Shoulder Injuries

Your shoulder joint (Glenohumeral joint) is a ball and socket joint. The end of your upper arm (humerus), or the ball, unites with the socket (glenoid fossa) of the shoulder blade (scapula) to form this ball and socket. This joint is surrounded by a capsule made of ligaments which is full of synovial fluid. This fluid lubricates the joint and allows for easy motion. The capsule itself is designed for optimal motion. Consequently, it has numerous folds that allow for movement. The capsule, which itself is not very strong, is surrounded by the rotator cuff muscles which act as active ligaments providing stability for the shoulder.

 

In the case of frozen shoulder, the capsule which surrounds your shoulder joint becomes inflamed and extremely rigid. Commonly there will also be a decrease in synovial fluid in the joint. Synovial fluid is a viscous lubricating fluid secreted by the membrane lining the joints and tendon sheaths.

 

This often-stubborn condition is characterized by severe pain and a progressive stiffness in the shoulder joint. With advancement of this condition your shoulder’s range of motion decreases substantially. This condition usually only affects one shoulder at a time, but in some cases, it can affect both shoulders.

 

A rotator cuff tear is a very common injury. These injuries are usually caused by either repetitive motion or trauma. These injuries, in the older population, are often due to a decrease in elasticity of muscles and tendons that occurs with the aging process. No matter what the cause, the location of pain from a rotator cuff tear is often quite difficult to pinpoint. Patients often describe the pain as being a broad area of involvement over the shoulder. Often the pain of a rotator cuff tear radiates down their arms and elbows.

 

If the rotator cuff is only partially torn, the pain experienced by the patient will likely be the predominant complaint. If there has been a complete tear of the rotator cuff the patient will not be able to perform certain motions with their shoulder.

 

When it comes to diagnosis, rotator cuff tears will not be seen on X-rays. Usually an ultrasound or MRI (magnetic resonance imaging) is needed to confirm the tear. In most cases a physical examination is all that is needed to diagnose this condition; that is unless there are indications of a complete tear, such as a complete inability to perform certain motions.

 

Fortunately, most rotator cuff tears do not need surgery. On the other hand, significant disability can result from untreated rotator cuff tears. Conservative treatments and exercise rehabilitation should always be tried before surgery is performed.

 

In most cases a rotator cuff injury can be treated within a short period of time with soft tissue procedures (Active Release, Graston Technique, Myofascial Release, Massage Therapy) and exercise alone. However, in other cases, what appears to be a simple rotator cuff injury often involves several other areas of the body. To resolve these cases a more complex understanding of shoulder biomechanics is needed. Without this understanding acute injuries often become chronic shoulder problems.

 

Swimmers, including triathletes, commonly suffer from shoulder pains.  This pain is usually felt either at the rotator cuff or between the shoulder blades.

 

Stresses in these areas affect the athlete’s performance long before they are even aware that they are having a problem.

 

Competitive swimmers must swim thousands of meters each day in order to achieve the fitness level required for competition. The front crawl is not kind to the shoulder joint, especially when executed incorrectly.

 

The majority of injuries suffered by such swimmers is related to the stress involved in the repetitive actions of their limbs while swimming, as many as 20,000 to 30,000 strokes per week for competitive training. In a typical workout of 4000 meters, each arm will rotate 1280 times. Any biomechanical problems at the start of the swim will only get worse with this many repetitions!

 

The most common injury is Swimmer’s Shoulder – a term commonly used to describe pain in the shoulder, and is almost always caused by the repetitive actions of the front crawl. This injury is also known as rotator cuff tendonitis or shoulder impingement syndrome.

 

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