Conditions Treated
Below is an overview of the shoulder, elbow and upper limb trauma conditions I commonly treat. This is a general guide only — diagnosis and management are always tailored to the individual patient after clinical assessment.
Shoulder
Shoulder arthritis
Wear of the cartilage in the ball-and-socket joint of the shoulder, causing pain (particularly at night), stiffness and reduced range of motion. When non-operative treatment no longer controls symptoms, joint replacement is highly effective.
Revision joint replacements
Revision surgery for a previously replaced shoulder that is loose, worn, dislocating or infected. These are complex operations tailored to the specific problem and remaining bone stock.
Rotator cuff tears
Injury to one or more of the tendons that surround and move the shoulder, causing pain (especially with overhead reaching or at night) and weakness. Small tears often settle with physiotherapy; larger or persistent tears may benefit from arthroscopic repair.
Shoulder instability
The shoulder feels loose, gives way or dislocates, most commonly after a first traumatic dislocation in a younger patient. Recurrent instability is usually best managed with arthroscopic repair or open bone-block stabilisation to prevent further episodes and long-term joint damage.
Acromioclavicular joint pain / dislocation
Pain over the small joint at the top of the shoulder (acromioclavicular joint), typically after a fall onto the point of the shoulder or from cumulative overhead loading. Treatment ranges from injection and activity modification to surgical excision, repair or reconstruction depending on cause and duration.
Adhesive capsulitis (Frozen shoulder)
Progressive stiffness and pain in the shoulder caused by tightening and inflammation of the joint capsule, most common in women aged 40–60 and in people with diabetes. Most cases settle over time with injection, hydrodilatation and physiotherapy; arthroscopic release is reserved for cases that do not.
Subacromial impingement and bursitis
Pain on lifting the arm from pinching and inflammation of the rotator cuff tendons and bursa in the space above the shoulder. Most cases respond to physiotherapy and injection; keyhole decompression can be considered when symptoms persist.
Proximal biceps tendinopathy
Pain at the front of the shoulder from wear or partial tearing of the long head of the biceps tendon where it enters the shoulder. Frequently addressed at the same time as rotator cuff surgery with a tenotomy or tenodesis.
Elbow
Elbow arthritis
Cartilage wear in the elbow causing pain, stiffness and, in some cases, catching or locking from loose bodies. Options range from keyhole clean-up in earlier stages through to elbow replacement for advanced disease.
Revision joint replacements
Revision surgery for a previously replaced elbow that has worn, loosened, dislocated or become infected. Highly individualised surgery.
Elbow instability
Recurrent or symptomatic laxity of the elbow, usually medial (ulnar collateral ligament) or lateral (posterolateral rotatory instability), often after a dislocation or repetitive valgus/throwing stress. Treatment ranges from bracing and rehabilitation to ligament repair or reconstruction.
Distal biceps tendon rupture
Sudden pain and a "pop" at the front of the elbow, usually when lifting a heavy object with the elbow bent, causing weakness of elbow flexion and forearm rotation. Prompt surgical reattachment within a few weeks restores strength and endurance; late presentations require reconstruction with a tendon graft.
Triceps tendon rupture
An uncommon injury of the tendon at the back of the elbow, typically after a fall onto an outstretched hand or with heavy pushing, resulting in loss of elbow extension against gravity. Surgical repair is recommended for complete tears.
Elbow impingement and loose bodies
Pain, catching or locking of the elbow caused by bone spurs, cartilage flakes or loose bodies within the joint, common in throwing athletes and manual workers. Arthroscopic removal of loose bodies and trimming of impinging spurs is usually very effective.
Lateral epicondylitis (Tennis elbow)
Pain over the bony point on the outside of the elbow from wear of the wrist-extensor tendon origin, typically triggered by gripping, lifting or repetitive wrist activity. The vast majority settle over 12–18 months with load management, physiotherapy and bracing. For refractory cases, PRP injection can be used. Surgery is reserved for a small minority.
Medial epicondylitis (Golfer's elbow)
Pain over the bony point on the inside of the elbow from wear of the flexor-pronator tendon origin, typically triggered by gripping or repetitive forearm activity. Managed similarly to tennis elbow with rehabilitation and, rarely, surgery.
Trauma
All upper limb fractures (excluding hand)
Fractures around the shoulder, arm, elbow, forearm and wrist. Many can be managed non-operatively; displaced or unstable patterns are best fixed early with plates, screws, nails or joint replacement to restore alignment and allow early motion and early return to activity.
Shoulder dislocation
The ball of the shoulder joint comes out of its socket, usually anteriorly after a fall or contact injury. Reduction followed by structured rehabilitation is standard; recurrent dislocation, particularly in younger patients, is best managed with arthroscopic or bone-block stabilisation.
Elbow dislocation
The elbow joint comes out of place, often with associated ligament and sometimes bone injury. Simple dislocations are treated with reduction and early guided motion; complex dislocations (with fractures) usually require surgical fixation.
Acute tendon injuries and ruptures
Sudden rupture of the biceps, triceps or rotator cuff tendon — usually recognisable by a "pop", bruising, weakness and change in muscle shape. Timely surgical repair (ideally within 3–4 weeks) restores strength and function.
Conditions Treated
Below is an overview of the shoulder, elbow and upper limb trauma conditions Dharsh commonly manages. This is a general guide only — diagnosis and management are always tailored to the individual patient after clinical assessment.
Shoulder
Shoulder arthritis
Wear of the cartilage in the ball-and-socket joint of the shoulder, causing pain (particularly at night), stiffness and reduced range of motion. When non-operative treatment no longer controls symptoms, joint replacement is highly effective.
Revision joint replacements
Revision surgery for a previously replaced shoulder that is loose, worn, dislocating or infected. These are complex operations tailored to the specific problem and remaining bone stock.
Rotator cuff tears
Injury to one or more of the tendons that surround and move the shoulder, causing pain (especially with overhead reaching or at night) and weakness. Small tears often settle with physiotherapy; larger or persistent tears may benefit from arthroscopic repair.
Shoulder instability
The shoulder feels loose, gives way or dislocates, most commonly after a first traumatic dislocation in a younger patient. Recurrent instability is usually best managed with arthroscopic repair or open bone-block stabilisation to prevent further episodes and long-term joint damage.
Acromioclavicular joint pain / dislocation
Pain over the small joint at the top of the shoulder (acromioclavicular joint), typically after a fall onto the point of the shoulder or from cumulative overhead loading. Treatment ranges from injection and activity modification to surgical excision, repair or reconstruction depending on cause and duration.
Adhesive capsulitis (Frozen shoulder)
Progressive stiffness and pain in the shoulder caused by tightening and inflammation of the joint capsule, most common in women aged 40–60 and in people with diabetes. Most cases settle over time with injection, hydrodilatation and physiotherapy; arthroscopic release is reserved for cases that do not.
Subacromial impingement and bursitis
Pain on lifting the arm from pinching and inflammation of the rotator cuff tendons and bursa in the space above the shoulder. Most cases respond to physiotherapy and injection; keyhole decompression can be considered when symptoms persist.
Proximal biceps tendinopathy
Pain at the front of the shoulder from wear or partial tearing of the long head of the biceps tendon where it enters the shoulder. Frequently addressed at the same time as rotator cuff surgery with a tenotomy or tenodesis.
Elbow
Elbow arthritis
Cartilage wear in the elbow causing pain, stiffness and, in some cases, catching or locking from loose bodies. Options range from keyhole clean-up in earlier stages through to elbow replacement for advanced disease.
Revision joint replacements
Revision surgery for a previously replaced elbow that has worn, loosened, dislocated or become infected. Highly individualised surgery.
Elbow instability
Recurrent or symptomatic laxity of the elbow, usually medial (ulnar collateral ligament) or lateral (posterolateral rotatory instability), often after a dislocation or repetitive valgus/throwing stress. Treatment ranges from bracing and rehabilitation to ligament repair or reconstruction.
Distal biceps tendon rupture
Sudden pain and a "pop" at the front of the elbow, usually when lifting a heavy object with the elbow bent, causing weakness of elbow flexion and forearm rotation. Prompt surgical reattachment within a few weeks restores strength and endurance; late presentations require reconstruction with a tendon graft.
Triceps tendon rupture
An uncommon injury of the tendon at the back of the elbow, typically after a fall onto an outstretched hand or with heavy pushing, resulting in loss of elbow extension against gravity. Surgical repair is recommended for complete tears.
Elbow impingement and loose bodies
Pain, catching or locking of the elbow caused by bone spurs, cartilage flakes or loose bodies within the joint, common in throwing athletes and manual workers. Arthroscopic removal of loose bodies and trimming of impinging spurs is usually very effective.
Lateral epicondylitis (Tennis elbow)
Pain over the bony point on the outside of the elbow from wear of the wrist-extensor tendon origin, typically triggered by gripping, lifting or repetitive wrist activity. The vast majority settle over 12–18 months with load management, physiotherapy and bracing. For refractory cases, PRP injection can be used. Surgery is reserved for a small minority.
Medial epicondylitis (Golfer's elbow)
Pain over the bony point on the inside of the elbow from wear of the flexor-pronator tendon origin, typically triggered by gripping or repetitive forearm activity. Managed similarly to tennis elbow with rehabilitation and, rarely, surgery.
Trauma
All upper limb fractures (excluding hand)
Fractures around the shoulder, arm, elbow, forearm and wrist. Many can be managed non-operatively; displaced or unstable patterns are best fixed early with plates, screws, nails or joint replacement to restore alignment and allow early motion and early return to activity.
Shoulder dislocation
The ball of the shoulder joint comes out of its socket, usually anteriorly after a fall or contact injury. Reduction followed by structured rehabilitation is standard; recurrent dislocation, particularly in younger patients, is best managed with arthroscopic or bone-block stabilisation.
Elbow dislocation
The elbow joint comes out of place, often with associated ligament and sometimes bone injury. Simple dislocations are treated with reduction and early guided motion; complex dislocations (with fractures) usually require surgical fixation.
Acute tendon injuries and ruptures
Sudden rupture of the biceps, triceps or rotator cuff tendon — usually recognisable by a "pop", bruising, weakness and change in muscle shape. Timely surgical repair (ideally within 3–4 weeks) restores strength and function.