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The three most common shoulder injuries and how to treat them

03 September 2020

There’s truth in the adage of ‘carrying the weight of the world on your shoulders’.  Whilst this is an emotional metaphor, there is a reason why our shoulders are often used to imply physical strength. 

Our shoulders are complex structures made up of bones, muscle, and cartilage. They play one of the most important roles in keeping our upper body mobile and help us with the everyday tasks we carry out without thought, like reaching up, lifting, and even getting the lid off your favourite jar of pickle.

As amazing as our shoulders are, they are also one of the most neglected parts of our body, that are susceptible to strain, repetitive injury and aging more so than any other joint.

Professor Lennard Funk, Consultant Shoulder Surgeon, gives us a run-down of the top 3 shoulder injuries and treatment options.

I see a range of shoulder injuries in my clinic, but the most common of these are shoulder seperation, dislocated shoulder and rotator cuff injuries. These injuries can vary in severity and there are multiple treatment options to relieve pain and restore functionality.

Shoulder separation (Acromioclavicular Joint Dislocation)

With more people cycling, especially over the lockdown period, this has become a very common injury in all age groups. It often occurs from falling directly onto the point of your shoulder, such as falling off a bike or horse. Symptoms include a shoulder pain leading to anache all around your shoulder. Initially, there will be swelling and a noticeable step deformity over the top of your shoulder. Your shoulder may appear and feel ‘dropped’. Your range of motion can also be affected, which can make lifting heavy objects or overreaching particularly difficult.

Shoulder separation is a common sporting injury, if you are an athlete then your athletic performance can be impacted as you have less power and motion in the shoulder. Perhaps unsurprisingly I’ve treated many of these in contact sport athletes such as rugby and football (soccer).

In most cases non-surgical treatment is enough. Anti-inflammatory medication can be used to reduce swelling, whilst physiotherapy can help restore mobility of the shoulder and strengthen the muscle surrounding the acromioclavicular joint. In more severe cases surgical intervention is required and this can usually be done as daycare surgery.

Dislocated shoulder

A dislocated shoulder occurs when the top part of your upper arm bone pops completely out of the shoulder socket or, subluxates, popping partially out of the shoulder socket.

Athletes who play contact sports can be particularly susceptible to shoulder dislocations.

In some cases, you can visibly see the shoulder is dislocated, and this will most likely be accompanied by intense pain. Other symptoms can include bruising or swelling, or inability to move the joint at all. If you think you have dislocated your shoulder it is important to seek immediate medical advice, do not try to move the shoulder.

A dislocated shoulder is usually diagnosed through examination. X-rays can be used to determine the cause of the injury and rule out more serious fractures. A skilled and trained clinician can usually shift the shoulder joint back into place – it is important that you do not attempt to do this yourself. Once the joint is back in place, you’ll need to wear a sling, other treatments include icing the joint, anti-inflammatory medication and physiotherapy.

The risk of recurrent dislocations is high in young athletes, especially males playing contact sports. Therefore, it would be advisable to see a specialist shoulder surgeon to assess the need for surgery to stabilise the joint and reduce further dislocations.

Rotator cuff injury

Lastly, let’s look at a rotator cuff injury. There is an old saying - “grey hair equals cuff tear”. In other words, the injury is a common part of the aging process, however it can affect people of all ages, including those who partake in regular sport.

The rotator cuff is the rubbery tissue that connects the muscles around your shoulder joint to the top of your arm. An injury to that area causes pain on the outside of the shoulder. The pain gets worse when you try lift your arm and it can be difficult to lift anything. Pain can also occur at night, which can affect your sleep.

There are varying degrees of rotator cuff tears, some may not require surgical intervention and can be managed through anti-inflammatory medication or physiotherapy. Other more serious tears can need surgery. Nowadays, we do this via arthroscopy (keyhole). To determine the treatment process, an MRI scan or ultrasound usually takes place to determine the extent of the tear.

These 3 shoulder injuries are very common, but can worsen overtime if left untreated.  So it is important to be aware of their symptoms and seek medical advice if you are concerned or in any pain. Early intervention can mean less invasive treatment, better outcomes and for athletes, an earlier return to sports.

To find out more about our orthopaedic upper limb services click here https://www.thewilmslowhospital.co.uk/treatments/orthopaedics-and-rheumatology/upper-body/

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