Download Shoulder Injuries

SHOULDER
INJURIES
WHAT? The shoulder is made up of three bones: the
upper arm bone (humerus), the shoulder blade (scapula),
and the collarbone (clavicle). A combination of muscles,
tendons, and ligaments help to keep the arm bone
centered in the shoulder socket (area where the upper
arm fits into the shoulder blade). The ligaments help
keep the three shoulder bones together. The muscles and
tendons work together to allow a wide range of motion
for the arm. In fact, the shoulder is the most mobile yet
most unstable joint in the body (Reynolds, 2012).
WHO? Anyone can have a shoulder injury or disorder.
The risk of injury usually increases for those who play
sports, do manual labor, and/or engage in repetitive
movements over time. Certain diseases of the spine
(cervical), liver, heart, and gallbladder can lead to pain
in the shoulder region. In addition, as we get older (i.e., >
60 yrs.), the soft tissues around the shoulder begins to
weaken.
IMPACT We rely heavily on the use of our shoulders
to do a wide range of upper body movements. When our
shoulder becomes injured, it affects many areas of our
lives all at once such as our ability to work, be physically
active, or perform many other routine daily tasks. In
addition, if left untreated, some shoulder injuries can
leave us with long-term chronic pain and lack of mobility
in our upper body.
The shoulder is made up of three bones:
the upper arm bone (humerus), the
shoulder blade (scapula), and the
collarbone (clavicle).
COMMON SHOULDER INJURIES
There are a variety of shoulder injuries but
most can be grouped into three main areas:
1) Soft Tissue Injuries: Common soft tissue injuries
are tendonitis, bursitis, and tendon or muscle tears.
i) Tendonitis is the inflammation of the tendons in
the shoulder joint, usually the rotator cuff (i.e., the
group of muscles and tendons that cover the head
of the upper arm bone and shoulder blade) or a
bicep tendon. When tendonitis occurs, the shoulder
tendons will become inflamed and painful making
movement of the area difficult. It usually occurs as
a result of wearing down the tendon(s) over time.
However, it can also be a result of a sudden injury
such as overhead activities from work or playing sports.
ii) Bursitis affects the small fluid filled sacs called
bursa, which help to cushion the contact between
bones, tendons, and muscles (found near the joints).
Similar to tendonitis, the bursa can become inflamed,
usually from overuse. Individuals will feel sore or
stiff in the affected area. Also, it will be tender to the
touch, and become swollen and red.
iii) Tendon or Muscle Tears can be quite painful as
they involve the splitting and tearing of the tendons
or muscle. Complete tears can be quite serious as the
tendon can pull away from the bone itself. Symptoms
can include sharp pain, tenderness, swelling, and
even bruising to the area. Movement of the tendons
or muscles in the affected area can be greatly reduced.
Rotator cuff and bicep tendon/muscle are the most
common site of these tear injuries.
2) Instability: These types of injuries occur when
the upper arm (i.e., humerus) is forced out of the
shoulder socket (i.e., scapula). These are also known
as shoulder dislocations and can be a partial or full
in nature. They are usually caused by a blow to the
shoulder or by falling on an outstretched hand. Once
these occur, the tendons and ligaments become more
loose and torn which can result in recurring injuries.
This type of injury can cause pain and unsteadiness
in the area when you raise your arm or move it away
from the body.
3) Arthritis: Shoulder problems and pain can also
be caused by arthritis. Although there are different
types of arthritis, the most common one is
osteoarthritis. This type of arthritis is from the wear
and tear of using the shoulder over the years. It will
usually develop slowly and the pain worsens over
time. Other symptoms may include swelling
and stiffness.
TREATMENT When a shoulder injury first occurs, it is
usually treated with rest, ice, compression, and elevation
(RICE) (AAOS, 2013). However, a qualified healthcare
provider (HCP) is the best one to make a decision as to
the seriousness and treatment of the injury. If the best
treatment option is RICE, this involves taking some
time away from the activity that is causing the
discomfort. Applying ice and a wrap (compression)
to the injured area can help reduce swelling and pain.
Keeping the shoulder elevated will also help to improve
blood flow. Since each shoulder injury is different, it is a
good idea to check with your HCP for how best to treat
the injury. If the injury becomes worse or does not seem
to be improving after two to three days, follow up with
your HCP immediately, as the injury might be much
more serious than first thought.
PREVENTION We rely on the shoulder joint for many daily
activities, which can make it difficult to try and avoid everything
that puts us at risk for injury. However, we can take steps to help
reduce the chance of a serious injury from occurring or developing
into a potential long-term shoulder disorder. Proper and regular
stretching and strength training will help to improve the range of
motion of the shoulder and help to create greater joint stability.
In addition, make sure to rest the area when our shoulders feel
sore or tired. We should also mix up activities to reduce constant
repetitive motion to our shoulder joints. This can go a long way in
helping us maintain healthy shoulders, so that we can continue to
work, and play, for the long term.
PROPER AND REGULAR STRETCHING
AND STRENGTH TRAINING WILL HELP
TO IMPROVE THE RANGE OF MOTION
OF THE SHOULDER AND HELP TO
CREATE GREATER JOINT STABILITY.
Key References:
American Academy of Orthopaedic Surgeons (AAOS) (2013). Shoulder and
common shoulder problems. Retrieved February 4, 2015 from http://orthoinfo.
aaos.org/topic.cfm?topic=a00065.
Reynolds, A. (2012). Imaging the injured shoulder. Radiologic Technology, 83, (3).
pp. 261-289.
© Windsor-Essex County Health Unit, July 2015.