Shouldering the burden of Injury
Thursday, March 30, 2017 - 09:38
The shoulder is one of the most mobile joints in the human body. As such it is very vulnerable to injury especially in sport. Most injuries to the shoulder involve muscles, ligaments and tendons rather than bones. Since the shoulder connects the arm and hand to the rest of the body, injuries to the shoulder can have a greater impact to daily living than other areas.
Like other injuries, shoulder injuries can occur under a variety of conditions such as:
- overuse injury due to repetitive motion
- injury due to impact during contact sports or falls
- strains due to overextension of movement
- stress due to changes to training programs or overexertion during competition
There are many types of injuries that occur around the shoulder and some of the most common will be highlighted here.
Common shoulder injuries:
Shoulder dislocation: This type of injury is one of the most common injuries to the shoulder and often the most painful. It is common in contact sports or due to falls, often occurring when the arm is outstretched and vulnerable to being pulled out of position or over-rotated. Dislocation occurs when the top part of the upper arm bone (humeral head) “pops” out of the shoulder socket (glenoid) either partially or completely. The athlete may experience pain, immobility, and sometimes tingling in the hand. The shoulder needs to be “put back” into place which can happen spontaneously but may require the assistance of a physician, followed by physical therapy. Because the tissues around the joint are also injured it is important not to return to play until strength is rebuilt around the shoulder to reduce the risk of reinjury. Unfortunately, over 50% of shoulder dislocations can recur which can cause increased instability to the joint.
Rotator Cuff Injury: The rotator cuff is a group of muscles and tendons that work together to keep the shoulder in its socket and is responsible for most of the movement and stability in the shoulder. Tendinitis or tears in this area are common in athletes using repetitive overhead movements (swimming, baseball, tennis, etc.). Pain, weakness, stiffness and reduced range of motion in the shoulder are often common symptoms of this type of injury. Often athletes will experience pain at night and difficulties sleeping. Tears should be diagnosed and treated early as they can get bigger and more difficult to treat later on.
Labral Tear: The ring of cartilage around the shoulder socket is called the labrum. The biceps tendon as well as stabilizing tendons attach around this area. These types of injuries usually occur after falls or impacts to the area or with repetitive overhead motions. Athletes may experience pain, loss of power, decreased range of motion or experience clicking/locking/grinding symptoms. These injuries can be difficult to diagnose and may require surgery to repair.
Acromioclavicular Joint Injury: The acromioclavicular joint links the shoulder blade to the collarbone; it usually can be identified as the hard small lump on the top of your shoulder. This joint is very important to overhead or throwing athletes and can be sprained through falls, being checked into boards, tackled, etc. It can also dislocate causing in a more painful lump on the shoulder. Sprains to the joint can often be the cause of more long-term pain than a dislocation and mild to moderate swelling may be evident on the top of the shoulder. If the ligaments are torn, you may see the collarbone protrude under the skin.
Broken Collarbone (Clavicle): A break to the collarbone is one of the more common shoulder injuries often happening after a direct impact (fall or collision) to the shoulder or by falling on the hands resulting in the pressure rising up through the arm and into the shoulder. Symptoms may include pain, bruising, and inability to move the shoulder. Broken bones in the shoulder are some of the most difficult to treat as immobilization is difficult to achieve. Slings and/or surgery are the most common treatment.
Shoulder injuries are numerous and the ones above are a few of the most common ones. Some injuries to the shoulder appear to be simple, but hide more complex issues. In some cases complications may cause nerve damage or injury to other tendons or ligaments trying to compensate for a weak shoulder. It is important to contact a medical professional to determine the proper course of treatment and rehabilitation for your specific case.
Common Shoulder Injuries. OrthoInfo. American Academy of Orthopaedic Surgeons.
Haddad, A. (2016). 3 Common Shoulder Sport Injuries. Sports-healthTM.
Shoulder Injury. Sports Medicine Info.
Sports Injuries: Sports Shoulder Injuries. Shoulderdoc.co.uk.
Sports-related Shoulder Injuries. UW Medicine.