A sudden, excessive strain on the upper arm can lead to painful injuries of the rotator cuff, especially when the tendon structures are already compromised. The rotator cuff consists of several tendons that keep the shoulder joint both mobile and stable. A precise diagnosis can be made using ultrasound or MRI examinations. Treatment options depend on the extent of the injury. In many cases, targeted therapy involving centring exercises is sufficient to relieve pain. However, in cases of partial or complete tendon tears, it is recommended that the tendon be repaired arthroscopically or via minimally invasive surgery, using bone anchors if necessary to reattach it.

A sudden, forceful fall onto the shoulder with the arm at the side can lead to an injury of the acromioclavicular (AC) joint, which is characterised by the so-called "piano key phenomenon", where the collarbone is pushed out of the joint. Treatment options depend on the severity of the injury and the instability of the clavicle. One possible approach is the use of an AC joint brace. However, in more severe cases, surgery is required.

A traumatic shoulder dislocation, also known as an injury to the internal structures of the shoulder joint, occurs when the arm is forcefully rotated outwards or inwards, forwards or backwards, causing the upper arm bone to be displaced from the joint socket and, in severe cases, even become locked. If the shoulder does not return to the socket on its own, urgent medical attention is required to reposition the joint correctly. Depending on the extent of damage to the internal structures, treatment may vary. In many cases, surgery can be avoided through targeted muscle strengthening exercises. However, if persistent instability or recurrent dislocations occur due to labrum tears and overstretching of the joint capsule, surgery may be necessary. The extent of the damage is assessed using contrast-enhanced MRI, and the shoulder is stabilised using arthroscopic techniques. Post-treatment involves immobilisation of the joint followed by careful, individualised physiotherapy or exercise therapy.

Osteoarthritis of the shoulder joint, also known as wear and tear of the shoulder joint, typically presents with discomfort at rest, especially at night, which can wake the patient. Over time, increased cartilage abrasion in the shoulder joint may occur due to injuries, chronic poor posture, or overuse. In addition to the cartilage damage, persistent inflammation of the shoulder joint can develop, often accompanied by joint effusions. In severe cases, bony growths may form, which, in addition to the osteoarthritis pain described above, can cause sharp, stabbing pain. Treatment of shoulder osteoarthritis depends on the degree of damage and the underlying cause. After diagnosis through X-rays and, if necessary, magnetic resonance imaging (MRI), a treatment plan is developed. Strengthening the muscles that move the shoulder joint forms the basis of any osteoarthritis therapy. To avoid surgery (implantation of an artificial joint), modern cartilage regeneration injections or administration of ACP (Autologous Conditioned Plasma) can achieve good medium- to long-term results in treating osteoarthritis. However, if an advanced stage of osteoarthritis is already identified during diagnostic procedures, timely implantation of an artificial joint can help maintain full mobility of the shoulder. If the rotator cuff is torn and so severely worn that it can no longer be repaired, the implantation of a shoulder prosthesis can be a good solution. Even with completely destroyed tendons and osteoarthritis, mobility up to the horizontal plane can be restored.

Impingement syndrome, also known as shoulder impingement, arises from persistent poor posture of the shoulder joint or the formation of a bony spur on the acromion (shoulder roof). This leads to chronic irritation of the bursa located beneath the acromion, causing the bursa to become pinched between the tendon that lifts the arm sideways and the bony acromion. Treatment of impingement syndrome primarily involves personalised physiotherapy aimed at achieving correct shoulder positioning. Anti-inflammatory injections into the bursa can help relieve pain and improve the ability to perform exercises. If damage to the tendons has already occurred due to friction against the bone, or if a bony spur is present, surgical treatment (arthroscopic) of the impingement syndrome is necessary. In such cases, the arm can usually be moved immediately after surgery.

A frozen shoulder, also known as a "stiff shoulder," is caused by inflammatory processes in the joint capsule that lead to painful shrinking. A common cause is the rupture of a calcium deposit in the shoulder joint. This results in significant restrictions in shoulder mobility, such as difficulty combing one’s hair due to the inability to bring the hand to the back of the head. Treatment of a frozen shoulder requires several high-dose corticosteroid injections to suppress the inflammation and stretch the joint capsule. These injections must be combined with intensive physiotherapy to achieve the best possible results. If a specific cause can be identified, such as a calcium deposit, it must be removed surgically. Should symptoms persist despite these treatments, an arthroscopic release of the joint capsule may be necessary to restore mobility.

Symptoms of a calcium deposit are characterised by pain and restricted movement in the shoulder joint. This can result from chronic irritation of the rotator cuff caused by poor posture or impingement syndrome. Night-time pain and sudden, sharp pains during movement are common. In advanced cases, the calcium deposit may rupture into the bursa, leading to severe joint inflammation and potentially causing a frozen shoulder. Treatment of calcium deposits includes anti-inflammatory injections, ultrasound-guided needling, shockwave therapy, or arthroscopic procedures to remove the deposit and prevent possible secondary damage.

Symptoms of bursitis can be triggered by a variety of factors, such as injuries, impingement syndrome, wear and tear, calcium deposits, frozen shoulder, and chronic degeneration of the shoulder joint. Bursitis usually presents with pain and a restriction of movement in the shoulder joint area. Treatment for bursitis typically includes rest, anti-inflammatory measures such as injection therapy, and, if necessary, surgical removal of the affected bursa, especially in cases of recurrent inflammation. A thorough diagnosis and identification of the underlying cause are crucial to ensure successful treatment.