Shoulder Injuries and Post-Surgical Rehabilitation
elderly man with physical therapist working on shoulder

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The shoulder complex is made up of three bones, which are connected by muscles, ligaments, and tendons. The large bone in the upper arm is called the humerus. The shoulder blade is called the scapula and the collarbone is called the clavicle. The top of the humerus is shaped like a ball. This ball sits in a socket on the end of the scapula. The ball is called the head of the humerus and the socket is called the glenoid fossa, hence the term “glenohumeral” joint. The glenoid fossa has a rim of tissue around it called the glenoid labrum. The glenoid labrum makes the glenoid fossa deeper. The glenohumeral joint is the most mobile joint in the body. 

Articular cartilage is a smooth shiny material that covers the humeral head and the glenoid fossa of the glenohumeral joint. There is articular cartilage anywhere that the bony surfaces come into contact with each other. Articular cartilage allows these bones to slide easily over each other as the arm moves. 

The glenohumeral joint is just one of the joints in the shoulder complex. The other two joints are the sternoclavicular joint and the acromioclavicular joint. The sternoclavicular joint allows a small amount of movement to occur between the inner (medial) part of the clavicle and the breastbone (sternum). The acromioclavicular joint allows a small amount of movement to occur between the outer (lateral) part of clavicle and a projection on the top of the scapula called the acromion process. The scapula sits on the back of the ribs and moves as the arm moves. 

Ligaments are like strong ropes that help connect bones and provide stability to joints. In the shoulder complex, ligaments provide stability to the sternoclavicular joint, the acromioclavicular joint and the glenohumeral joint. The ligaments around the sternoclavicular joint and the acromioclavicular joint are strong and tight and do not allow for much movement in these joints. 

The glenohumeral joint is surrounded by a large, loose “bag” called a capsule. The capsule has to be large and loose to allow for the many movement of this joint. Ligaments reinforce the capsule and connect the humeral head to the glenoid fossa of the scapula. These ligaments work with muscles to provide stability to the glenohumeral joint. The glenoid labrum also helps provide stability to the joint. 

Tendons connect muscles to bone. There are four muscles (supraspinatus, infraspinatus, subscapularis and teres minor) that surround the glenohumeral joint. These four muscles are attached to the scapula. They turn into tendons, which in turn attach to the humerus. The tendons of these four muscles make up the “rotator cuff” that blends into and helps support the glenohumeral joint capsule. The muscles of the rotator cuff and their tendons provide stability to the glenohumeral joint when the arm is in motion. The biceps muscle is located in the front of the upper arm. It has two tendons, one of which attaches above the glenoid fossa. This tendon runs down the front of the glenohumeral joint and provides added stability to the glenohumeral joint. There are muscles that stabilize the scapula and others that help move the arm. The rhomboid muscles, trapezius muscle and serratus anterior muscle are a few of the scapular stabilizing muscles. The pectoralis major muscle, the deltoid muscle and the muscles of the rotator cuff are some of the muscles that move the arm at the glenohumeral joint. The upper part of the trapezius muscle also helps “shrug” the shoulder. All of the muscles that are part of the shoulder complex work together in order to move the arm through its many possible ranges of movement. 

Finally, a bursa (pl. bursae) is a fluid filled sac that decreases the friction between two tissues. Bursae also protect tissues from bony structures. In the shoulder, the subacromial bursa (also called the subdeltoid bursa) covers the rotator cuff tendons and protects them from the overlying acromion process. Normally, this bursa has very little fluid in it but if it becomes irritated it can fill with fluid, become painful and also irritate the surrounding rotator cuff tendons. 

Many shoulder problems result from the injury of the above mentioned structures. Physical therapy is often effective in treating these conditions if the injury does not require surgery. Also, physical therapy is a vital aspect of rehabilitation following shoulder surgery. 

Our physical therapists are specially trained to rehabilitate your shoulder injuries. 

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Cole Smith, PT, DPT

Doctor of Physical Therapy

Specialty: Orthopedic Conditions, Post-Operative Rehabilitation, Gait and Balance

  • University of North Georgia 2022 
  • GPT Start Year: 2022

Lydia Gailey, PT, DPT

Doctor of Physical Therapy

Specialty: Pelvic Floor Rehabilitation, Sacroiliac Joint Dysfunction, Low Back Pain

 

  • University of North Georgia 2015
  • 7 years experience
  • GPT Start Year: 2017

Nicole Burkett, PT

Physical Therapist

Specialty: Sacroiliac Joint Dysfunction and Low Back Pain, Cervical Pain, Balance Training

  • University of North Georgia 1997
  • 25 Years Experience
  • GPT Start Year: 2014

Sarah Edwards, PTA

Physical Therapist Assistant

Specialty: Sacroiliac Joint Dysfunction 

Bio: Sarah has been with Gainesville Physical Therapy since 2004. She grew up in Athens, GA and graduated from Athens Technical College in 2004. She currently lives in Jefferson, GA with her two children and dogs. Sarah actively participates with cub scouts and enjoys outdoor activities like camping, hiking and swimming. Specialties include treatment of sacroiliac joint dysfunction and the restorative disc program.

Ree Hyatt, PTA

Physical Therapist Assistant

Specialty: Manual Hand Therapy 

Bio: Ree has been involved in physical therapy for over 36 years. He worked as a physical therapy specialist in the U.S. Army from 1977 to 1980. He also worked as a technician in acute care at Lanier Park Hospital from 1980-1987. Ree has been at Gainesville Physical Therapy since 1987. In 2004, he got his Associates Degree as a Physical Therapy Assistant (PTA) at Athens Technical College. He specializes in hand treatment and the custom fabrication splints.

Darren Hilchie, PT

Physical Therapist

Specialty: Shoulder Rehabilitation, Therapy of the Knee, Manual Therapy

Bio: Darren has been with Gainesville Physical Therapy for 15 years. He graduated from North Georgia College and State University in 2007 as a physical therapist. Darren practiced Exercise Physiology for 5 years in the US and Canada before returning to school to become a physical therapist.

  • North Georgia College and State University 2007
  • 15 Years of Experience
  • GPT Start Year: 2007

Kristy Basinger, PT, CHT

Physical Therapist and Certified Hand Therapist

Specialty: Certified Hand Therapy, Manual Therapy, Post-Operative Spine Rehabilitation

Bio: Kristy Basinger, PT, CHT has practiced physical therapy in Gainesville since 1995. Her clinical specialties include hand therapy, orthopedic manual therapy, and her favorite modality is dry needling.

  • St. Louis University 1995
  • 27 Years Experience
  • GPT Start Year: 1995

Joanne Hamilton, PT

Co-Director & Physical Therapist

Specialty: Industrial Rehabilitation, Arthritis Education, Manual Therapy

Bio: Joanne Hamilton, PT is a Clinical Co-Director of Gainesville Physical Therapy, and has given national presentations on various topics, including Functional Capacity Evaluations, Validity Testing, Management of Injured Workers, and Work Site Assessments.

  • West Virginia University 1978
  • 44 years experience
  • GPT Start Year: 1986

Jeff Skorput, PT

Co-Director & Physical Therapist

Specialty: Sacroiliac Joint Dysfunction & Low Back Pain, Total Joint Rehabilitation, Manual Therapy

Bio: Jeff Skorput, PT joined Gainesville Physical Therapy in 1987. He completed his certificate program in Orthopedic Physical Therapy in 1984. He teaches continuing education courses on the topic of Lumbar Spine and Sacroiliac Joint Dysfunction Evaluation and Treatment. 

  • University of Vermont 1977
  • 45 Years of Experience
  • GPT Start Year: 1987

Vicki Sims, PT, CHT

Co-Director, Physical Therapist, & Certified Hand Therapist

Specialty: Sacroiliac Joint Dysfunction & Low Back Pain, Hand Therapy, Manual Therapy

Bio: Vicki Sims, PT, CHT is a Clinical Co-Director of Gainesville Physical Therapy. Vicki has helped pioneer diagnosis and treatment for Sacroiliac Dysfunction since 1985. She is the co-author of four clinical papers on the sacroiliac joint, and author of “The Definitive Book on the Treatment of SI Joint Dysfunction.” 

  • Georgia State University 1976
  • 46 Years Experience 
  • GPT Start Year: 1986