Intrinsic Shoulder problems are problems due to anatomic injury in the shoulder.

The shoulder joint is very mobile and therefore not very stable. The humerus, or arm bone fits into the scapula or shoulder blade in the part of the scapula called the glenoid, the cup. The glenoid is enlarged by a cup of cartilage that fits in it called the labrum. The humerus is held firmly in the glenoid by four muscles called the rotator cuff. The rotator cuff is composed of four muscles: the supraspinatus, infraspinatus, teres minor and the subscapularis. The shoulder is further stabilized by the ligaments around (superior glenohumeral, middle glenohumeral and inferior glenohumeral ligmanets) The The scapular is also attached to the clavical (collar bone) via the Acromial clavicular joint.

AC joint arthritis:
This type of arthritis is usually treated with a simple injection and modification of activities (which are specially modified for your activities)

Bicipital tendoinitis:
this is overuse injury is usually treated with Ultrasound, activity modification, and occasional injections although these should be avoided due to risk of rupture.

Labral tears:
Can occur due to over use or injuries such as dislocations. It can be treated conservatively. However, if pain still persists it may require surgery.

Rotator cuff injuries:
can generally be treated with a injection and strengthening exercises first for the larger, shoulder stabilizer muscles and then to the rotator cuff. However, if there is a complete tear this will usually require surgery so as to avoid later arthritis.

Dislocation:
obviously need relocation but are associated with labral tears, rotator cuff injuries and nerve injuries. If they occur earlier than forty they have a high likelihood of reoccurring.

Scapular diskinesia:
is when the scapula moves incorrectly or not well enough for the movement of the rest of the shoulder. It usually requires retraining of the shoulder, occasionally an injection under the scapula (shoulder blade). At last resort it is treated via surgery, but the risks and difficulty of the surgery are great and the surgery results in a loss in the range of motion of the shoulder.

Glenohumeral joint arthritis:
This type of arthritis is located in the shoulder joint where the humerus (arm bone) meets the shoulder blade. It can be treated with a steroid injection. At last resort there is a shoulder replacement that may result in some pain relief, but does not return the range of motion and results in a decreased ability to life objects.

Ligament injuries:
There are multiple shoulder ligaments that support the shoulder. AC joint is supported by three ligmament, the AC ligament and the two other ligments that as a group are called the CC ligament (coranoid-clavicular), several Glenohumeral ligaments (Superior, Middle and Inferior). The treatment of each of these is very specific. Some only require time to heal, some may get benefit from prolotherapy. Some can be treated without surgery.

Shoulder instability:
There are two main types Multidirectional and AMBRI. The multidirectional is treated with conservative therapy and due to excessive laxity. The AMBRI may be treated with surgery.