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Shoulder & elbow surgery

Struggling with a shoulder or elbow problem? We can help

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If there's one way to almost guarantee a shoulder or elbow injury, it's to play professional rugby, cricket, tennis, or golf. Having said that, sports players (both amateur and professional) represent only a small part of the number of people who use the specialist facilities here at Three Shires Hospital on a daily basis.

Our patients also include people who are here to correct every day accidental injuries to their upper body, or who are experiencing pain through natural wear and tear on those parts especially shoulders and elbows.

Three Shires is able to offer patient centered treatment led by specialist consultants at its shoulder and elbow clinic. You can find Three Shires Hospital within the grounds of St. Andrews Hospital close to Northampton General Hospital.

With 14 consulting rooms and 49 private rooms, each with their own full en-suite facilities, Three Shires is not only well located for the many sports people and clubs who rely on it, but also for the local population who need fast access to medical help, private operations, advice, or other professional care including physiotherapy and other treatments whether surgery is required or not. 

At the top of your arm where the ball end of the humerus bone slots into its socket in the scapula (or shoulder blade), there are numerous tendons, muscles, and other tissue all of which form what's called the rotator cuff.

If any parts of these softer tissues are damaged, you'll lose some (or in the worst case, all) ability to move or rotate your arm. This is what's called a rotator cuff injury.

Rotator cuff injuries are the most common injuries we see in the shoulder and elbow clinic, and many are caused through sport, in particular, rugby where the shoulder often comes into heavy contact with other players as well as the ground during tackles.

It's not restricted to sport obviously, any actions we take that cause strain to the shoulder area can result in trauma to the tendons and muscles that surround it, and of course as we age, wear and tear becomes a factor too, though that tends to result in arthritis more than anything else. 

Arthritis is just a name that describes pain or stiffness felt in joints in the body. There are over 100 different types of arthritis, but the most common are osteoarthritis (degenerative joint disease), and rheumatoid arthritis.

Whilst arthritis in general tends to affect the elderly rather than the young, anyone who has had problems with their shoulder either through sport or accidental injury can develop arthritis sooner.

Rheumatoid arthritis is also a problem for younger people, typically from the age of 30 onwards. This is an autoimmune disease where the immune system starts attacking healthy cells resulting in damage that eventually leads to the disease.

It's important with rheumatoid arthritis to control the condition in order to stop damage to the joints as early as possible. Whilst it's not possible to cure this type of arthritis, it is possible with the right treatments to hinder its progress.

Should damage occur to the joints themselves, then surgery to repair the joint, or to replace the joint completely may be the only option. 

If you've ever seen the ball and socket joint of the shoulder (or any ball and socket joint in the body for that matter), you'll know how flimsy it appears to be. That is, there isn't much 'socket' for the ball to sit in.

The reason for that is flexibility. The shoulder joint allows us to move our arms in almost every direction including a nearly 360 degree rotation (which is why cricketers are prone to shoulder problems due to the nature of bowling).

The only things that keep the shoulder and arm ball and socket joint from separating are the muscles, tendons, and other soft tissue that surround it (the rotator cuff).

If any parts of the shoulder should get damaged or tear in any way, and excess pressure is put on the joint, a dislocation (or impaired movement) can result (note this can also happen if the shoulder is fractured in any way). 

Top of the list of problems we see here at Three Shires is tennis elbow (or lateral epicondylitis to give it its medical name). Although it has obvious connections with tennis players, it can affect anyone who uses their hands repetitively, particularly if it involves their grip.

Tennis elbow happens when the tendons on the outside of the lower arm (the forearm) become traumatised in some way. It can happen at any age, although is more usual in middle age.

Pain is felt on the outer part of the elbow at first and can then spread along the lower arm towards the wrist. As it gets worse, you may find it hard to straighten your arm, and in the worst case it can be painful even when the arm is at rest. 

You may be thinking golfers' elbow is the same thing as tennis elbow, but there is a difference, and that difference is where you first feel the pain should you be unlucky enough to experience it.

Where tennis elbow starts with pain on the outside of the elbow, golfers' elbow starts on the inside. It's medical name is medial epicondylitis (the clue to these two conditions is in the terms medial - towards the middle, and lateral - moving away from the middle).

Golfers' elbow comes from similar activities (gripping and loosening of the grip repeatedly) as well as swinging actions (with tennis, a serve uses an overarm action, whereas with golf, it's an underarm action).

Don't get too caught up with the names though, both these conditions can result from a myriad of activities not just sports. For example, people who work in trades such as builders, carpenters, plumbers, and electricians constantly use their hands to grip tools and so can suffer from either of these conditions too. 

Whether you've been referred to Three Shires by your GP, medical insurance company, or are paying for your treatment privately, you will find everything that's necessary here to ensure you get the best medical advice and attention.

That includes specialist equipment including MRI scanning, ultrasound and Xray, as well as medical staff should you need to stay overnight or longer, and of course your own private room with en-suite. 

Where required, after care will be put in place to ensure your recovery is as swift as possible and may include physiotherapy as well as other palliative care. If you have any questions or would like to find out more, please call us on 01604 620311 and we will be happy to help. 

Specialists offering Shoulder & elbow surgery

Mr Pierre Nasr

Consultant Orthopaedic Surgeon

MBBS BSc Dip IMC RCS(Ed) FRCS (Tr&Orth)

BMI Three Shires Hospital

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