Plancher Orthopaedics & Sports Medicine Shoulder Treatment
Shoulder injuries can be grouped in 2 categories; instability and impingement. The anatomy of the shoulder includes the humerus, clavicle, and acromion. Overhead and upper extremity sports such as basketball, football, swimming, tennis, and baseball are associated with shoulder injuries. The shoulder is best compared to a golf ball on a tee since it allows significant amounts of motion, therefore it is vulnerable to instability and episodes of dislocation. When a shoulder dislocates, X-Rays and an MRI should be obtained to evaluate for bony abnormality and cartilage damage of the cushioning (called the labrum) between the “golf ball and the tee”. A labral tear can be caused by dislocations and is an injury that occurs most often in adolescents and can result in clicking and further instability. In the throwing and overhead athlete, labral tears should be fixed surgically for best results. Non-surgical treatment of physical therapy to strengthen surrounding muscles can be effective in the non-athletic population however if clicking or another episode of instability occurs, surgery is recommended.
The most common shoulder injury is impingement of the 4 rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis). Impingement injuries target adults and elderly people. It can occur with either a single trauma or with repetitive overhead motions. Impingement involves the rotator cuff muscles, specifically the supraspinatus getting pinched in the space between the humerus and the acromion. Physical therapy to strengthen these rotator cuff muscles and the muscles that stabilize the scapula (or shoulder blade in the back) can help reduce symptoms. If they persist, repair of the rotator cuff muscles provides relief in tears that are small or moderate size. Early detection is important because if a tear is massive or is retracted too far from its attachment point, it becomes more difficult to fix.
Some other common injuries that occur in the shoulder include biceps tendonitis and frozen shoulder. Biceps tendonitis is an inflammation in the front of the shoulder where the biceps tendon attaches. Frozen shoulder can be a complication after a fracture or surgery when the shoulder is immobilized for a long period of time. Frozen shoulder is a formation of scar tissue within the shoulder, which decreases the movement allowed. Individuals with diabetes are also more susceptible to frozen shoulder. Common treatments for both biceps tendonitis and frozen shoulder include physical therapy or injections, and in severe cases include surgical intervention.
For more information regarding shoulder injuries and appropriate treatment options if you or someone you know are experiencing symptoms or pain, contact our office for an appointment.