Shoulder Conditions
& Treatment

The rotator cuff is a group of four muscles and tendons that stabilize the shoulder and power nearly every arm movement, from lifting groceries to reaching for a top shelf to swinging a golf club. Rotator cuff tears range from small, partial-thickness tears caused by gradual wear to complete, full-thickness tears often triggered by a fall or sudden injury. They're one of the most common sources of shoulder pain, especially as we get older, though they can affect active adults of any age.

Common signs and symptoms include:

• Pain with overhead activity or reaching

• Weakness when lifting or rotating the arm

• Pain that disrupts sleep, especially lying on the affected shoulder

• A catching or grinding sensation with certain movements

• Difficulty performing everyday tasks like getting dressed or reaching behind your back

Not every rotator cuff tear needs surgery. Many partial tears respond well to physical therapy focused on strengthening the surrounding shoulder muscles. When a tear is significant, painful, or hasn't improved with conservative treatment, arthroscopic rotator cuff repair restores the tendon's attachment to the bone. Outcomes are generally favorable, with the large majority of patients returning to their normal activities after repair, though recovery and results depend on the size of the tear, the quality of the tissue, and how long symptoms were present before treatment.

Dr. Eskew evaluates the size and pattern of your tear, along with your goals and activity level, to build a plan aimed at getting you back to full strength and function.

A shoulder dislocation happens when the ball of the shoulder joint slips out of its socket. This often tears the labrum, the ring of cartilage that helps hold the joint in place. Most dislocations occur toward the front of the shoulder, called anterior instability. But the shoulder can also dislocate toward the back, known as posterior instability. This pattern is less common and is frequently missed, especially in athletes who push, block, or bench press. Once the labrum is torn, the shoulder is often more prone to repeat dislocations or a lingering sense of instability, particularly in younger, active patients.

Common signs and symptoms include:

• A shoulder that dislocates, or a sensation of the shoulder slipping or giving way

• Pain, swelling, and limited motion after the initial injury

• A recurring sense of instability with certain arm positions, whether overhead or during pushing and lifting

• Weakness or catching with overhead or reaching movements

Not every first dislocation needs surgery. But recurrence rates after nonsurgical treatment can be high, especially in younger athletes. When surgery is needed, arthroscopic labral repair reattaches the torn labrum and restores stability, whether the instability is anterior, posterior, or both. Outcomes are strong. Studies show roughly 80% of patients return to sport after surgery, with recurrence rates typically under 15% at long-term follow-up. If your case involves significant bone loss or repeated dislocations, additional procedures may be needed for lasting stability.

If your shoulder has ever slipped out of place, or just doesn't feel right anymore, it's worth having it looked at. Dr. Eskew can pinpoint exactly what's going on and build a plan to get your shoulder stable again.

Shoulder arthritis develops when the cartilage cushioning the joint wears down over time, causing bone to grind against bone. It can come from years of wear, a prior injury, or a large, long-standing rotator cuff tear that changes how the joint moves. Whatever the cause, the result is often the same: pain that limits movement, work, and the activities you enjoy.

Common signs and symptoms include:

• Deep, aching pain in the shoulder that worsens with activity

• Stiffness or a loss of motion, especially reaching overhead or behind your back

• A grinding or clicking sensation with movement

• Pain that disrupts sleep

• Symptoms that gradually worsen over months or years

Many patients find real relief through nonsurgical treatment first: activity modification, physical therapy, anti-inflammatory medication, or injections. When arthritis is advanced and these options no longer provide relief, shoulder replacement is one of the most successful procedures in orthopedic surgery. The type of replacement depends on the condition of your rotator cuff. Anatomic total shoulder replacement is used when the rotator cuff is intact, while reverse total shoulder replacement is often the better option when the cuff is damaged or torn. Outcomes for both are excellent, with roughly 90% of patients experiencing significant pain relief and improved function, and implant survival rates remaining high a decade or more after surgery.

If shoulder pain has started to take over your days or your nights, you don't have to keep living around it. Dr. Eskew can help you understand exactly what's driving your pain and whether it's time to consider your options.

Shoulder impingement occurs when the rotator cuff tendons become irritated or compressed as they pass through a narrow space at the top of the shoulder, often during overhead motion. It's one of the most common causes of shoulder pain, and while it can occur on its own, it can also be an early sign of rotator cuff irritation or a related tendon problem.

Common signs and symptoms include:

• Pain with overhead reaching or lifting the arm to the side

• Pain that worsens at certain angles, often described as a painful arc of motion

• Aching that can extend down the outer arm

• Weakness or discomfort with activities like reaching overhead or behind the back

The strongest evidence supports physical therapy, specifically targeted strengthening and movement retraining, as the first-line treatment for shoulder impingement, and most patients see meaningful improvement without surgery. Research has also shown that surgical decompression doesn't consistently outperform physical therapy or even placebo surgery in rigorous trials, which is why Dr. Eskew starts with a thorough, evidence-based nonsurgical approach before considering surgery. When symptoms persist despite a genuine course of therapy, or when impingement is tied to a separate issue like a rotator cuff tear, further evaluation and treatment options can be discussed.

Dr. Eskew takes the time to determine what's truly driving your pain, so you're not steered toward surgery you don't need.

The biceps tendon runs through the front of the shoulder on its way to the biceps muscle, passing through a narrow groove where it's especially vulnerable to irritation. Biceps tendinitis is inflammation of this tendon, often caused by repetitive overhead activity, throwing, or overuse, though it can also develop alongside other shoulder problems like rotator cuff or labral injuries.

Common signs and symptoms include:

• Pain at the front of the shoulder, often radiating down toward the biceps

• Pain that worsens with overhead activity, lifting, or throwing

• Aching or tenderness when pressing on the front of the shoulder

• A catching or snapping sensation, if the tendon becomes unstable within its groove

Biceps tendinitis usually responds well to nonsurgical treatment, including rest, activity modification, physical therapy, and anti-inflammatory measures. When an injection is needed, Dr. Eskew offers ultrasound-guided long head of the biceps tendon (LHBT) injections, allowing for precise, targeted delivery directly to the source of your pain. Because biceps tendinitis often overlaps with other shoulder conditions, particularly labral tears or rotator cuff irritation, getting the diagnosis right matters. If pain doesn't improve with conservative treatment, or if the tendon is unstable or torn, further treatment, up to and including a biceps tenodesis procedure, may be needed.

Dr. Eskew evaluates your shoulder as a whole to determine whether biceps tendinitis is the primary issue or a sign of something else going on, so your treatment plan addresses the true source of your pain.

A separated shoulder involves the acromioclavicular (AC) joint, where the collarbone meets the top of the shoulder blade, not the ball-and-socket joint itself. It's a common injury from a fall or direct hit to the shoulder, often seen in contact sports and cycling accidents. Injuries are graded by severity, from a mild sprain to a complete tear of the supporting ligaments with visible deformity.

Common signs and symptoms include:

• Pain and tenderness at the top of the shoulder

• A visible bump or step-off where the collarbone sits higher than normal

• Pain with overhead motion or reaching across the body

• Swelling and bruising after the injury

Treatment depends heavily on the grade of the injury. Lower-grade separations are almost always treated without surgery, using a sling, activity modification, and physical therapy, with most patients returning to full activity within a matter of weeks. Higher-grade separations are more debated. Research has generally shown that nonsurgical treatment leads to a faster return to sport and work, with clinical outcomes comparable to surgery in most patients. Surgery is typically reserved for the most severe injuries or for patients who continue to have pain and instability despite a full course of nonsurgical treatment.

Dr. Eskew evaluates the grade of your injury and your specific goals to determine whether nonsurgical care or surgical stabilization is the right path for you.

The pectoralis major (chest) and latissimus dorsi (back) tendons attach powerful muscles to the upper arm bone, and both can tear under the extreme forces generated during heavy lifting, throwing, or pulling movements. A pectoralis major tear is often felt as a sudden pop or tearing sensation during a bench press or similar lift, while latissimus dorsi and teres major tears are less common but occur in high-level athletes, including throwers, climbers, and water sports athletes.

Common signs and symptoms include:

• A sudden pop or tearing sensation during a lift or forceful movement

• Immediate pain, bruising, and swelling in the chest, armpit, or upper arm

• Visible deformity or an abnormal contour of the muscle

• Noticeable weakness with pushing (pectoralis) or pulling and internal rotation (latissimus dorsi) movements

Not every tear requires surgery, and outcomes for nonsurgical treatment can be reasonable for lower-demand patients. However, for athletes and active individuals who want to return to lifting, throwing, or overhead sports at a high level, surgical repair generally offers the best chance at restoring full strength. Repair techniques have advanced significantly, with modern suture anchor and cortical button methods providing reliable fixation and good functional outcomes. Because these are relatively uncommon injuries that are sometimes missed on initial evaluation, an accurate diagnosis matters.

Dr. Eskew evaluates the specific tendon involved and the extent of the tear to build a plan focused on restoring your strength for whatever your sport or lifestyle demands.

Frozen shoulder occurs when the capsule surrounding the shoulder joint thickens and tightens, causing pain and a progressive loss of motion. It typically develops without a clear injury, most often in adults between 40 and 65, and is more common in people with diabetes. What makes it frustrating for many patients is the slow, staged progression: pain and stiffness that worsen for months before they begin to improve.

Common signs and symptoms include:

• Gradual, worsening shoulder pain, often without a specific injury

• Progressive loss of motion in all directions, both active and passive

• Difficulty with everyday tasks like reaching overhead, behind the back, or across the body

• Pain that disrupts sleep, especially early in the condition

• Symptoms that move through stages: freezing, frozen, and thawing, often over many months

The good news is that the large majority of patients improve with nonsurgical treatment. Physical therapy is the foundation of care, often paired with anti-inflammatory measures or a corticosteroid injection. For patients who don't respond to initial treatment, options like hydrodilatation (a guided injection that gently stretches the joint capsule) or manipulation under anesthesia can accelerate recovery. Surgery, typically an arthroscopic capsular release, is reserved for cases that remain stiff and painful despite a genuine course of nonsurgical care. Frozen shoulder can take time to fully resolve, but early, appropriate treatment can meaningfully shorten that timeline.

Dr. Eskew identifies exactly where you are in the process and builds a treatment plan aimed at getting your motion, and your comfort, back as quickly as possible.

Shoulder trauma covers a range of injuries, most often from a fall, direct blow, or motor vehicle accident, and can involve the collarbone, the upper arm bone, or the joint where the collarbone meets the breastbone. Getting the right diagnosis quickly matters, since some fractures heal well without surgery while others need prompt surgical stabilization to restore function and prevent long-term complications.

Common types of shoulder trauma include:

• Proximal humerus fractures, a break at the top of the upper arm bone, common after a fall, especially in older adults

• Clavicle (collarbone) fractures, often from a fall onto the shoulder or a direct impact, common in cycling and contact sports

• Sternoclavicular (SC) joint dislocations, where the collarbone separates from the breastbone, an uncommon but potentially serious injury depending on the direction of displacement

• Humeral shaft fractures, breaks along the length of the upper arm bone, typically from significant trauma

• Scapula (shoulder blade) fractures, usually associated with high-energy trauma

Common signs and symptoms include:

• Significant pain, swelling, and bruising after a fall or impact

• Visible deformity or an inability to move the arm

• Numbness or tingling, if nerves near the injury are affected

• Difficulty bearing weight through the arm or shoulder

Treatment depends on the type, location, and severity of the injury, as well as your age and activity level. Many fractures, particularly less displaced proximal humerus and clavicle fractures, heal well with nonoperative treatment: a period of immobilization followed by physical therapy. More significant or displaced fractures may require open reduction and internal fixation (ORIF), using plates and screws to restore alignment and stability. In select cases, particularly complex proximal humerus fractures in older patients, shoulder replacement (often reverse total shoulder arthroplasty) offers more predictable pain relief and function than attempting to repair severely fragmented bone.

Dr. Eskew evaluates your specific fracture pattern, bone quality, and goals to determine the treatment most likely to restore your shoulder's strength and function.