Understanding and Avoiding Shoulder Injuries in Sports

03/17/2010, by Andrew Bulczynski, M.D. | Category: Orthopaedic Surgeons, Rotator Cuff Injuries, Rotator Cuff Tears
The shoulder is a ball and socket joint that has the largest range of motion of all joints in the body and allows motion in multiple planes.  Most people have heard of the rotator cuff, yet most do not know there are four rotator cuff muscles.  Their chief function is to center the humeral head in the glenoid which is ball in socket.  Some of the most common shoulder injuries include impingement, bursitis, bicep tendonitis, rotator cuff tendonitis and tears.  Laberal tears may result in pain and/or instability. 
 
Shoulder Impingement
 
The most common shoulder complaint is pain and most often this is caused by shoulder impingement, which is when there is pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted.  It may result from repetitive overhead activity such as swimming, overhead serving in tennis or volleyball or throwing a baseball.  Additional contributing factors include shoulder and upper back muscle imbalances as well as decreased core strength. 

Symptoms of shoulder impingement include pain the upper shoulder, radiation of pain down the upper arm, pain and weakness with overhead motion as with lifting and reaching. 

Impingement may lead to rotator cuff injury such as tendonitis and/or tearing.  Treatment is generally rest, ice and non-steroid anti-inflammatory medications such as Advil or Aleve.  If these measures aren’t successful or pain is significant, it is advisable to consult with a physician.  At this point, physical therapy and/or cortisone injections may be required and occasionally cases surgery may be required.

Shoulder Instability

Shoulder instability refers to the looseness of the joint where the ball comes out of the socket.  Recurrent instability may result after a dislocation or because of loose ligaments.  Symptoms may include pain, looseness of the shoulder, a sensation of the shoulder “coming out of joint”  and weakness.  It is typically diagnosed by the history of injury, physical examination and MRI.

The treatment for instability consists of a physical therapy program aimed at Optimizing range of motion, stability and strength.  This is usually done through therapeutic exercises that include rotational exercises using rubber bands, cables or weights.  Occasionally, persistent instability may require surgical attention. 

Preventing Shoulder Injuries
 
To prevent shoulder injury it is important to maintain a good level of strength and fitness in shoulder and arm muscles as well as the core.  When exercising, warm up effectively, stretch the shoulder and arm before activity and most importantly use proper form while throwing, swimming, playing racquet sports or lifting, especially overhead.  If at any time new pain develops, decrease the frequency and/or intensity until the pain subsides.  Return to the activity when the joint is fully rehabilitated.
 
 
 
 
 
Andrew Bulczynski, M.D. Dr. Andrew Bulczynski graduated from Northwestern University Medical School in 1999. He completed his Orthopaedic Surgery Residency at Loyola University Medical Center in Maywood, Illinois and Sports Medicine Fellowship training in Eugene, Oregon, and Lake Tahoe, California. He is board certified by the American Board of Orthopaedic Surgery.