The shoulder is arguably the most complex joint in the body. It is capable of
degrees of motion that no other part of the body can perform.
Since it is
complex in nature, as well as frequently used in most sports, including
weightlifting, it is highly prone to injuries that can range from mild to
severe and may even require surgery. Worse, injuries, no matter how minor, can
cause prolonged or even chronic pain in the joint and potentially limit the
range of motion, which can negatively impact the quality of life for the
individual.
اضافة اعلان
But shoulder
injuries do not result from playing sports only. A 2019 study found that 29
percent of shoulder injuries were sport related, and the sport most responsible
was soccer.
Understanding the
types of shoulder injuries, as well as how to manage and prevent these
injuries, can reduce instances and recovery.
Anatomy of the
shoulder
The shoulder’s range of motion is due to the fact that it is not a single
joint. It actually comprises four different joints, each with multiple muscles
responsible for movement. In total, there are 19 different muscles that assist
movement, but there are four muscles that are particularly important; they are
referred to as the rotator cuff.
The rotator cuff
is primarily responsible for stabilizing the shoulder joint. In order to
accomplish this, there are tendons that serve as connection points for muscle
to bone. There are also eight fluid-filled sacs, called bursa, which help
cushion joints.
Strain/sprain
In simple terms, a sprain is when a ligament is overstretched or torn,
and a strain is when a muscle is overstretched or torn. Since the shoulder
joint comprises many muscles and ligaments, it is not uncommon for these
injuries to occur.
This type of
injury most commonly occurs as a result of direct impact during sports, such as
a fall, but can also occur due to fatigue or improper warm-up. Swelling usually
occurs rapidly and pain is focused at the front of the shoulder. When palpating
(i.e., touching or massaging) the area feels tender. Symptoms can range from
mild to severe, depending on the extent of the injury. In more severe cases, it
can result in the inability to move the shoulder.
Sprains and
strains typically do not require surgical treatment; they mostly need rest,
immobilizing the joint by using a sling, anti-inflammatory medication, and ice.
Some severe cases may require physical therapy. Mild cases typically recover
within 1–2 weeks, but more moderate cases may take up to 6–8 weeks. In severe
cases, the pain may subside within 4–6 weeks, but may need 3–5 months of
rehabilitation before full activity may be resumed.
Tendinitis
Tendinitis is an injury in which the shoulder tendons, primarily the
rotator cuff, become inflamed. Tendinitis can be caused by overuse or by sudden
injury. It is most commonly seen in action where the arms are raised above the
head. This type of injury is common in sports such as
volleyball, basketball,
swimming, and overhead weightlifting workouts. Symptoms may range in intensity;
sufferers of the condition generally feel pain or tenderness, and have limited
range of motion.
The treatment for
shoulder tendinitis is similar to that of sprains and strains, with emphasis
placed on rest and reducing inflammation. In some severe cases where the pain is
severe and constant, cortisone injections may be warranted. Tendinitis also
takes weeks to months to recover from, and should resolve on its own.
Bursitis
Bursitis is an injury in which too much friction had been applied to the
bursa and results in inflammation. There are three different types of bursitis,
but sports-related bursitis falls under the category of traumatic bursitis. It
is relatively uncommon and acute in nature, meaning it will resolve in time.
This type of
injury is most commonly seen in athletes that have the area rubbed repeatedly
on a hard surface or is struck, such as in
American football or wrestling.
Typically, after an impact, it is common for the area to become tender and
warm, as well as swollen. Moreover, due to the impact, there may be associated
bruising.
A 2019 study found that 29 percent of shoulder injuries were sport related, and the sport most responsible was soccer.
Bursitis can
typically be managed with rest, ice, and anti-inflammatory medications. In some
cases, the bursa may need to be aspirated: a small needle is used to draw fluid
or blood and relieve pressure.
Bursitis does not
necessarily limit range of motion, unless due to pain, but care should be taken
to not reinjure the affected area for a few weeks after healing.
Tendon tear
A tendon tear of the shoulder is one of the more severe forms of shoulder
injury, and is commonly referred to as a torn rotator cuff. A common
misconception is that a torn rotator cuff is the result of a single incident.
Although it can be the result of falls or accidents (i.e., acute tear), it is
most commonly the result of repeated stress over time (i.e., degenerative
tear).
This type of
injury is commonly seen in sports such as baseball, tennis, rowing, or
weightlifting.
In case of
degenerative tears, the actual tear itself may be painless and go unnoticed.
However, complete tears can be quite painful and severe, and result in
immediate weakness in the arm.
Depending on the
severity of the tear, pain can be constant or only when moving the shoulder.
Additionally, there is often weakness when lifting or rotating the arm and one
may have a crackling sensation while moving.
A torn rotator
cuff is quite severe in nature and should not be ignored, as it may result in
worsening the damage. Depending on the severity, this injury may be managed
without the need for surgery, but rest is paramount. Steroid injections (i.e.,
cortisone) might be used to help manage pain and inflammation. Surgery may be
needed if symptoms last longer than 6–12 months or the tear is severe.
How to prevent and manage a shoulder injury
Sports-related shoulder injuries should not be taken lightly. Accidents
are bound to happen in many sports, but there are some ways to help prevent or
reduce the risk of developing a shoulder injury.
Stretching is a simple, yet effective way to help
prevent strains, sprains, and tears. By stretching, you allow the muscles,
tendons, and ligaments to become more flexible and improve your shoulder’s
range of motion. In conjunction with stretching, exercising the shoulder
muscles can help strengthen and stabilize the joint. In order to do this, you
do not necessarily have to lift weights. Simple exercises such as yoga,
push-ups, and arm rotations can accomplish this. Lastly, setting limits and
resting cannot be emphasized enough. This holds especially true for sports that
involve heavy use of the shoulders. Not overdoing it and giving your body time
to heal from the stress during exercise can greatly reduce the risk of injury.
If you have
already experienced a shoulder injury and would like to seek rehabilitation or
consultation, check out Al Tamayuz Physiotherapy Center in Abdoun. They provide
free consultations and even specialize in sports physiotherapy.
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