Shoulder complaints

If you experience pain in or around the shoulder joint, we speak of shoulder complaints. There are many different types of shoulder complaints. As a result, we cannot pinpoint an unequivocal cause. Making the same movements for a long time, inflammation, and trigger points are examples of causes of shoulder joint complaints. A specialized orthopedic surgeon from OrthoDirect examines your shoulder, makes a diagnosis, and ensures that you quickly get rid of your complaints with a tailor-made shoulder treatment.

-An orthopedic surgeon who specializes in shoulder surgery.

– If necessary, an ultrasound and an ultrasound-guided infiltration immediately My

treatment plan

-Close cooperation with the GP and physiotherapist

-Treatment is almost always reimbursed by your health insurance.

– There will be no waiting times

Do you have shoulder complaints? Visit OrthoDirect to solve your complaints. We have no waiting times. In most cases, you can even visit us on the same day. Contact us to make an appointment.

+1 355 622 8329 Make an appointment.

“During my baseball practice, my shoulder started to hurt more and more. Throwing and hitting have become more difficult. The GP referred me to OrthoDirect. Dr. Tulner helped me quickly and very professionally. I am now playing a top match again without pain! ” – Amsterdam resident Walid Junop

Shoulder Anatomy

The shoulder is made up of several joints: an acromioclavicular joint, a scapulothoracic joint, and a glenohumeral joint. The AC joint is located between the collarbone and the shoulder blade, and the scapulothoracic joint is located between the ribs and the shoulder blade. The last joint (glenohumeral) is located between the upper arm and the shoulder blade. This is the part that causes the head of the upper arm to move into the socket of the shoulder blade. In addition to the hair, there are various ligaments and muscles in the shoulder. All these muscles, tendons, and joints can cause complaints.

The most common shoulder problems are

Shoulder complaints can limit you in daily life. For example, you can no longer practice your sport, lift heavy things or move freely. Shoulder complaints have several causes. They can also be acute or chronic and specific or non-specific:

-Acute shoulder complaints are complaints that arise after a wrong movement or fall, for example, during sports or after an accident.

-Chronic shoulder complaints are complaints that have been present for at least three months.

-Specific shoulder complaints: the cause of the complaints is clear.

-Non-specific shoulder complaints: the cause of the complaints is (still) unclear.

View the most common shoulder complaints and the associated treatments below.

Shoulder treatment

The treatment of your shoulder complaints depends on where the pain is located. The treatment of a frozen shoulder is significantly different from that of a biceps tendon tear. In most cases, a frozen shoulder will heal on its own. For a biceps tendon tear, we usually recommend rest and physiotherapeutic exercises. When tendons are clamped in the shoulder, we try to reduce the complaints with exercises and sometimes an anti-inflammatory injection. If this has no effect, we will consider surgery. If the shoulder is so worn, we place a shoulder prosthesis. Read more below about the common shoulder complaints and the associated treatments.

Quick to

Frozen shoulder

Bicep tendon tear

Impingement or entrapment of the shoulder

Shoulder instability

Artrose of the shoulder

Dislocated shoulder

SLAP injuries

Shoulder fractures

Tendon calcification

Rotator cuff tears

Biceps tendonitis (inflammation of the biceps)

Frozen shoulder or frozen shoulder?

A frozen shoulder is caused by inflammation of the shoulder tendons but can also occur for no apparent reason. Certain cells of the shoulder capsule change under the influence of chemicals into cells with different functions. This causes a serious limitation of movement in the shoulder.


Different phases can be distinguished with different symptoms in each phase.

-First phase: the freezing phase

   Combination of pain and incipient restriction of movement.

Phase 2: The Frozen Phase

   The pain gradually disappears, but the limitation of movement remains.

Phase 3: The extinguishing phase

   The restrictions on movement are disappearing more and more.

It takes an average of one year to go through the phases.


The causes of a frozen shoulder are not always clear, but we can assume the following causes:

-Underlying inflammation of the shoulder tendons

-Inflammation after trauma or surgery

Patients with diabetes, thyroid disease, or Dupuytren’s disease have a greater chance of developing a frozen shoulder.

Shoulder treatment

A frozen shoulder heals on its own in almost all cases, but it can take a long time. Pijnstillende medicatie, fysiotherapie en injecties kunnen het herstel bevorderen. Indien er geen verbetering optreedt en de schouder in de ‘bevroren fase’ blijft is een operatieve behandeling noodzakelijk.

Do you suffer from a frozen shoulder? Call for advice or make an appointment immediately.

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Biceps tendon tear

A biceps tendon tear is a partial or complete tear of the long biceps tendon. This tendon runs from the biceps to the top of the shoulder joint. A biceps tear gives a sharp pain.


-An acute, sharp pain in the elbow, shoulder, or upper arm

-A snapping, crackling or tearing sound or sensation

-Bruising in the middle of the upper arm ball-shaped swelling

-Loss of strength when bending the elbow or lifting


– Long-term (over) load

– Wear on the tendon

– Sudden overload shortened muscles stiffness of the joints

Shoulder treatment

In most cases, we treat a biceps tendon tear with rest and physiotherapy exercises. You will be required to wear a sling or polling and will be given non-steroidal anti-inflammatory medications. Together with a physiotherapist, you train the muscles around the biceps tendon to compensate for the loss of function. Only younger patients who need the full strength of the biceps or who are concerned about the aesthetic consequences do we treat surgically. In that case, a bone anchor and sutures are applied.

Do you recognize the above symptoms and do you suspect a ruptured biceps tendon? Contact us. +1 355 622 8329 Make an appointment.

Impingement or entrapment

The tendons of the shoulder can become wedged between the roof of the shoulder and the upper arm. We call this impingement of the shoulder. Pain and restricted movement are common complaints, although the symptoms vary from person to person.


-There is a pain in the upper arm with a typical pain pattern

-Pain during or after an activity

-Spontaneous pain at night

-Continuous shooting pains

-Loss of strength with efforts above the shoulders.


-Swelling of the structures under the shoulder roof

-Additional space is occupied by the structures under the shoulder roof

-Reduction of the space under the shoulder roof

-Movement of the rotator cuff muscles.

-The varying shapes of the shoulder roof

Shoulder treatment

In the event of impingement or entrapment, we first try to reduce the complaints with exercises to train the rotator cuff muscles and lengthen them. In the case of severe pain, an anti-inflammatory injection is administered. If these methods have no effect, an operation can be considered in which the bursa is removed and possibly also the sloping part of the roof of the shoulder is planned straight.

Shoulder instability

An unstable feeling in the shoulder is one of the most common shoulder problems. Different muscles, ligaments, and other elements work together to ensure that the shoulder remains stable and in the socket. Injuries to any of the structures can cause instability.


-Pronounced “sharp pain” at complete dislocation (dislocated shoulder)

-Deformity of the joint

-Pain with specific movements, such as lifting and turning the arm outward.


– Injury to the capsule and labrum after an accident

– Broken bone

– Torn muscles

– Congenital instability due to a general laxity of the joints

– Hypermobility

– Acquired instability by frequently moving the shoulder into extreme positions.

Shoulder treatment

With shoulder instability, the surrounding rotator cuff muscles must become strong enough to promote stability. Physiotherapy strengthens the muscles around the shoulder. In the case of post-traumatic instability, we usually opt for surgical treatment, in which we repair the injury to the capsule and labrum.

Do you recognize the above symptoms? Contact OrthoDirect at 035 622 8329. Make an appointment.

Artrose shoulder (shoulder prosthesis)

We speak of artists of the shoulder when the head no longer moves smoothly because the ends of the bones are rough and deformed. In a normal, healthy shoulder, the ends of the bones are covered with cartilage.  Artrosis can be painful and affect mobility and daily activities.


-Stiffness and pain

-Due to pain, it is not possible to lie on the shoulder at night

-The pain gets worse after putting weight on the joint

– Weather conditions influence the degree of pain

-Daily activities, such as getting dressed, washing, or picking things up, are hampered by pain and stiffness.


Arthritis of the shoulder usually develops with age or due to excessive stress on the shoulder.

Shoulder treatment

At the beginning of artrosis, we can reduce the pain and movement complaints with rest, medication, and exercises. If there is serious artrosis, we will place a shoulder prosthesis during an operation. The type of prosthesis depends on the degree of arthrosis. The orthopedic surgeon explains during the first consultation what the options are and what the treatment entails.

Do you have the above complaints? Visit OrthoDirect. We would like to see if you have a sore shoulder. +31 35 622 8329 Make an appointment.

Acromioclavicular dislocation

We speak of an AC dislocation when the AC joint, which is located between the collarbone and part of the shoulder blade, dislocates. This not only causes pain complaints but can also cause damage to the hair.


  • Mild to pronounced pain at the site of the joint.
  • Moving collarbone
  • Swelling around the joint
  • Unstable joint.


  • Direct fall on the shoulder
  • Clap on the shoulder, for example during sports

Shoulder treatment

We make a diagnosis based on an examination and an X-ray. Usually, surgery is not necessary for an AC luxation. You will wear a sling or polling for several weeks. In severe dislocation, the joint must be reduced with surgery. Pins, wires, a synthetic band, or a screw then hold the joint in place.

Has your shoulder been dislocated by a fall or blow? Contact OrthoDirect directly. We will help you quickly.

+1 355 622 8329  Make an appointment

SLAP injuries

The long biceps tendon attaches to the labrum, a connective tissue ring in the shoulder. In a SLAP injury, the labrum is torn at this attachment. A tear in the attachment occurs mainly in overhand athletes or after a fall on an outstretched arm.


  • An acute injury is a sharp pain deep in the shoulder
  • For injuries that develop gradually, mainly sharp pain with overhead activities, clenching feeling when moving above shoulder height
  • A clicking or popping sound
  • Unsteady feeling in the shoulder
  • Loss of strength in the arm.


  • A fall on an outstretched hand with the arm against the body
  • Dislocation of the shoulder
  • An acute pull on the biceps tendon during certain overhead activities
  • Damage to the tissue due to overload occurs mainly in avid athletes (including tennis, volleyball, basketball, and baseball).

Shoulder treatment

We make the diagnosis based on symptoms, clinical examination, and additional research. Depending on the severity of the injury, we perform conservative or surgical treatment. We try to strengthen the stability of the shoulder and attachment with conservative treatment. If this is not enough, surgery is necessary. The orthopedic surgeon works through two or three small stitch holes. The orthopedic surgeon inspects all structures around the joint, after which he fixes the injury with bone anchors and sutures.

Do you recognize any of the above symptoms? Make an appointment immediately for the first consultation at OrthoDirect.

+31 35 622 8329 Make an appointment.

Fractures at the shoulder

A shoulder fracture is relatively common. Four to five percent of all fractures involve a fracture of the shoulder joint. A broken shoulder is usually the result of a fall on the shoulder or outstretched arm. In most cases, it concerns a fracture that has not or has been minimally displaced.


Swelling around the shoulder.

Pain when moving the arm.

Acute pain after fall.


A shoulder fracture usually occurs after a fall on the shoulder or stretched arm.

The elderly have a higher risk of fractures due to osteoporosis or osteoporosis.

Shoulder treatment

The treatment required depends on the severity and complexity of the fracture.

You will be given a sling or bandage to hold the bone in place and reduce the pain. In the case of a fracture without displacement, we have the fracture repaired in this way.

If bone fragments have been moved, the orthopedic surgeon will put them back in the correct place. In the event of an unstable fracture, the assembly is held in place with screws and pins.

If there is a serious shoulder fracture, displacement of the head, and no blood supply in the shoulder, we opt for a shoulder prosthesis.

If you have pain in your shoulder after a fall, contact your doctor or orthopedist immediately.

035 622 8329 Make an appointment

Tendon calcification in the shoulder

Calcium deposits in the shoulder mainly occur when there is reduced blood flow. Lime in the tendons of the shoulder is not the result of an (accident) fall or overload. Tendon calcification occurs in three to five percent of the population. Only a small proportion experience complaints.


Nagging or severe pain.

Impingement symptoms.

Nocturnal pain when lying on the shoulder.

Pain with movements above the shoulder.

Pain radiating from the front of the shoulder to the upper arm.

Loss of strength or stiffness in the arm and shoulder.


Calcium deposits are part of the aging of tendons and mainly occur in women and men between the ages of 40 and 50. There is no connection with:




calcium intake;

hard labor.

Shoulder treatment

In general, tendon calcification is a self-healing condition. To reduce the pain, the orthopedic surgeon treats the tendon inflammation with anti-inflammatories and gives advice for rest, exercises and painkillers. A pain-relieving injection can also be given.

Feel free to visit OrthoDirect if you experience shoulder complaints. We are happy to help you.

035 622 8329 Make an appointment

“After a fall I was unable to move my arm without pain. I contacted Dr. Tulner. I got him on the phone right away and was allowed to come by the same day with the tear inon my shoulder. He was able to help me immediately, luckily surgery was not necessary.” Johannes from Amsterdam

Rotator cuff tear

The rotator cuff muscles are the shoulder muscles that largely provide shoulder stability. A tear in one or more of these muscles causes instability of the shoulder and leads to shoulder complaints, such as impingement.


Pain in the shoulder and upper arm.

Loss of strength with outward and upward movements.

Feeling of instability or dislocation of the shoulder.

Difficulty raising the arm and movements above shoulder height.

Pain when lying on the shoulder.


Muscle overload.

Fall on the shoulder or arm.

Shoulder treatment

With special exercises for the four rotator cuff muscles, the tissue can strengthen and thus recover. If the tear does not heal with exercises, the orthopedic surgeon will perform surgery to repair the tear.

Biceps tendonitis (inflammation of the biceps)

Inflammation of the biceps tendon, the tendon that runs from the biceps to the front of the shoulder, is a result of overloading the tendon structure. Prolonged inflammation of the tendon can cause a tear.


Deep, sharp pain in the front and top of the shoulder.

Pain radiating to the front of the upper arm.

Pain worsens with overhead movements.

Pain decreases with rest.

Crackling or blocking sensation at the top of the biceps.


Acute or repetitive straining of the tendon.

Fall or hit the shoulder.

Repeated bending of the elbow.

Lifting heavyweights.

Previous injury to biceps.

The bad posture of the trunk and shoulder.

Decreased shoulder instability.

Shoulder treatment

In most cases, an inflammation of the biceps tendon can be resolved with rest and the temporary avoidance of sports and intensive work, in combination with anti-inflammatory medication and physiotherapy. We only consider an injection when the complaints persist or are very severe. If the above measures do not reduce the symptoms, surgery will be the next step.

It is important that you contact a specialist in time if you experience shoulder complaints. This will prevent any damage from increasing.

035 622 8329 Make an appointment

Costs and Fee

The exact costs of shoulder treatment at OrthoDirect depend on your complaints and the final treatment. In the first consultation we draw up a personal treatment plan and we inform you immediately about the costs. In most cases, the shoulder treatment is fully reimbursed by the health insurer. In that case, you only have to pay the deductible. View an indication of the costs on our rates page.

“I came to OrthoDirect through a teammate. I was very pleased that I immediately saw Dr. Tulner on the phone and I was able to come by that afternoon. He immediately took me seriously and soon discovered that I had a crush. I started working with a physiotherapist to strengthen my muscles and my pain quickly disappeared.” – Job de Vries from Hilversum

Make an appointment for a shoulder treatment

Make an appointment immediately at OrthoDirect and have your shoulder complaints resolved. Contact us on 035 622 8329 or fill in the appointment form online. Then we will contact you soon!

Need a quick consultation and treated quickly?

Then make an appointment now!

Make an appointment

Need a quick consultation and treated quickly?
Then make an appointment now!