SHOULDER INJURIES Mr. McKay

Athletic Training

References: BY. GA EUL JUNG

Shoulder Joint

Bones of the Shoulder

Ball & Socket joint consisting of:

◦ Scapula

◦ Humerus

◦ Clavicle

◦ Sternum

Joints of the Shoulder

Glenohumeral Joint (GH)

Acromioclavicular Joint (AC)

Sternoclavicular Joint (SC)

◦ P.157 definitions

Common Mechanisms of

Shoulder Injuries Overuse

Impact

Improper form

Prolonged injury

Muscle of the Shoulder/

Rotator Cuff

SITS

Shoulder Separation

Daniel Gibson

Rudi Johnson

…..

Causes Falls directly on the

shoulder Ex) Contact from

another player or tumble on the shoulder.

Symptoms Limited movement Swelling and

bruising Possible deformity

Prevents Physical Therapy Surgery

Rehabilitations Put Ice Take non-steroidal

anti-inflammatory drugs

Physical Therapy after surgery

What does a separated shoulder look like?

SKELETAL INJURIES

Fractured Clavicle Is the most commonly fractured bone of the

shoulder.

Mechanism:

◦ Majority occur from direct blows to the bone

◦ Result from falls on the arm/shoulder

Signs & Symptoms

◦ Swelling/deformity of the clavicle

◦ Possible broken bone projecting through the skin

◦ Snapping or popping sound

◦ Severe discoloration

◦ Athlete holding the arm and unable to move it

Fractured Clavicle

Treatment for Fractured Clavicle

Treat for possible shock.

Carefully apply a sling and swath bandage.

Apply a sterile dressing to any open

wound.

Bring to hospital for x-ray.

Scapula Fracture

A much less common injury.

Commonly occurs to football players:

Mechanism:

◦ Direct blow to the scapula region

Signs & Symptoms:

◦ Considerable pain

◦ Loss of function

Treatment:

◦ X-ray to determine fracture

◦ Place in sling & bind for 6 weeks

SOFT TISSUE INJURIES

Shoulder Dislocations

Shane Warne

Candace

Parker

……

Causes

Hit,Fall,or pull

Symptoms

Inability to move

the arm

Bruising or swelling

Visibly displaced

shoulder

Prevent

Warm up proper any physical activity or practice or competition

Use special equipments to protect shoulders in athlete

Rehabilitation

Seek medical attention to a doctor

Surgery

Physiotherapy

Be performed by qualified personnel in a medical environment

Acromioclavicular Injuries

Damage to the ligaments that support the

acromioclaviclar joint.

Mechanism- Impact or direct blow

Signs & Symptoms: First & Second Degree Sprains will result in mild swelling

and tenderness, and discoloration around the joint.

Any movement will result in pain.

Athlete may report a snapping or popping sound.

With third degree sprains there will be significant

deformity.

Acromioclavicular Treatment

Immediately apply ice and compression

over the AC joint.

Use a sling and swathe method to hold

ice in place

Refer the athlete to a physician to be

looked at.

Glenohumeral Joint Injuries Major ligaments include: capsular ligament

and the coracohumeral ligament.

The GH joint and the shoulder girdle allow

nearly all the movements of the shoulder.

The most common joint to pop out or

dislocate. (HEAD OF HUMERUS out of

place)

Mechanism:

- Having the arm forcefully abducted or

externally rotated.

GH Joint Injury

GH Joint Injuries

Signs & Symptoms

◦ Deformity of the shoulder joint, shoulder is lost

or sloping downwards.

◦ The arm of the affected side will appear longer.

◦ Athlete will be supporting the injured arm with

the uninjured arm.

◦ Extremely painful for any type of movement.

Treatment

Pop back into place by medical

professional

Apply Ice and compression, on the front

& back of shoulder.

Place a towel underneath the axilla

(underarm)

Apply sling and swathe.

Immediately refer athlete to physician.

Treat for shock if necessary.

Sternoclavicular (SC) Joint Injuries

Formed by the proximal end of the clavicle

and the manubrium of the sternum.

Ligaments include:

◦ Joint Capsule

◦ Anterior/Posterior SC ligaments

◦ Interclavicular ligament

◦ Costoclavicular

Mechanism

◦ External Blow to the shoulder region, which

results in a dislocation in the proximal end of

the clavicle.

SC Joint Injuries

Signs & Symptoms:

◦ In most cases (2nd & 3rd degree) will result in

deformity.

◦ Swelling

◦ Limited movement of the shoulder girdle

◦ Snapping/Popping/Tearing sound at the SC

◦ Arm may be held closely to the body, with the

head/neck tilted to the injured shoulder

SC Joint Treatment

Apply ice and compress, using the sling &

swathe method.

Treat the athlete for shock if necessary.

Bring athlete to be checked out by

physician.

STRAINS/TENDONINJURIES

Biceps Tendinitis

Jered Weaver

Continuing …

Causes Overuse

Symptoms Pain when the arm

is bent and straightening

Pain over the front of the shoulder

Elbow painful

Prevents Rest your body Increase the frequency

and intensity of exercise gradually

Apply ICE

Rehabilitations Rest ICE Medication Stretching Strengthening

Rotator Cuff Tears

Muscles of the Rotator Cuff

SITS

Rotator CuffMechanism

Repetitive overhead motions or overhead throwing

Symptoms

Pain when lifting the arm

Weakness when rotating the arm or lifting

Cracking sensation

Pain in follow through

Stiffness 12 to 24 hrs later

Tenderness around the humeral head

Rotator Cuff

Rehabilitation

Rest and limited overhead activity

Surgery

Strengthening exercise and physical therapy

Anti-inflammatory medication

Prevention

Warming up properly

Do proper strength and conditioning

Specific exercise that strengthens the muscles around the shoulder blade.

GH Joint Related Impingement

Syndrome Impinge means “upon or against

Something”

Syndrome means “a number of symptoms occurring

together and characterizing a

specific disease”

GH is the most common type of

impingement syndrome, occurs when a soft

tissue like a bursa or tendon is being squeezed by

moving joint structures.

Impingement Syndrome

Commonly occurs to athletes who

perform more over head motions, such as

volleyball, basketball, tennis, squash, track &

field events, etc.

Signs & Symptoms

◦ Pain when the GH joint is abducted

◦ Loss of strength

◦ Nocturnal pain

◦ Pain felt deep within the shoulder

Impingement Syndrome Treatment

Rest

Ice

Anti-Inflammatory Medication

Physical Therapy

In worst case scenario, surgery may be

required to help reduce the stress and

pressure beneath the arm.

Contusions of the Shoulder

Commonly occur in sports, especially to

the AC joint.

GH joint is more protected by muscles,

where as the AC joint is much more

exposed.

Mechanism:

◦ Blows to the shoulder region

When an athlete sustains a hit like this, it

is commonly referred to as a shoulder

pointer.

Shoulder Pointer

Signs & Symptoms:

◦ History of a recent blow to the shoulder

◦ Muscle spasms

◦ Discoloration and swelling, especially over the

regions of the AC joint

Treatment of Shoulder Pointer

◦ Immediately apply ice and compression over

the injured areas.

◦ In severe cases apply a sling

◦ If there is still a significant amount of swelling

72 hours later, refer athlete to a physician.

Bibliography

Biceps Tendinitis

http://www.leadtheway.ca/biceps_tendinitis.htm

http://orthoinfo.aaos.org/topic.cfm?topic=A00026

Shoulder separation

http://www.bchealthguide.org/kbase/topic/special/tw9147spec/sec1.htm

Shoulder Dislocation

http://www.antibodywear.com/articles/shoulder_dislocations_symptoms_and_treatment_02.asp

http://www.shoulder-pain-management.com/shoulderdislocation.html

Rotator Cuff Tears

http://orthoinfo.aaos.org/topic.cfm?topic=A00064

http://72.14.205.104/search?q=cache:RNMGZQu2lpkJ:ezinearticles.com/%3FRotator-Cuff:--Exercises-and-Strategies-to-Prevent-Injury%26id%3D44386+prevent+rotator+cuff+tears&hl=ko&ct=clnk&cd=1&gl=ca