The most frequent sporting injuries in the shoulder involve dislocations, rotator cuff injuries, labral tears, acromioclavicular joint (ACJ) injuries, biceps injuries, thrower’s shoulder, bursitis and fractures. Depending on the kind of sports, the injuries can also vary. For instance, rotator cuff tears and biceps lesions are more common in sports involving extensive heavy weight lifting while dislocations and ACJ injuries are more common in contact sports.
Adequate assessment of the severity of the shoulder injury is difficult as certain muscle strains also seem similar to serious injuries. A shoulder therapist or surgeon should be immediately consulted when an injury occurs for early management of the problem. If possible, X-rays and MRI scan must be taken.
Dislocations in Shoulder
The shoulder is the most mobile joint in the human body. However, this mobility is traded off by relative instability. This results in dislocation. For certain people, a minor trauma is enough to affect the shoulder. If there is a dislocation, it is important to put the joint back in position and follow it up with physiotherapy.
It has been observed that in over half the cases, the dislocations recur. This is particularly true in the case of young sports persons. If the shoulder undergoes repeated dislocations, it can result in sever instability, stretching of the joint and other issues that can cause poor performance in sports. It is therefore important to undergo a surgical fixation. Keyhole repair is the best method to treat shoulder injuries as it involves less pain, less complications and also speedy recovery. This means that the person can return to sports soon.
More commonly found in athletes involved in overhead throwing, tackling and heavy lifting, the Superior Labral Antero-Posterior (SLAP) tears occur when the biceps anchored in the shoulder is forcibly peeled or pulled off its bone attachment by a large force. The symptoms of SLAP are pain deep inside the shoulder while performing a sporting activity. Certain people also complain of a clicking sensation and pain that extends down the upper arm. This issue is difficult to diagnose without looking inside the shoulder using an arthroscope.
Rotator Cuff Tears
The rotator cuff is a collection of many important tendons, which provide stability and movement to the shoulder. When it becomes damaged, pain and weakness may result. Athletes with tear in their rotator cuff can benefit from early repair because the tears can become larger over time. This becomes difficult to repair later on.
If you have doubts regarding a tear in your shoulder, an ultrasound scan can help. It has the ability to pick up tears early, resulting in early treatment. Keyhole surgery is the most recommended treatment for rotator cuff tears.
Subacromial impingement is caused by repeated use of arms overhead. In some older athletes, it can also occur with the development of small bony spurs that trap the rotator cuff tendons above the main shoulder joint. This situation is also called bursitis, impingement syndrome, rotator cuff tendinitis or supraspinatus tendinitis. This condition can be improved using injections and physiotherapy.
Surgical fixture of this problem is done through keyhole surgery. It involves cleaning of the subacromial bursa where the bony spur is removed, a procedure known as arthroscopic subacromial decompression.
Acromioclavicular Joint Injuries
When you hold your shoulder with your palm, the small hard lump you feel on the top is called the acromioclavicular joint or simply ACJ. It is an important joint for athletes who want to participate in throwing events which require extensive overhead motion of the joint. Repeated falls on the shoulder and tackling can leave this joint sprained. Sometimes it can also lead to dislocation.
If your ACJ is sprained, it can cause long term pain compared to dislocated joints. If the pain persists even after injections and physiotherapy, it is better to surgically correct it. The operation can be done arthroscopically as it causes less post-operative pain and early recovery.
An athlete doing repetitive overhead throwing can result in stretching of the shoulder, which can cause the back to get tighter. Eventually this issue can cause an abnormal gliding of the shoulder joint and a catching of the labrum and the rotator cuff. This can lead to tear in the rotator cuff and abnormal wear of the labrum. A specialise is required to diagnose and repair this condition.
The weakest point in the biceps muscle is the part where the tendon attaches to the bone at the elbow and the junction in between the biceps muscle and the tendon. Most of the biceps injuries in athletes involve rupture in the elbow in the athletes. A pop is usually felt and a lump is seen in the front of the arm.
A prompt early repair is advisable in this because it is difficult to repair them at a later point of time. In older people, the rupture can also occur at the shoulder and can be associated with rotator cuff tears.
Some athletes get what is known as biceps pulley lesions and they should be considered when there is pain on top and front of the shoulder. Keyhole surgery by an experienced surgeon is the only solution to this as well.
It is a rare phenomenon to have the shoulder become stiff and painful with no apparent cause among athletes. There is however a common practice where the stiff shoulder results after an injury. It is essential in these cases to treat the stiffness early and then treat the underlying injury. A shoulder surgeon works jointly with an experienced physiotherapist for a better recovery in these cases.
Swimming is an activity that involves repetitive overhead movement of the hands. Frequent muscular imbalance occurs around the shoulder complex to accommodate for this, which causes the swimmers to become prone to shoulder pain. Over two thirds of professional swimmers suffer from this at some stage in their career.
An experienced shoulder therapist should be able to treat this issue. The treatment mostly involves addressing the muscular imbalance. An arthroscopic surgery may be required for the subacromial impingement and shoulder instability.
The cushion surrounding the shoulder socket is called the labrum. It is similar to the meniscus in the knee. It has the tendency to tear just like the meniscus causing injuries to the shoulder. Falls or direct blows to the shoulder are the reasons for labral tears. They can also occur during throwing or pulling. MR Arthrograms with special dye injected into the shoulder joint is a good way to diagnose labral tears. It can be confirmed with arthroscopy. If the tears are large, they are called Bankart tears.
There are specific patterns of injury, which are a result of intense tackling that is part of the rugby game. Many professional rugby players have reported this issue. The injuries are very similar to the ones seen in Thrower’s shoulder. However, these injuries are not predictable. Certain specialized tests are required to diagnose and treat these injuries for better recovery.
It is difficult to treat fractures around the shoulder operatively when compared to other fractures. However, there are new fixation devices and safer surgical techniques, which enable the doctors to fix difficult fractures early and allow for a return to sports.
Arthritis in the shoulders is a condition when the joint wears with age or overuse. There is a reduction in the lubricant in the joint causing it to become stiff and painful. If you can keep the shoulder active and the muscles toned along with taking painkillers, it can help. But if the pain is severe enough to affect daily routines such as sleep and movement, then a joint replacement surgery is recommended. When compared to the traditional shoulder replacements, a resurfacing shoulder replacement offers many advantages. The best published result of this is the Copeland Surface Replacement Arthroplasty or CSRA. It allows insertion by minimally invasive surgical approaches. It reduces hospital stay and the athlete can return to his or her daily activities soon.