Pediatric Orthopedic surgeons width="1024" height="188"


Our orthopedic doctors treat painful shoulder problems occurring in babies, children, teenagers, and adolescents. As doctors, we see more common shoulder injuries accompanied by pain for children who participate in organized sports involving baseball, volleyball, football, and swimming.

We understand how a shoulder injury can also injure the growth plate in your child. Our goal is to help children recover and heal successfully. We have had extra training in children’s growth plates and can factor them into our treatment plans. This allows children’s and adolescents’ bones to grow as successfully as possible.

The Shoulder

Shoulder InjuryThe shoulder, as most people know it, is a collection of joints that work together with tendons and muscles to allow the arm to move in a wide range of motion, from rubbing your back to throwing an excellent pitch. However, there is a cost to mobility. It may worsen shoulder instability or impingement of soft tissue or bony structures, leading to pain. You may experience pain solely when moving your shoulder, or you may experience pain all of the time. The pain may only last for a short time or it could last longer, necessitating medical attention.

This article discusses some of the most prevalent causes of shoulder pain, as well as treatment alternatives. You can ask your doctor for more information about shoulder pain. Your shoulder is comprised of three bones: the Humerus (upper arm bone), the scapula (shoulder blade), and the collarbone (collarbone) (clavicle). Your upper arm bone’s headrests in a spherical socket in your shoulder blade. The glenoid is the name given to this socket. Your arm bone is kept centered in your shoulder socket by a complex system of muscles and tendons. The rotator cuff is the name given to these issues. They connect your shoulder blade to the head of your upper arm bone.


Shorter Recovery Times

“Hospital stays for my patients after surgery are shorter than most. I prepare the child for the surgery in advance. The preparation helps the children recover quicker after surgery, shortening their hospital stay. This may provide a win-win for the children and their families.” Shyam Kishan, MD

Shoulder Injury Causes

Most shoulder issues fall into four major groups:

  • Instability
  • Arthritis
  • Fracture (broken bone)
  • Tumors, infection, and nerve-related disorders are some of the less prevalent reasons for shoulder pain.


Bursae are fluid-filled sacs located in all of the joints of the body, including the shoulder. They serve as cushions between bones and the soft tissues that cover them, as well as reducing friction between gliding muscles and the bone. The bursa between the rotator cuff and the region of the shoulder blade known as the acromion can become inflamed and swollen as a result of overuse of the shoulder. Subacromial bursitis is the result of this situation. Bursitis and rotator cuff tendonitis are frequently seen together. Inflammation and pain can occur in the shoulder’s many tissues. Many ordinary tasks, such as combing hair or getting dressed, may become challenging.


A tendon is a strand of tissue that connects a muscle to a bone. Inflammation of the tendon is the most common cause of tendinitis. As noted below, tendonitis is classified into two types.

Acute. Acute tendonitis can occur by excessive ball throwing or other overhead actions at work or in sports.

Chronic. Chronic tendinitis occurs from degenerative disorders such as arthritis or age-related wear and strain. The four rotator cuff tendons and one of the biceps tendons are the most usually afflicted tendons in the shoulder. A rotator cuff is a group of four tiny muscles and tendons that cover the upper arm bone’s head and hold it in the shoulder socket. The rotator cuff is a ligament that serves to stabilize and move the shoulder.

Tendon Tears

Acute injury, degenerative changes in the tendons due to aging, long-term misuse, wear and tear, or a sudden injury can cause tendons to split and rip. These tears can occur partially or totally, causing the tendon to separate from its bone connection. The tendon is torn away from its attachment to the bone in the majority of cases of complete tears. The most prevalent of these injuries are rotator cuff and biceps tendon tears.


When the arm is raised away from the body, the top of the shoulder blade (acromion) presses against the surrounding soft tissues, causing shoulder impingement. The acromion scrapes on the rotator cuff tendons and bursa as the arm is raised, or “impinges.” Bursitis and tendinitis might develop as a result, causing pain and restricting movement.


When the upper arm bone’s head is driven out of the shoulder socket, shoulder instability develops. Overuse of a sudden injury might cause this. Shoulder dislocations occur partially, with the upper arm’s ball just partially protruding from the socket. Subluxation is a term for this. The ball comes completely out of the socket when it dislocates completely. When the ligaments, tendons, and muscles that surround the shoulder become loose or injured, dislocations can occur repeatedly. When your child elevates his or her arm or moves it away from the body, recurrent dislocations, which can occur partially or fully, cause pain and unsteadiness. Subluxations or dislocations that occur frequently raise the chance of developing arthritis in the joint.


Arthritis can cause shoulder pain and it comes in a variety of forms. Osteoarthritis, sometimes known as “wear and tear” arthritis, is the most frequent type of arthritis in the shoulder. In middle age, swelling, pain, and stiffness are frequent problems. Osteoarthritis progresses slowly, and the pain it causes progressively worsens. Osteoarthritis can occur in sports or work-related accidents, as well as general wear and tear. Other types of arthritis can develop from rotator cuff injuries, infection, or joint lining irritation. In order to alleviate arthritis discomfort, many people avoid shoulder motions. This can cause the soft tissue components of the joint to tighten or stiffen, resulting in a painful restriction of motion.


Bones that have been shattered are known as fractures. The clavicle (collarbone), Humerus (upper arm bone), and scapula (shoulder blade) are all involved in shoulder fractures (shoulder blade). In elderly persons, a fall from a standing height is a typical cause of shoulder fractures. A high-energy event, such as a car accident or a contact sports injury, is frequently the cause of shoulder fractures in younger patients. Fractures in the shoulder area can result in extreme discomfort, edema, and bruising.

The doctors at the Medical City Children’s Orthopedics and Spine Specialists Practice only treat children.  As such, our doctors have become experts with children and adolescents and treat their shoulders.  We urge parents to bring their children to us to ensure proper treatment and healing,

Doctor’s Examination

When your child has an acute injury that causes a lot of pain, you as a parent should take your child to the doctor’s office as soon as possible. If the discomfort or pain appears mild, a young person should rest for a few days to see if the problem will go away on its own. If the pain continues, the parents should take their child to a pediatric orthopedic doctor for an immediate examination. Your doctor will perform a comprehensive examination to establish the source of the shoulder pain and discuss treatment options with the parent.

Medical History

An in-depth medical history is an initial stage in the evaluation. To determine both your child’s general health and the likely causes of the shoulder problem, your doctor may inquire how and when the pain began, if it has occurred before and how it was handled, and other inquiries. Because most shoulder disorders are increased and relieved by specific activities, a medical history will help in determining the reason for the pain.

Physical Examination

To determine the source of your child’s shoulder pain, a thorough examination will take place. Our doctor will look closely for physical anomalies, edema, deformity, or muscle weakness, as well as painful regions. Our doctor will assess shoulder strength and range of motion.


  • Your doctor may order tests to figure out what’s causing your child’s discomfort and if there are any underlying problems.
  • X-rays. Any damage to the bones that make up the shoulder joint will become visible. Ultrasound and magnetic resonance imaging (MRI). These imaging studies produce more accurate images of soft tissues. Your doctor may use an MRI to look for damage to the ligaments and tendons that surround the shoulder joint.
  • A CT scan is a type of imaging that uses a computer to create a three-dimensional image. This machine combines X-rays and computer technology to provide a very detailed image of the bones in the shoulder area.
  • Electrical research. Your doctor may recommend a test to assess nerve function, such as an EMG (electromyogram).
  • Arthrogram. Dye is injected into the shoulder during this x-ray scan to best match the joint and its surrounding muscles and tendons. Its use with an MRI will help with the diagnosis.
  • Arthroscopy. A fiber-optic camera is used by your doctor to view the joint during this surgical operation. To identify soft tissue injuries that are not visible on physical examination, X-rays, or other tests, the doctor will use an arthroscopy.


Activity changes: Rest, modifying your child’s activity, and physical therapy are all common treatments for improving shoulder strength and flexibility. Children can prevent further shoulder pain by simply avoiding overexertion or overdoing activities in which your child does not generally partake.

Medications: To relieve inflammation and pain, your doctor may prescribe medication. If pain medicine is recommended, it should be taken exactly as prescribed. To ease discomfort, your doctor may prescribe numbing drugs or steroid injections.

Surgery: Some shoulder disorders may necessitate surgery. However, simple therapy strategies such as changing activities, rest, exercise, and medication will help the vast majority of patients with shoulder pain. Exercise may not help for certain types of shoulder issues, such as repeated dislocations and some rotator cuff injuries. Doctors may recommend surgery in certain circumstances. Arthroscopy can remove scar tissue or repair injured tissues, or a doctor may recommend open procedures for major reconstructions or shoulder replacements.

More About the Shoulder

The shoulder is the most movable joint in the human body, consisting of three bones, many muscles, ligaments, and tendons. Its appropriate operation is vital for daily tasks since it allows for a wide range of motion. Shoulder injuries account for more than four million visits to the doctor each year, making shoulder pain one of the most common orthopedic issues in the United States. Inflammation, instability, arthritis, or a fracture can all cause shoulder pain or reduced function.

Medical City Children’s Orthopedic and Spine Specialists specialize in the treatment of shoulder injuries and disorders. Our board-certified orthopedic doctors are experts in making accurate diagnoses and developing individualized treatment plans for each patient. Our doctors begin with conservative treatment methods, including injections or physical therapy, as well as sophisticated surgery to restore function to this vital joint. If your child’s shoulder prevents him or her from playing and having an active lifestyle, schedule an appointment with one of our shoulder specialists at Medical City Children’s Orthopedic and Spine Specialists.

Shoulder Injuries

Shoulder injuries usually occur in the shoulder joint. Injuries that occur as a result of one particularly traumatic episode are referred to as acute injuries. In fact, when children’s skeletons are still growing, acute injuries can occur. Sometimes children’s injuries can affect the growth of the bone by injuring the growth plate. For example, shoulder growth plate fractures can occur when a child falls on the shoulder or the outstretched hand. These fractures commonly involve the upper part of the humerus bone or the clavicle. Sometimes, they are in fact clavicle fractures. Normally, growth plate injuries happen because the growing cartilage/bone becomes the weakest structure compared to the surrounding shoulder ligaments. Most growth plate fractures heal without complications, but these injuries often require special attention to avoid future problems with growth.

A parent’s first stop when their child has a broken shoulder bone and is in pain is to ensure the child gets evaluated by a pediatric orthopedic physician. A pediatric Orthopedic with several years of training, like those at Medical City Children’s Orthopedic and Spine Specialists.  Our experienced surgeons understand growth plates and how to address them when contemplating the right diagnosis and treatment. Other examples of acute injuries to the shoulder include dislocation or separation (AC Sprain). Either of these two injuries can occur with a blow to the shoulder or with a fall on the outstretched arm. Shoulder dislocations can result in a cartilage tear in the shoulder, otherwise known as a labral tear.

Overuse Injuries

Thus, injuries that occur over time because of repetitive activity are known as overuse injuries. For instance, Little League Shoulder also referred to as chronic kids’ shoulder pain, occurs in a ball-throwing sport. For example, a shoulder injury in a baseball player may occur because of overuse and inflammation. If this condition happens around the growth plate in the upper part of the humerus bone is also referred to as proximal humeral epiphysiolysis.

Secondly, overuse injuries can also occur in the soft tissues of the shoulder (tendons, ligaments, capsule, etc.) and growth plate. Depending on the symptoms, doctors may refer to this condition as the following:

  • Rotator Cuff Injury
  • Rotator Cuff tendonitis
  • A Rotator Cuff impingement
  • Rotator Cuff tear
  • Rotator Cuff problem

Some young athletes suffer from recurrent shoulder instability that interferes with their ability to continue with their sports or daily activities.

Shoulder Pain Symptoms

Usually, a child or teenager’s shoulder pain and swelling occur after a traumatic injury. The pain may occur in a specific area or in a specific particular location. Also, severe pain, numbness, tingling, and restriction of range of motion may indicate a more serious injury. Additionally, chronic (or overuse) injury may present more gradually, with more vague complaints of pain that are made worse with overhead activity. Overhead athletes may notice a decline in their performance due to the pain. 

Shoulder Surgery

In conclusion, consulting a pediatric orthopedic specialist is warranted when pain and swelling persist when using one of their arms. Especially when home treatment such as RICE (Rest, Ice, Compression, Elevation) did not help the symptoms.  If your child cannot return to activities or sports, or if he or she has joint swelling, locking, or instability, seeking timely professional assistance becomes essential. Therefore, seeing a pediatric orthopedic professional should happen immediately — especially if your injured child is still growing. In summary, injuries that occur near the growth plate can be challenging to recognize. Finally, appropriate treatment will ensure successful healing.

At Medical City Children’s Orthopedic and Spine Specialists, we have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX and our doctors are board-certified and specialize in a growing skeletal system. This includes the diagnosis and treatment of a wide range of injuries that affect school-age athletes. Subsequently, should surgery become necessary and required, our pediatric orthopedic physicians will discuss specialized, age-appropriate, and minimally invasive surgical options with the parents.

We invite parents to give us a call when their children suffer shoulder conditions that cause discomfort or pain.



American Academy of Orthoapedic Surgeons: Shoulder Injuries 

Our experienced and skilled physicians at Medical City Children’s Orthopedic and Spine Specialists diagnose and treat shoulder conditions.

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five
convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.