in my Vienna office, I make an initial diagnosis and design an effective treatment plan together with you.

Depending on your needs, I treat your shoulder complaints conservatively, using regenerative therapy or pain therapy. In particularly delicate cases, when gentler treatments are not promising, I recommend surgical intervention, which I will personally perform as an experienced shoulder surgeon.

Make an appointment at my Vienna doctor’s office and let’s get to the root of your shoulder problems!

Why problems often occur in the shoulder and shoulder joint area

The shoulder is the term used to describe the entire region of the body around the shoulder joint. It consists of the humeral head, the bones of the shoulder girdle and the soft tissues surrounding it.

IIn addition to the actual (main) joint, the glenohumeral joint, the shoulder also includes other joints – so-called accessory joints.

In fact, the most mobile joints in our body are located in the shoulder area.

The problem: In relation to the strain, the shoulder has a rather weak supporting apparatus. Ligaments, tendon insertion and muscles often cannot withstand high stresses.

It’s no wonder that complaints or even injuries can quickly occur with overuse or incorrect strain. A shoulder dislocation, rotator cuff lesion or calcific tendonitis are experienced faster than you think!

What I can do for you as a shoulder specialist and shoulder surgeon

As a shoulder specialist, I strive to restore tendons and ligaments without reducing range of motion. In doing so, I draw from a broad spectrum of therapies and proceed as gently and effectively as possible. If conservative therapies, regenerative therapy and pain therapy do not promise a noticeable improvement in your symptoms, I recommend surgical intervention if necessary. The art of minimally invasive shoulder surgery is to improve the interaction of the shoulder joint and the accessory joints and to establish a pain-free range of motion.

As a board member and president emeritus of the AGA Society for Arthroscopy and Joint Surgery, Europe’s largest professional society for arthroscopy, I guarantee minimally invasive surgery at the highest level. If you would like to learn more about the tools and capabilities of arthroscopy, you can visit the Understanding Arthroscopy page.

As the founder of the Austrian Shoulder Center and as one of only a few shoulder specialists in Vienna who has already gained great experience in the field of arthroscopy and open shoulder surgery, I am sure that my team and I will find the right solution for your shoulder problems.

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    You have problems with your elbow – maybe you only feel first small symptoms, maybe the discomfort already leads to significant pain and movement restrictions.

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    You realize that visiting your family doctor and taking pain medication is no longer enough to bring about relief from pain or restoration of mobility.

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    You realize that visiting your family doctor and taking pain medication is no longer enough to bring about relief from pain or restoration of mobility.

Visit me in my Vienna office. My team and I can help you. Thanks to great experience in the diagnosis and treatment of elbow problems, we will find the right solution for you. Whether this solution is regenerative therapy, pain management, or surgery depends on the nature and extent of the condition.

The right therapy for your shoulder pain

Treatment options of a shoulder specialist

If you are currently suffering from shoulder problems, our little encyclopedia may help you identify the causes – and may also take away your fear of treatment or therapies.

In it, I have summarized for you some of the most common causes of pain and pathologies in the shoulder area, while also answering the three most important questions in each case: What is affected? How is it determined? And what therapy can be used to treat the causes and symptoms?

Complaints range from throwers shoulder to shoulder joint arthritis, from calcific tendonitis to frozen shoulder. Because not all pain is the same.

Of course, this encyclopedia should and can only offer you a first insight.

In order to know what your specific problem is and how best to treat it, I recommend a visit to our Vienna office at the Health Pi Medial Center at Wollzeile 1-3.

My motto is “trust comes from getting to know each other”, and trust is the most important aspect of the relationship between the shoulder specialist and his patients.

Therefore, do not hesitate to contact us in Vienna today. I am very much looking forward to your visit. I promise you that my team and I will do everything possible to significantly improve your quality of life.

Make an appointment in my Vienna office and let us eliminate the cause of your shoulder pain!

The small encyclopedia of shoulder complaints

The most common complaints and diseases in the shoulder area, how to identify them and what treatment really helps.

Superior capsular reconstruction

The superior capsule is the upper portion of the shoulder capsule and extends from the glenoid (shoulder socket) to the humeral head. Biomechanical studies have shown that it plays an important role in humeral head centering in the shoulder joint and is thus responsible for ensuring coordinated movement.

If there is a complete rotator cuff tear and it is not repaired or the repair does not heal, the shoulder joint can become unstable and movement, especially upward, is no longer possible in a coordinated manner.

Reconstruction of the superior shoulder capsule alone has been shown to restore stable conditions with recovery of pain-free range of motion.


The indication for superior capsular reconstruction is the massive irreparable rotator cuff defect with intact or repairable subscapularis tendon after failed conservative deltoid rehabilitation. Fixed superior glenohumeral instability must be excluded.


Superior capsular reconstruction: diagnosis

A thorough examination with x-rays to determine the degree of arthritis of the shoulder joint is critical. An infiltration test with local anesthetic should always be performed to rule out pain-related causes of the lack of mobility. Magnetic resonance imaging is essential to assess the damage to the rotator cuff tendons and muscles.


Superior capsular reconstruction: treatment & therapy

The operation can be performed arthroscopically. First, all parts of the tendon that can still be reconstructed need to be repaired. The superior capsule is then restored. In the original procedure it is done with a long strip of tendon that must be taken from the hip region. Due to the greater risk of a second operation and a large wound area, a so-called allograft is used nowadays. This involves sterile human skin from an organ donor with the advantage that no further surgical field needs to be opened in the patient and the donor skin is also significantly more resistant than a harvested tendon.

The graft is then fixed to the glenoid and humeral head, restoring the biomechanics of the shoulder joint. The graft is then fixed to the glenoid and humeral head, restoring the biomechanics of the shoulder joint.

After a rehabilitation period of approx. 3-6 months, patients can again perform everyday activities without pain with their previously often painful and immobile arm.

The risk of the procedure is extremely low because it is an arthroscopic surgery with little soft tissue trauma and the allograft is sterile. Most importantly, it is a joint-preserving anatomical reconstructive surgery, which subsequently allows all options in case of a necessary revision surgery.

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Thrower shoulder

The shoulder joint is a ball and socket joint with a large head and a small socket (glenoid). To increase the contact area, a cartilage fiber ring (labrum) runs around the bony glenoid. The long head of biceps tendon originates at the upper pole of the glenoid and labrum. Normally, the labrum is firmly attached to the glenoid. After severe trauma (traction on the outstretched arm) or repeated microtrauma due to overhead sports (tennis, volleyball,…), detachment of this labrum-biceps tendon complex may occur. Complaints in throwing or overhead movements and instabilities of the long head of biceps tendon also always result in a unilateral weakening of the shoulder blade muscles (scapular dyskinesia) or even shortening of the posterior shoulder capsule (GIRD).


Thrower’s shoulder: diagnosis

The diagnosis is not always clear and often can only be made correctly by a specialist. Proper screening is critical, as there are a great many screening tests, but few are goal-directed. In general, if a detachment of the labrum-biceps tendon complex (SLAP lesion) is suspected, only an MRI with contrast medium (arthro-MRI) should be performed. All other pathologies are diagnosed purely clinically.

Thrower’s shoulder: treatment & therapy

Conservative therapy with activity modification, pain medication, and especially physical therapy should always be tried first. The main focus is on stabilizing and strengthening exercises for the shoulder blade muscles and stretching the posterior shoulder capsule.

In the case of a completely detached long head of biceps tendon or its rupture, surgical therapy is usually necessary. In the context of shoulder arthroscopy, there are 3 treatment options depending on the pathology, claim, age, and profession of the patient:

  1. 1. To refix the long head of biceps tendon origin anatomically. This usually entails a rehabilitation period of more than 6 months and pain may occur for up to a year.
  2. Simply cutting the long biceps tendon and allowing it to scar in its groove (tenotomy). Immediate loading is possible; sometimes, especially in muscular individuals, cramping and cosmetic impairment (“Popey sign”) may occur.
  3. 3. To cut the long biceps tendon and reattach it to the upper arm in a bone canal (tendodesis). The rehabilitation period is about 6-8 weeks, a rare occurrence of cramps or slipping of the muscle belly is possible.

A decision on the choice of surgical procedure should be made together with the patient.

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Shoulder joint arthritis

The shoulder joint is one of the most complex joints in the human body and has the greatest range of motion of all. Like all joints, it is made up of bones, tendons, muscles and cartilage.

Osteoarthritis is a degenerative disease where the joint cartilage wears away and eventually only the bone remains. The joint space disappears and new bone is formed.

Patients experience chronic continuous pain, even at night, which prevents them from sleeping. The mobility in the joint is severely restricted. If the muscles and tendons also wear out, there is also a significant loss of strength.


Shoulder joint arthrosis: diagnosis

Clinical examination first reveals limited mobility. An X-ray then confirms the diagnosis and other causes can be ruled out. Magnetic resonance imaging is used exclusively to assess the condition of muscles and tendons.

Shoulder joint arthrosis: treatment & therapy

Primarily the therapy is conservative

  • with the intake of painkillers,
  • Physical therapy to improve mobility and strengthen muscles,
  • and, in the beginning, occasional cortisone injections to suppress the inflammatory stimulus.
  • Therefore, regenerative therapy with injections of a combination of hyaluronic acid and blood plasma (PRP or ACP) or also stem cell concentrates are the most sensible method to avoid or postpone surgery.

If conservative therapy no longer helps, joint replacement is recommended. Depending on the age of the patient and the condition of the muscles and tendons, there are several options:

  • • In young patients or with circumscribed cartilage damage or moderate osteoarthritis, the cartilage defect can be covered with metal during a shoulder arthroscopy. This method was developed in Austria and is unique worldwide. Patients can leave the hospital the same day or the next day and move the arm fully depending on the pain.
  • If the wear is already significantly advanced, but the muscles and tendons are preserved, a so-called anatomical shoulder prosthesis can be implanted. In this procedure, the humeral head is replaced with metal and the glenoid cavity is replaced with a plastic socket.
  • If the muscles and tendons are equally worn out, a special type of shoulder prosthesis can be installed, called an inverse prosthesis. The head and socket are inverted and the center of rotation is shifted to the center of the body, resulting in a longer lever arm and the arm can be moved using only the deltoid muscle.

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Impingement syndrome

Shoulder impingement is the painful pinching of the shoulder tendons (rotator cuff) between the humeral head and the bony roof of the scapula (acromion). Pain occurs when the arm is raised at shoulder level and typically persists until the arm is raised above shoulder level. The pain extends over the outer region of the upper arm or forward into the biceps muscle region. The pain can also cause sleep disturbances.


Causes of impingement syndrome:

  1. 1. Dynamic factors (muscle imbalance of the scapula muscles, non-physiological movement rhythm and shoulder capsule shrinkage):
  • Continuous microtraumas lead to a thickened, inflamed, painful bursa and further to inflammation and swelling of the tendons of the rotator cuff (tendinitis).
  • More persistent microtrauma can cause tears of the rotator cuff and thus thickened scarring (tendinosis).
  • • Microtrauma can also cause the formation of a bony spur at the base of the coraco-acromial ligament, which exacerbates these symptoms.
  1. 2. Static factors (changes in the bony structures of the scapula roof can lead to constriction symptoms):
  • Different scapula roof shapes
  • Bone spur formation
  • Degeneratively altered acromioclavicular joint
  • Rarely an unstable, non-fused bony part of the acromion (mesacromion).

Impingement syndrome: diagnosis

Impingement syndrome is often a diagnosis of exclusion, so a thorough clinical examination, especially of scapula mobility, is enormously important. X-rays may then reveal constricting bony obstructions. Magnetic resonance imaging is crucial, as it is here that the tendon damage, whether pure inflammation or already partial tearing, can be determined.


Impingement syndrome: treatment & therapy

The treatment depends on the cause, duration of the symptoms, existing restrictions and already performed treatment methods.

In principle, 90% of all impingement syndromes can be treated conservatively. The decisive factor is the correct diagnosis. The therapy is mainly done by specialized physiotherapy with modification of the movement pattern and muscle strengthening as well as stretching of the shoulder capsule. The initial pain can be relieved by taking anti-inflammatory analgesics exceptionally 1 – 2 cortisone infiltrations into the subacromial space.

If, contrary to expectations, conservative therapy does not bring about any improvement, arthroscopic surgery can be performed. In this procedure, bony or soft tissue obstructions are removed, thus widening the subacromial space again.

Postoperatively, active movement exercises can be started immediately. A shoulder bandage is not required. Strengthening exercises can be performed after 4 weeks, once the shoulder joint has regained approximately full range of motion. The operation has a success rate of 90%. Surgery-specific risks include infection (<0.3%), cutaneous nerve injury, postoperative frozen shoulder, and incomplete pain relief.

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Frozen Shoulder

Frozen shoulder is an extremely distressing and limiting shoulder condition that causes acute shoulder pain and gradual stiffening and loss of function of the shoulder joint. Most patients with frozen shoulder have no known cause. Women, between the ages of 35 and 55, and diabetics or patients with hyperthyroidism are at increased risk. However, frozen shoulder can also occur after trauma, rotator cuff rupture or shoulder surgery and prolong the recovery period.

Frozen shoulder is caused by inflammation and thickening of the capsular-ligamentous structures of the shoulder. Frozen shoulder is caused by inflammation and thickening of the capsular-ligamentous structures of the shoulder. At first, there is always a restriction of external rotation, as well as an inability to reach to the back.


Frozen shoulder usually presents with 3 phases: Pain phase, Stiffening phase, Resolution phase. The duration of the disease can be 18 – 24 months. The phases are not of the same length or the same severity in all patients.

The pain phase is characterized by capsulitis with a chronic background pain, especially at rest and at night. Initially, this non-specific pain without a clear stiffening easily leads to confusion with other clinical pictures, such as impingement syndrome. The pain phase can last up to 6 months. The pain phase can last up to 6 months.

The stiffening phase is characterized by loss of shoulder mobility in all planes. It is impossible for the patient to gain a greater range of motion even with the help of the healthy arm. Chronic constant pain gradually disappears; only pain on exertion remains (such as end-grade or reflex movements). Sleeping on the shoulder can cause pain as well. Patients compensate with movements from the scapula, but this can lead to overloading of the cervical-neck region.

The resolution phase usually occurs spontaneously 12 months after the onset of pain and is characterized by a gradual improvement in mobility. Most patients regain full range of motion. Residual stiffness usually remains with risk factors such as diabetes, hyperthyroidism, or after fractures.


Frozen Shoulder: Diagnosis

Diagnosis is made primarily from history and clinical examination. As imaging examinations, the only useful one is an x-ray in 2 planes to rule out osteoarthritis, calcium depot or fracture. MRI only extremely rarely provides additional necessary information and is therefore not required.


Frozen Shoulder: Treatment & Therapy

Because of the known course of the disease, treatment is usually conservative. Treatment includes pain management and preservation of mobility. Pain can be relieved with analgesic and anti-inflammatory drugs (NSAIDs), as well as cortisone injections into the joint. A special form of joint injection, hydrodilation, generally provides the greatest benefit. In this procedure, cortisone and a local anesthetic are injected into the joint, followed by large amounts of fluid (NaCl). The large amount of fluid stretches the capsule and loosens adhesions, sometimes tearing the joint capsule. As a rule, the earlier joint injections are given, the better they help. Other measures, such as acupuncture, electrotherapy or massages can bring short-term improvement. Mobility should be maintained with use of the arm. Painful stretching should be avoided at all costs, as it can prolong the duration of the disease. Stretching of the joint capsule under extracorporeal shock wave therapy usually provides the greatest benefit.

Rarely, it is necessary to perform surgery, specifically shoulder arthroscopy In patients with severe loss of function, no support in daily life, or threat of job loss, arthroscopic mobilization of the shoulder can be considered no earlier than 6 months after the onset of pain. Furthermore, if the onset of the resolution phase is significantly delayed (longer than 18 months) or the quality of life is highly compromised, arthroscopic capsule removal and ligament release can be performed. But even after surgery, constant exercise of the shoulder is necessary. Ideally, patients begin movement exercises immediately after surgery while still in the hospital under a blockage of the arm nerve plexus, as this allows them to still perform them without pain.

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Rotator cuff rupture

The rotator cuff consists of 4 tendons with their respective muscles. From front to back, these are subscapularis, supraspinatus, infraspinatus and teres minor. Surrounding the shoulder joint, they center the humeral head in the glenoid socket, counterbalance the force of the deltoid muscle and help to use the arm with strength in lifting it. Various causes lead to tears of these tendons; largely of the supraspinatus and subscapularis.

Traumatic rotator cuff tears occur mainly in the population under 55 years of age, on the one hand due to an accident, on the other hand due to disproportionate occupational or sports-related overhead movements, especially under weight-bearing.

Degenerative rotator cuff tears are mainly caused by age-related overuse of the tendons over many years, which constantly rub against the bony acromion. An anatomically overhanging bony acromion plays some role in these patients. Remarkably, about half of the population over age 65 has rotator cuff tears, but most do not even notice and are asymptomatic because other muscles take over.


Symptoms depend mainly on the crack size and extension. The pain is essentially due to the inflammation caused by the torn tendon and is greater the smaller the tear. Weakness and loss of motion depend on how much tendon material is torn; the greater the tear, the greater the loss of function. Small rotator cuff defects may have a self-healing tendency, whereas a complete tear that is already retracting will continue to progress.


Rotator cuff rupture: diagnosis

First and foremost, a thorough clinical examination is necessary to determine which of the rotator cuff tendons is torn. A dynamic ultrasound examination right in the office helps to determine the extent of the damage. Radiographs are important to rule out possible shoulder osteoarthritis or calcific deposit. Crucial, especially for surgical planning, is magnetic resonance imaging to determine the extent of tendon damage and muscle atrophy.

Rotator cuff rupture: treatment & therapy

Especially in the case of small tears and pain with little loss of function, conservative therapy should always be used in the beginning. The goal is to control the symptoms. With proper therapy and acceptance of limitations, up to 90% of patients with this condition can live well, as exemplified by the large population with silent rotator cuff tears.

The therapy essentially includes:


  • Regenerative measures such as blood plasma injections (PRP, ACS or Stem cell injections) to restart tissue regeneration. Small cracks or partial cracks can heal. Small cracks or partial cracks can heal.
  • and, as the most important support, exercise therapy so that the healthy muscles learn to take over the function of the damaged muscles.

It may take 3 to 6 months for conservative therapy to show improvement.


If you should not respond to conservative therapy or if the tear is already so large that there are considerable functional limitations, a surgical procedure is generally the best option. Shoulder arthroscopy is the gold standard for the treatment of tendon ruptures in the shoulder, and only in exceptional cases an open procedure needs to be chosen (e.g., muscle-tendon transfers for irreparable rotator cuff tears).

Nowadays any rotator cuff tear can be treated and reconstructed arthroscopically. Depending on the existing tear size and tissue quality, the healing rate is between 60% and 90%. The larger the tear and the longer the time between initial symptoms and surgery, the poorer the chance of healing. With the surgical options available nowadays and good results, symptomatic rotator cuff rupture is an urgent reason for surgery. In my own patient population, I have been able to demonstrate over 90% tendon healing in published studies.

Although it is a standard procedure, the operation is comparatively major and entails a long rehabilitation period of 3 to 6 months. Regardless of the surgical approach, as studies have demonstrated, the success of tendon healing depends on numerous factors beyond the surgeon’s control, such as tissue quality, muscle atrophy, inadequate tendon material, diabetes, nicotine abuse, and so on.

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Acromioclavicular joint arthritis

The acromioclavicular (AC) joint is the part of the shoulder where the collar bone meets the bony acromion. Due to the constant stress, x-rays show early signs of wear and tear (AC joint osteoarthritis) in over 80% of the population. However, pain and inflammation occur only after trauma or overuse.


Acromioclavicular joint arthritis: diagnosis

Typically, there is definite tenderness over the AC joint and reaching to the opposite shoulder is painful.


X-ray shows significant wear and magnetic resonance imaging may show fluid in the bones of the AC joint (bone marrow edema) or disintegration of the end of the clavicle (osteolysis).


Acromioclavicular joint arthritis: treatment & therapy

Generally, therapy is non-surgical with the use of pain medications, activity modifications, and cortisone injections into the AC joint.


If the symptoms are persistent, the degenerated parts of the joint need to be resected during a shoulder arthroscopy. The procedure can be performed in the day clinic and takes about 20-30 minutes. Despite the brevity of the surgery, the patient may still experience discomfort over the end of the clavicle for up to 6 months afterwards.

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Acromioclavicular joint dislocation

Dislocation of the acromioclavicular joint is one of the most common injuries. Typically triggered by a direct fall onto the acromion, this injury occurs primarily in falls while bicycling, snowboarding, skiing or playing soccer.

The joint capsule and the ligaments stabilizing the collarbone are torn.


Acromioclavicular joint dislocation: Diagnosis

AC joint dislocation is primarily detected by physical examination. An X-ray image with weight-bearing compared to the unijured side then shows the extent of the vertical instability. In order to be able to assess the extent of the horizontal instability, a special X-ray image, the so-called Alexander image, must be taken. The injury is classified into 7 stages depending on the severity of the dislocation (according to Rockwood), and surgery should only be performed from stage 3 on. Magnetic resonance imaging provides little additional information.


Acromioclavicular joint dislocation: Treatment & Therapy

Stages 1-2 and sometimes 3 can be treated conservatively with temporary immobilization and use of pain medication.

If one decides to perform surgery, it should be done within the first 3-4 weeks, otherwise the success rate decreases significantly.

During shoulder arthroscopy surgery, various implants are used to bring the clavicle back to the bony acromion, allowing the joint capsule and injured ligaments to heal.

If the surgery is performed later than 3-4 weeks, the reconstruction should be reinforced with biologic material such a tendon, usually taken from the knee joint, because too much time has already passed and the torn ligaments of the clavicle are already scarred and cannot heal.

Postoperatively, the shoulder must be immobilized for 4 weeks, after which physiotherapy should be performed. Contact sports are only allowed again after 6 months.

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Calcareous shoulder

In calcific shoulder calcium deposits occur in the rotator cuff tendons, especisally in the supraspinatus tendon. This condition is also incorrectly referred to as bursitis calcarea (i.e., bursitis) or periarthritis humero-scapularis. This term goes back to the time before arthroscopy, when it was not possible to locate the calcium.

The cause of this disease is largely unknown, the majority of patients affected are in the age group between 35 and 50 years. In 15% of patients, the calcification occurs on both sides. A connection with metabolic diseases or incorrect nutrition is not known.


The disease progresses in 4 phases and often the calcium deposit dissolves spontaneously, but this can take up to 18 months or more. Many patients do not experience any limitations and often a calcium deposit on X-ray is an incidental finding. However, if discomfort does occur, it is usually excruciating pain that hardly improves even in response to painkillers and injections.


Calcified shoulder: diagnosis

The quickest and most effective method of detecting a calcium deposit is to take an X-ray, preferably in 4 planes, so that the calcium can be localized immediately. Magnetic resonance imaging is not necessary. On ultrasound the deposit can also be detected and treated subsequently.



Calcified shoulder: treatment & therapy

At first, the focus is always on conservative therapy with immobilization and activity modification. The performance of a maximum of 3 cortisone infiltrations, preferably ultrasound-targeted into the bursa, is allowed to contain the massive pain. The most promising therapy is the so-called “lavage or ballotage” of the calcium deposit. In this process, under ultrasound control and local anesthesia the calcification is aspirated and removed. If it is too hard an electrolysis can induce the repair process.

Shock wave therapy is also a very effective procedure to dissolve the calcium, but only if high-energy focused shock wave therapy is used.

The most effective way to get rid of the calcium is to remove it during a shoulder arthroscopy. The procedure takes 20 minutes, can be performed as a day case, and the patient is allowed to move the shoulder immediately. Under good physiotherapeutic guidance, the operated arm can be almost fully used again after 2 weeks. The operation has a success rate of over 95%.

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Shoulder instability

The shoulder joint is the most mobile joint in the human body and also the joint that is dislocated the most. In this case, the head of the humerus comes out of the socket and can usually only be put back in place with medical assistance. Subluxation is the partial protrusion of the humeral head. Congenital connective tissue weakness (hypermobility) promotes shoulder instability.

Contact sports such as soccer, snowboarding, soccer, ice hockey, and unfortunate falls represent the majority of causes of shoulder instability. The younger the patient, the higher the risk of further dislocations of the shoulder. Despite physical therapy and strengthening exercises, the rate of recurrent shoulder dislocation in under 30-year-olds is over 90%. If the trauma adds a bone defect, the rate is even higher regardless of age. Any further shoulder dislocation can further damage the cartilage and bone of the shoulder joint and cause premature wear and tear.


Shoulder instability: diagnosis

A dislocated shoulder joint can usually only be put back into place with medical assistance. An x-ray examination is important to confirm the correct fit after the humeral head has been set. A computed tomography scan is necessary to determine the extent of possible bone loss. A magnetic resonance imaging scan shows the detachment of the labrum from the glenoid cavity.

Any shoulder dislocation (shoulder luxation) should be evaluated by a specialist.


Shoulder instability: treatment & therapy

If activity is not changed after the initial shoulder dislocation, surgical stabilization is usually the treatment of choice. In the most common cases, the surgery is performed arthroscopically, refixing the capsular ligamentous apparatus back into place. Rarely, an open capsular shift may be necessary if the shoulder capsule volume is extensive. Bony glenoid reconstruction is indicated for bone loss at the glenoid cavity. In this procedure, a bone is removed from the iliac crest and folded over a slit in the glenoid cavity to restore the bony from. The advantage is that no screws need to be used (J-span plastic). In skilled hands, the procedure can also be performed arthroscopically.

Postoperatively, the shoulder should be immobilized in a bandage for 6 weeks. Afterwards, the full range of motion is trained again under physiotherapeutic guidance. Endurance sports can be resumed after 3 months, contact sports after 6 months.


  • Every shoulder dislocation must be medically clarified.
  • The younger the patient, the higher the recurrence rate.
  • The more often a shoulder luxates, the greater the risk of arthrosis.
  • If there is overmovement, there is a greater risk of shoulder dislocation.

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