Skip to main content

Other Causes of Shoulder Stiffness

  • Chapter
Book cover Shoulder Stiffness

Abstract

There are many possible causes of a stiff shoulder. In this chapter, the authors will discuss some of the secondary causes of shoulder stiffness. This includes factors such as neurological disorders, heterotopic ossification, calcification tendonitis, degenerative arthritis, generalized arthritis, and posttraumatic causes. Each of these factors has a different effect on the presentation and required management of shoulder stiffness.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. O’Dwyer NJ, Ada L, Neilson PD. Spasticity and muscle contracture following stroke. Brain. 1996;119(Pt 5):1737–49.

    Article  PubMed  Google Scholar 

  2. Farmer SE, James M. Contractures in orthopaedic and neurological conditions: a review of causes and treatment. Disabil Rehabil. 2001;23(13):549–58.

    Article  CAS  PubMed  Google Scholar 

  3. Elbasiouny SM, Moroz D, Bakr MM, Mushahwar VK. Management of spasticity after spinal cord injury: current techniques and future directions. Neurorehabil Neural Repair. 2010;24(1):23–33.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Yelnik AP, Colle FM, Bonan IV, Vicaut E. Treatment of shoulder pain in spastic hemiplegia by reducing spasticity of the subscapular muscle: a randomised, double blind, placebo controlled study of botulinum toxin A. J Neurol Neurosurg Psychiatry. 2007;78(8):845–8.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Rekand T. Clinical assessment and management of spasticity: a review. Acta Neurol Scand Suppl. 2010;190:62–6.

    Article  PubMed  Google Scholar 

  6. Montané E, Vallano A, Laporte JR. Oral antispastic drugs in nonprogressive neurologic diseases: a systematic review. Neurology. 2004;63(8):1357–63.

    Article  PubMed  Google Scholar 

  7. Kim YW, Shin JC, Yoon J-G, Kim Y-K, Lee SC. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study. Chin Med J (Engl). 2013;126(24):4638–43.

    Google Scholar 

  8. Birch R. Nerve repair. In: Wolfe SW, Hotchkiss R, Pederson WC, Kozin SH, editors. Green’s operative hand surgery. 6th ed. Philadelphia: Churchill Livingstone; 2010. p. 1035–74.

    Google Scholar 

  9. Pearl ML. Shoulder problems in children with brachial plexus birth palsy: evaluation and management. J Am Acad Orthop Surg. 2009;17(4):242–54.

    PubMed  Google Scholar 

  10. Sunderland SS. Nerves and nerve injuries. 2nd ed. Edinburgh: Churchill Livingstone; 1978.

    Google Scholar 

  11. Oberlin C, Beal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5–C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994;19(2):232–7.

    Article  CAS  PubMed  Google Scholar 

  12. Teboul F, Kakkar R, Ameur N, Beaulieu J-Y, Oberlin C. Transfer of fascicles from the ulnar nerve to the nerve to the biceps in the treatment of upper brachial plexus palsy. J Bone Joint Surg Am. 2004;86-A(7):1485–90.

    PubMed  Google Scholar 

  13. Spinner RJ, Shin AY, Hebert-Blouin M-N, Elhassan BT, Bishop AT. Traumatic brachial plexus injury. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, editors. Green’s operative hand surgery. 2nd ed. Philadelphia: Churchill Livingstone; 2010. p. 1235–92.

    Google Scholar 

  14. Levy O, Iyer S, Atoun E, Peter N, Hous N, Cash D, et al. Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis? J Shoulder Elbow Surg. 2013;22(4):505–11.

    Article  PubMed  Google Scholar 

  15. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty. 1999;14(6):756–60.

    Article  CAS  PubMed  Google Scholar 

  16. Ibarra C, Craig EV. Soft-tissue balancing in total shoulder arthroplasty. Orthop Clin North Am. 1998;29(3):415–22.

    Article  CAS  PubMed  Google Scholar 

  17. Cleeman E, Brunelli M, Gothelf T, Hayes P, Flatow EL. Releases of subscapularis contracture: an anatomic and clinical study. J Shoulder Elbow Surg. 2003;12(3):231–6.

    Article  PubMed  Google Scholar 

  18. Nicholson GP, Twigg S, Blatz B, Sturonas-Brown B, Wilson J. Subscapularis lengthening in shoulder arthroplasty. J Shoulder Elbow Surg. 2010;19(3):427–33.

    Article  PubMed  Google Scholar 

  19. Sperling JW, Cofield RH, Rowland CM. Neer hemiarthroplasty and Neer total shoulder arthroplasty in patients fifty years old or less. Long-term results. J Bone Joint Surg Am. 1998;80(4):464–73.

    CAS  PubMed  Google Scholar 

  20. Pfahler M, Jena F, Neyton L, Sirveaux F, Molé D. Hemiarthroplasty versus total shoulder prosthesis: results of cemented glenoid components. J Shoulder Elbow Surg. 2006;15(2):154–63.

    Article  CAS  PubMed  Google Scholar 

  21. Strauss EJ, Verma NN, Salata MJ, McGill KC, Klifto C, Nicholson GP, et al. The high failure rate of biologic resurfacing of the glenoid in young patients with glenohumeral arthritis. J Shoulder Elbow Surg. 2014;23(3):409–19.

    Article  PubMed  Google Scholar 

  22. Denard PJ, Walch G. Current concepts in the surgical management of primary glenohumeral arthritis with a biconcave glenoid. J Shoulder Elbow Surg. 2013;22(11):1589–98.

    Article  PubMed  Google Scholar 

  23. Bateman E, Donald SM. Reconstruction of massive uncontained glenoid defects using a combined autograft-allograft construct with reverse shoulder arthroplasty: preliminary results. J Shoulder Elbow Surg. 2012;21(7):925–34.

    Article  PubMed  Google Scholar 

  24. Clitherow HDS, Frampton CMA, Astley TM. Effect of glenoid cementation on total shoulder arthroplasty for degenerative arthritis of the shoulder: a review of the New Zealand National Joint Registry. J Shoulder Elbow Surg. 2014;23(6):775–81.

    Article  PubMed  Google Scholar 

  25. Namdari S, Skelley N, Keener JD, Galatz LM, Yamaguchi K. What is the role of arthroscopic debridement for glenohumeral arthritis? A critical examination of the literature. Arthroscopy. 2013;29(8):1392–8.

    Article  PubMed  Google Scholar 

  26. New Zealand Orthopaedic Association. The New Zealand Joint Registry annual report [Internet]. 2013. p. 95–106. Available from: http://www.nzoa.org.nz/system/files/NJR%2014%20Year%20Report.pdf.

  27. Gonzalez J-F, Alami GB, Baque F, Walch G, Boileau P. Complications of unconstrained shoulder prostheses. J Shoulder Elbow Surg. 2011;20(4):666–82.

    Article  PubMed  Google Scholar 

  28. Sperling JW, Cofield RH, Rowland CM. Minimum fifteen-year follow-up of Neer hemiarthroplasty and total shoulder arthroplasty in patients aged fifty years or younger. J Shoulder Elbow Surg. 2004;13(6):604–13.

    Article  PubMed  Google Scholar 

  29. Bohsali KI, Wirth MA, Rockwood CA. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(10):2279–92.

    Article  PubMed  Google Scholar 

  30. Wiater BP, Moravek JE, Wiater JM. The evaluation of the failed shoulder arthroplasty. J Shoulder Elbow Surg. 2014;23(5):745–58.

    Google Scholar 

  31. Zumstein MA, Pinedo M, Old J, Boileau P. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg. 2011;20(1):146–57.

    Article  PubMed  Google Scholar 

  32. Cheung E, Willis M, Walker M, Clark R, Frankle MA. Complications in reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2011;19(7):439–49.

    PubMed  Google Scholar 

  33. Australian Orthopaedic Association. Demographics and outcomes of shoulder arthroplasty [Internet]. Australian National Joint Registry Report No. 6. 2013. p. 1–65. Available from: https://aoanjrr.dmac.adelaide.edu.au/documents/10180/127369/Demographics%20and%20Outcomes%20of%20Shoulder%20Arthroplasty.

  34. Sershon RA, Van Thiel GS, Lin EC, McGill KC, Cole BJ, Verma NN, et al. Clinical outcomes of reverse total shoulder arthroplasty in patients aged younger than 60 years. J Shoulder Elbow Surg. 2014;23(3):395–400.

    Article  PubMed  Google Scholar 

  35. Busilacchi A, Bottegoni C, Gigante A. Arthroscopic management of heterotopic ossification of the subscapularis tendon in a patient with tuberculosis: a case report. J Shoulder Elbow Surg. 2012;21(1):e1–5.

    Article  Google Scholar 

  36. Pansard E, Schnitzler A, Lautridou C, Judet T, Denormandie P, Genêt F. Heterotopic ossification of the shoulder after central nervous system lesion: indications for surgery and results. J Shoulder Elbow Surg. 2013;22(6):767–74.

    Article  PubMed  Google Scholar 

  37. Jayasundara JASB, Punchihewa GL, de Alwis DS. An unusual case of adult onset progressive heterotopic ossification suggesting a variant form of fibrodysplasia ossificans progressiva. Singapore Med J. 2012;53(4):e83–6.

    CAS  PubMed  Google Scholar 

  38. Warner JJ, Ejnisman B, Akpinar S. Surgical management of heterotopic ossification of the shoulder. J Shoulder Elbow Surg. 1999;8(2):175–8.

    Article  CAS  PubMed  Google Scholar 

  39. Aubut J-AL, Mehta S, Cullen N, Teasell RW, ERABI Group, Scire Research Team. A comparison of heterotopic ossification treatment within the traumatic brain and spinal cord injured population: an evidence based systematic review. NeuroRehabilitation. 2011;28(2):151–60.

    PubMed Central  PubMed  Google Scholar 

  40. Ploumis A, Belbasis L, Ntzani E, Tsekeris P, Xenakis T. Radiotherapy for prevention of heterotopic ossification of the elbow: a systematic review of the literature. J Shoulder Elbow Surg. 2013;22(11):1580–8.

    Article  PubMed  Google Scholar 

  41. Ahmed SI, Burns TC, Landt C, Hayda R. Heterotopic ossification in high-grade open fractures sustained in combat: risk factors and prevalence. J Orthop Trauma. 2013;27(3):162–9.

    Article  PubMed  Google Scholar 

  42. Tanner MW, Cofield RH. Prosthetic arthroplasty for fractures and fracture-dislocations of the proximal humerus. Clin Orthop Relat Res. 1983;179:116–28.

    Article  PubMed  Google Scholar 

  43. Kjaersgaard-Andersen P, Frich LH, Søjbjerg JO, Sneppen O. Heterotopic bone formation following total shoulder arthroplasty. J Arthroplasty. 1989;4(2):99–104.

    Article  CAS  PubMed  Google Scholar 

  44. Sperling JW, Cofield RH, Rowland CM. Heterotopic ossification after total shoulder arthroplasty. J Arthroplasty. 2000;15(2):179–82.

    Article  CAS  PubMed  Google Scholar 

  45. Grönhagen CM, Abbaszadegan H, Révay SA, Adolphson PY. Medium-term results after primary hemiarthroplasty for comminute proximal humerus fractures: a study of 46 patients followed up for an average of 4.4 years. J Shoulder Elbow Surg. 2007;16(6):766–73.

    Article  PubMed  Google Scholar 

  46. Kircher J, Martinek V, Mittelmeier W. Heterotopic ossification after minimally invasive rotator cuff repair. Arthroscopy. 2007;23(12):1359.e1–3.

    Article  Google Scholar 

  47. Matsumoto I, Ito Y, Tomo H, Nakao Y, Takaoka K. Case reports: ossified mass of the rotator cuff tendon in the subacromial bursa. Clin Orthop Relat Res. 2005;437:247–50.

    Article  PubMed  Google Scholar 

  48. Genêt F, Jourdan C, Schnitzler A, Lautridou C, Guillemot D, Judet T, et al. Troublesome heterotopic ossification after central nervous system damage: a survey of 570 surgeries. Feany M, editor. PLoS One. 2011;6(1):e16632.

    Article  PubMed Central  PubMed  Google Scholar 

  49. da Paz AC, Carod Artal FJ, Kalil RK. The function of proprioceptors in bone organization: a possible explanation for neurogenic heterotopic ossification in patients with neurological damage. Med Hypotheses. 2007;68(1):67–73.

    Article  PubMed  Google Scholar 

  50. Isaacson BM, Brown AA, Brunker LB, Higgins TF, Bloebaum RD. Clarifying the structure and bone mineral content of heterotopic ossification. J Surg Res. 2011;167(2):e163–70.

    Article  PubMed  Google Scholar 

  51. Bauer AS, Lawson BK, Bliss RL, Dyer GSM. Risk factors for posttraumatic heterotopic ossification of the elbow: case-control study. J Hand Surg Am. 2012;37(7):1422–6.

    Article  PubMed  Google Scholar 

  52. Brooker AF, Bowerman JW, Robinson RA, Riley LH. Ectopic ossification following total hip replacement. J Bone Joint Surg Am. 1973;55:1629–32.

    CAS  PubMed  Google Scholar 

  53. Knelles D, Barthel T, Karrer A, Kraus U, Eulert J, Kölbl O. Prevention of heterotopic ossification after total hip replacement. A prospective, randomised study using acetylsalicylic acid, indomethacin and fractional or single-dose irradiation. J Bone Joint Surg Br. 1997;79(4):596–602.

    Article  CAS  PubMed  Google Scholar 

  54. Hamid N, Ashraf N, Bosse MJ, Connor PM, Kellam JF, Sims SH, et al. Radiation therapy for heterotopic ossification prophylaxis acutely after elbow trauma: a prospective randomized study. J Bone Joint Surg Am. 2010;92(11):2032–8.

    Article  PubMed  Google Scholar 

  55. Boehm TD, Wallace WA, Neumann L. Heterotopic ossification after primary shoulder arthroplasty. J Shoulder Elbow Surg. 2005;14(1):6–10.

    Article  PubMed  Google Scholar 

  56. Mishra MV, Austin L, Parvizi J, Ramsey M, Showalter TN. Safety and efficacy of radiation therapy as secondary prophylaxis for heterotopic ossification of non-hip joints. J Med Imaging Radiat Oncol. 2011;55(3):333–6.

    Article  PubMed  Google Scholar 

  57. Berris T, Mazonakis M, Kachris S, Damilakis J. Peripheral organ doses from radiotherapy for heterotopic ossification of non-hip joints: is there a risk for radiation-induced malignancies? Phys Med. 2014;30(3):309–13.

    Article  PubMed  Google Scholar 

  58. Lee EK, Namdari S, Hosalkar HS, Keenan MA, Baldwin KD. Clinical results of the excision of heterotopic bone around the elbow: a systematic review. J Shoulder Elbow Surg. 2013;22(5):716–22.

    Article  PubMed  Google Scholar 

  59. Brislin KJ, Field LD, Savoie 3rd FH. Complications after arthroscopic rotator cuff repair. Arthroscopy. 2007;23(2):124–8.

    Article  PubMed  Google Scholar 

  60. Codman EA. Calcified deposits in the supraspinatus tendon. In: The shoulder: rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Boston: Thomas Todd; 1934. p. 178–215.

    Google Scholar 

  61. McLaughlin HL. Lesions of the musculotendinous cuff of the shoulder: III. Observations on the pathology, course and treatment of calcific deposits. Ann Surg. 1946;124:354–62.

    Article  PubMed Central  Google Scholar 

  62. Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management. J Am Acad Orthop Surg. 1997;5(4):183–91.

    PubMed  Google Scholar 

  63. Uhthoff HK, Sarkar K, Maynard JA. Calcifying tendinitis. A new concept of its pathogenesis. Clin Orthop Relat Res. 1976;118:164–8.

    PubMed  Google Scholar 

  64. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12,122 shoulders. JAMA. 1941;116(22):2477–82.

    Article  Google Scholar 

  65. Comfort TH, Arafiles P. Barbotage of the shoulder with image-intensified fluoroscopic control of needle placement for calcific tendinitis. Clin Orthop Relat Res. 1978;135:171–8.

    PubMed  Google Scholar 

  66. Ebenbichler GR, Erdogmus CB, Resch KL, Funovics MA, Kainberger F, Barisani G, Aringer M, Nicolakis P, Wiesinger GF, Baghestanian M, Preisinger E, Fialka-Moser V, Weinstabl R. Ultrasound therapy for calcific tendinitis of the shoulder. N Engl J Med. 1999;340(20):1533–8.

    Article  CAS  PubMed  Google Scholar 

  67. Gerdesmeyer L, Wagenpfeil S, Haake M, Maier M, Loew M, Wörtler K, Lampe R, Seil R, Handle G, Gassel S, Rompe JD. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003;290(19):2573–80.

    Article  CAS  PubMed  Google Scholar 

  68. Hurt G, Baker Jr CL. Calcific tendinitis of the shoulder. Orthop Clin North Am. 2003;34(4):567–75.

    Article  PubMed  Google Scholar 

  69. Albert JD, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, et al. High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial. J Bone Joint Surg Br. 2007;89(3):335–41.

    Google Scholar 

  70. Wittenberg RH, Rubenthaler F, Ludwig J, Willburger RE, Steffen R. Surgical or conservative treatment for chronic rotator cuff calcifying tendinitis – a matched-pair analysis of 100 patients. Arch Orthop Trauma Surg. 2001;121(1–2):56–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gregory I. Bain MBBS, PhD, FA(Orth)A, FRACS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 ISAKOS

About this chapter

Cite this chapter

Clitherow, H.D.S., Bain, G.I., Mazzocca, A.D. (2015). Other Causes of Shoulder Stiffness. In: Itoi, E., et al. Shoulder Stiffness. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46370-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-46370-3_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46369-7

  • Online ISBN: 978-3-662-46370-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics