Overuse Injuries of the Shoulder

What are the common injuries to the shoulder?

Most of the shoulder complaints are due to the soft tissues( muscles, tendons, ligaments) lesions and majority are rotator cuff disorders. Shoulder joint is the most mobile joint of the body which comes at the expense of it’s stability. There is a very fine balance between the mobility and stability and if it’s lost patient will experience pain and discomfort.

What is Rotator cuff?

Rotator cuff is a complex interweaving of 4 muscles which originated from the scapula( shoulder blade) and get attached to the humerus ( long bone of the upper arm). There is one more muscle ( long head of biceps) the tendon of which is intimately associated with the rotator cuff. The function of rotator cuff is to contribute to both mobility and stability. It stabilises the shoulder joint dynamically and assist in rotation and abduction( lifting the arm up).

How does the rotator cuff gets injured?

The shoulder joint is a ball and socket joint . The remarkable feature of the shoulder is it’s range of motion that allows an athlete to play high level sports and even for for a non-athletic person to be able to achieve a range of movement in activities of daily living. To avoid injuries the rotator cuff helps to stabilise such a mobile complex. The rotator cuff depresses the head of the humerus( the long bone of upper arm) counteracting the effect of deltoid muscle (muscle over the shoulder) which pulls the head of the humerus superiorly, in over-head activities. With overuse excessive demands are placed on rotator cuff muscles that eventually leads to tears, tendinitis.

What tests are required for someone with shoulder pain?

Ultrasound and MRI are the most helpful imaging modalities in assessing rotator cuff. Plain X-rays can show irregularities of the bone and calcification.

What is biceps tendinosis /tenosynovitis?

The tendon of the long head of biceps and rotator cuff have a close relationship. It gets inflamed by the same mechanism that causes rotator cuff injury, therefore they are treated in the same manner as we treat rotator cuff tendinosis.

How are shoulder injuries treated?

Treatment involves rest, ice NSAID’s, Range of motion exercises once the symptoms subside. and a graduated programme of rehabilitation. PRP injection is a promising strategy to improve rotator cuff healing. It works well for small and medium sized tears.


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