Shoulder injuries

Shoulder injuries are common among athletes such as baseball players, golfers, cricketers who overuse their arm in their sporting activities. Players of contact sports like football and rugby are also susceptible to shoulder injuries. This article highlights some of the most common shoulder injuries.

Acromioclavicular joint injury or AC joint injury.

The AC joint is the point where the clavicle (collar bone) meets the scapular (shoulder blade). This joint can be injured by falling on the shoulder, elbow or onto an outstretched arm. This injury is common among throwers. Symptoms are pain on moving the shoulder especially when trying to lift the arm overhead, swelling and a lump may form. Rest, ice and ultrasound help to relieve pain. A sling may be worn to immobilise the joint and prevent further injury. AC joint injuries are graded from mild to severe, 1, 2 and 3.

Treatment for grades 1 and 2 include wearing a sling, taking pain medications and resting the shoulder. For a grade 3 injury surgery followed by rehabilitation may be needed. After surgery, we may use ice, electrical stimulation and other techniques to control pain. Passive range-of-motion exercises where we move the arm, will begin as soon as the pain eases. Active range-of-motion exercises for strengthening will follow. Recovery for a grade 1 injury may take three weeks, for a grade 2 injury 6 weeks and a grade 3 injury may take up to 12 weeks.

Shoulder dislocation

A dislocated shoulder is a very common injury that can occur during contact sports such as football, rugby or judo. Pain accompanies the event and the person has a feeling of the shoulder 'popping out'. It will even look different from the other side. The shoulder will have to be relocated by your doctor to prevent further complications. Resting the shoulder in a sling is recommended and according to the extent of the injury, surgery may be indicated. Therapy focuses on shoulder strengthening once the pain is under control. A partially dislocated shoulder is called a subluxation and the joint may return to its normal position on its own, although there might be some signs of deformity.

Rotator cuff injury

The rotator cuff is a group of muscles that work together to provide stability to the shoulder and to rotate the shoulder joint. The acronym SITT usually applies to these muscles: The supraspinatus, infraspinatus, teres major and teres minor. Athletes such as baseball players, cricketers and swimmers, who rotate the arm a lot are prone to this condition. Injury may occur during sudden forceful movement and the person may get a tearing feeling in the shoulder followed by pain down the arm. Abduction (moving the arm out to the side) will be difficult. Surgery may be required in some cases.

We will perform a thorough assessment to determine the type and extent of your injury and to design a treatment plan. Ice, heat and ultrasound may be used to control pain. Wearing a sling helps to stabilise the shoulder. You will be taught pendulum exercises to improve range-of-motion and strengthen the shoulder. Functional activities such as ADLs form a major part of therapy.

Frozen shoulder

Not a form of injury, frozen shoulder (also known as adhesive capsulitis) is a condition characterised by stiffness and pain in your shoulder joint. As the condition worsens, your shoulder's range of motion becomes markedly reduced.

Most often, frozen shoulder occurs with no associated injury. Some patients develop a the condition after a traumatic injury to the shoulder, but this is not necessarily the cause. Some risk factors for developing a frozen shoulder include age and gender (middle aged women are more susceptible), endocrine abnormalities (such as diabetes and thyroid problems), shoulder injury or surgery, and several systemic conditions such as heart disease and Parkinson's disease.

Most often, a frozen shoulder can be diagnosed on examination, and no special tests are needed. Frozen shoulder treatment primarily consists of pain relief and physiotherapy. Most patients find relief with simple steps, although the entire treatment process can take several months or longer.