Shoulder Injuries
Common Injuries
Bursitis
Bursitis occurs when a small fluid-filled sac that protects the shoulder joint, called the bursa, becomes inflamed. This can be caused by sports or jobs that require you to frequently reach overhead.
Symptoms may include difficulty reaching overhead, weakness, pain, and a "pop" sound when moving the arm.
Rotator cuff tears/Tendonitis
The rotator cuff is made up of four muscles that hold the shoulder in place and allow for movement. A tear in the rotator cuff can occur from a sudden movement or fall, lifting something too heavy, or overuse that goes untreated.
Symptoms of a rotator cuff tear include deep pain, weakness, and inability to lift the arm.
Impingement
The rotator cuff is made up of four muscles and bands of connective tissue called tendons that hold the shoulder in place and allow for movement. Impingement occurs when rotator cuff tendons or the bursa—a small fluid-filled sac that protects the shoulder joint—are pinched between two bony parts of the shoulder. The pinched structures become irritated, painful, and swollen.
Symptoms can include pain with movements of the arm above shoulder height, a "pop" sound, and weakness of the arm.
Dislocation
Dislocation occurs when the ends of bones that should come together to form a joint slip out of place. In a shoulder dislocation, the "ball," or end of the upper arm bone, has slipped out of its normal position in the "socket."
Dislocations are common in contact sports, such as football, or in sports that involve falls like gymnastics. Symptoms include pain, obvious deformity, and inability to move the arm.
Subluxation
A subluxation occurs when the ends of bones that should come together to form a joint partially slip out of place. The "ball," or end of the upper arm bone, is abnormally positioned in its "socket."
Subluxations occur most commonly in athletes who participate in sports requiring great shoulder mobility, such as swimming and gymnastics. Symptoms include pain, deformity, tenderness, swelling, or bruising. Loss of feeling may occur if nerves have been damaged.
SLAP and Bankart tears
The labrum is a cuff of cartilage that forms a cup for the upper arm bone to move within. The bicep muscle is attached to the labrum by a band of connective tissue called a tendon. Superior labrum from anterior to posterior tears—or SLAP tears—occur when this tendon is torn. Falling onto an outstretched hand or repetitive overhead use, throwing, or lifting can cause SLAP tears.
Bankart tears usually occur in association with dislocations of the shoulder. When the end of the upper arm bone—or the "ball"—dislocates from its normal position in the labrum—or "socket"—the labrum is often torn in the process. Dislocations and, therefore, Bankart tears are common in contact sports, such as football, or in sports that involve falls like gymnastics.
Symptoms of a SLAP tear may include pain with movement, deep pain within the shoulder or shoulder joint, or a "catching" sensation in the shoulder joint. Symptoms of a Bankart tear can include repeated dislocations, a "catching" sensation in the shoulder joint, or aching of the shoulder.
Frozen shoulder
Frozen shoulder, called adhesive capsulitis, occurs when connective tissue that holds the shoulder in place tightens, limiting mobility and causing pain. It is still not clear what causes frozen shoulder, but patients who had previous shoulder injuries or those with general medical conditions such as diabetes are more prone to developing this condition.
Symptoms include dull, aching pain; stiffness; restricted motion or loss of motion.
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Prevention
To reduce your risk of shoulder injuries, focus on these points:
1. Good flexibility equals free movement and less injury. Stretch after exercise or during down time. Every muscle should be stretched a few times for 20 to 30 seconds each, three to four times per week.
2. Build core muscles. Strong abdominals and, more importantly, back muscles help hold shoulder blades in their proper place.
3. Strengthen all muscles of the upper extremity. The muscles of the body are interconnected, so if your wrists, arms, and back are strong, the shoulder muscles will not have to carry all of the burden when lifting, throwing, pulling, etc. Most importantly, strengthen shoulder muscles with exercises such as flies, push ups, shoulder shrugs, and supine press.
Treatment
Treat shoulder injuries initially with rest and ice. Seek medical advice if pain persists for more than 72 hours despite this treatment. Rest the affected area. Avoid lifting or working overhead. Apply a cloth-covered ice pack to the affected area for no more than 20 minutes at a time, three to four times a day. If your physician approves, use over-the-counter anti-inflammatory medication such as Advil or Aleve.