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Shoulder Injuries

Shoulder Injuries . By Taelar Shelton, MS, ATC, AT/L. Contusions . MOI: Blows to the shoulder S&S: discoloration, pain and restricted movement Treatment: RICE, protection with padding . Shoulder Pointer. MOI: Blow to the lateral shoulder

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Shoulder Injuries

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  1. Shoulder Injuries By Taelar Shelton, MS, ATC, AT/L

  2. Contusions • MOI: Blows to the shoulder • S&S: discoloration, pain and restricted movement • Treatment: RICE, protection with padding

  3. Shoulder Pointer • MOI: Blow to the lateral shoulder • S&S: tender on lateral clavicle (bone bruise), similar to A/C sprain, severe discomfort, limited ROM • Rx: RICE, shoulder sling or ace wrap

  4. Rotator Cuff Strains: “SITS” muscles • MOI: violent pull to the arm, abnormal or excessive rotation, FOOSH • S&S: Swelling, point tenderness, pain, loss of function • Rx: rehab (conservative approach), proper instruction on form, strengthening and ice; surgery

  5. Rotator Cuff Impingement • MOI: over use or disuse, inflammation of the tendon takes up too much space • S&S: joint pain during and after activity • Rx: warm up before activity, rehab exercises, ice therapy, work on techniques; rest

  6. Sternoclavicular (S/C) Sprains • MOI: twisting an elevated arm, indirect force, blow that hits poorly padded clavicle • S&S: usually a deformity from the dislocation, point tenderness, pain, swelling, discoloration, decreased ROM • Can be serious if dislocated inferiorly • Rx: reduced clavicle dislocation by physician, immobilize, gradual rehab program

  7. Acromioclavicular (A/C) sprain • MOI: fall on tip of shoulder, blow to posterior shoulder or FOOSH • S&S: obvious deformity (depends on severity), point tenderness, pain, loss of movement, instability • Rx: ice, sling, referral • Grade 3 A/C sprain “sepparation” involves the A/C ligament and the coroclavicular ligaments

  8. Glenohumeral joint sprain • MOI: Ant- arm forced upward or rotated • S&S: pain, decrease in ROM, tender to palpation, pain when MOI is reproduced • Rx: Rest, ice, compression and sling; rehab program

  9. Subluxations and Dislocations Subluxation Dislocation • Head of the humerus is displaced and reduces on its own • Head of the humerus is displaced and doesn’t return to normal position without reduction

  10. Dislocation • Anterior- External rotation, forced abduction • Inferior- violent pull inferiorly • Posterior- FOOSH, internal roation

  11. Anterior Dislocation (most common) • MOI: external rotation and forced abduction • S&S: flat deltoid appearance, pain, axillary pain and deformity, holding the involved arm, disability • Rx: first time dislocations can be associated with a fracture, refer and immobilize

  12. Chronic recurrent instabilities • Macrotraumatic- one or more traumatic situations • Atraumatic- volunatry displaces shouder joint • Microtraumatic-faulty biomechanics leading to tissue laxity (repeativite use) • Recurrent- continual stretching of ligaments, capsule and muscles

  13. Bursitis • MOI: trauma or overuse leads to inflmmation of the bursa • S&S: pain around the bursa, can lead to impingement • Rx: Rest, heat after the inflammatory response is over, range of motion exercises, ice after activity and during inflammatory response

  14. Thoracic Outlet Syndrome MOI: Compression over cervicle rib, muscle spasm, compression of major blood vessels and nerves between rib and clavicle, compression beneath corocoid process S&S: numbness, cold feeling, poor cirulation, muscle weakness, muscle atrophy, nerve palsy Rx: conservative approach in 50-80% of cases -sling -NSIAD’s Strengthening and postural correction

  15. Clavicle Fx • MOI: FOOSH or direct blow • S&S: usually the middle 1/3, deformity, tenderness and pain • Rx: sling, ice and x-ray

  16. Myositis Ossificans • MOI: contussion that did not get treated properly • S&S: swelling and irritation that lasts for 2-3 weeks • Rx: get an MRI or xray (tricpes to the right)

  17. Bicipital Tenosynovitis • MOI: repetitive internal roation irritates the synovial sheath of the biceps, can sprain the transverse ligament • S&S: ache on the anterior aspect or the lateral side of the shoulder, tenderness on the biceps tendon, inflammation, “pop” of the tendon on the bone • Rx: rest and ice, gradual reconditioning program

  18. Biceps Rupture • MOI: Over stretching or a powerful movement • S&S: Snap, intense pain, prodruding bluge in the middle of the biceps, muscle weakness • Rx: sling and refer = surgical repair

  19. Upper Humeral Fx • MOI: direct blow, FOOSH or dislocation • S&S: pain, inability to move, point tenderness, discoloration • Rx: sling, referral to MD

  20. Epiphyseal Fx • MOI: common in youth athletes (10 years or younger) from an indirect force

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