SHOULDER INJURIES

1. SHOULDER INJURIES Mr. McKay Athletic Training References: BY. GA EUL JUNG

2. Shoulder Joint

3. Bones of the Shoulder • Ball & Socket joint consisting of: • Scapula • Humerus • Clavicle • Sternum

4. Joints of the Shoulder • Glenohumeral Joint (GH) • Acromioclavicular Joint (AC) • Sternoclavicular Joint (SC) • P.157 definitions

5. Common Mechanisms of Shoulder Injuries • Overuse • Impact • Improper form • Prolonged injury

6. Muscle of the Shoulder/Rotator Cuff • SITS

7. Shoulder Separation Daniel Gibson Rudi Johnson

8. ….. Causes • Falls directly on the shoulder Ex) Contact from another player or tumble on the shoulder. Symptoms • Limited movement • Swelling and bruising • Possible deformity Prevents • Physical Therapy • Surgery Rehabilitations • Put Ice • Take non-steroidal anti-inflammatory drugs • Physical Therapy after surgery

9. What does a separated shoulder look like?

10. Skeletal INJURIES

11. Fractured Clavicle • Is the most commonly fractured bone of the shoulder. • Mechanism: • Majority occur from direct blows to the bone • Result from falls on the arm/shoulder • Signs & Symptoms • Swelling/deformity of the clavicle • Possible broken bone projecting through the skin • Snapping or popping sound • Severe discoloration • Athlete holding the arm and unable to move it

12. Fractured Clavicle

13. Treatment for Fractured Clavicle • Treat for possible shock. • Carefully apply a sling and swath bandage. • Apply a sterile dressing to any open wound. • Bring to hospital for x-ray.

14. Scapula Fracture • A much less common injury. • Commonly occurs to football players: • Mechanism: • Direct blow to the scapula region • Signs & Symptoms: • Considerable pain • Loss of function • Treatment: • X-ray to determine fracture • Place in sling & bind for 6 weeks

15. Soft Tissue Injuries

16. Shoulder Dislocations Shane Warne Candace Parker

17. …… Causes • Hit,Fall,or pull Symptoms • Inability to move the arm • Bruising or swelling • Visibly displaced shoulder Prevent • Warm up proper any physical activity or practice or competition • Use special equipments to protect shoulders in athlete Rehabilitation • Seek medical attention to a doctor • Surgery • Physiotherapy • Be performed by qualified personnel in a medical environment

19. Acromioclavicular Injuries • Damage to the ligaments that support the acromioclaviclar joint. • Mechanism- Impact or direct blow • Signs & Symptoms: • First & Second Degree Sprains will result in mild swelling and tenderness, and discoloration around the joint. • Any movement will result in pain. • Athlete may report a snapping or popping sound. • With third degree sprains there will be significant deformity.

20. Acromioclavicular Treatment • Immediately apply ice and compression over the AC joint. • Use a sling and swathe method to hold ice in place • Refer the athlete to a physician to be looked at.

21. Glenohumeral Joint Injuries • Major ligaments include: capsular ligament and the coracohumeral ligament. • The GH joint and the shoulder girdle allow nearly all the movements of the shoulder. • The most common joint to pop out or dislocate. (HEAD OF HUMERUS out of place) Mechanism: • Having the arm forcefully abducted or externally rotated.

22. GH Joint Injury

23. GH Joint Injuries • Signs & Symptoms • Deformity of the shoulder joint, shoulder is lost or sloping downwards. • The arm of the affected side will appear longer. • Athlete will be supporting the injured arm with the uninjured arm. • Extremely painful for any type of movement.

24. Treatment • Pop back into place by medical professional • Apply Ice and compression, on the front & back of shoulder. • Place a towel underneath the axilla (underarm) • Apply sling and swathe. • Immediately refer athlete to physician. • Treat for shock if necessary.

25. Sternoclavicular (SC) Joint Injuries • Formed by the proximal end of the clavicle and the manubrium of the sternum. • Ligaments include: • Joint Capsule • Anterior/Posterior SC ligaments • Interclavicular ligament • Costoclavicular • Mechanism • External Blow to the shoulder region, which results in a dislocation in the proximal end of the clavicle.

27. SC Joint Injuries • Signs & Symptoms: • In most cases (2nd & 3rd degree) will result in deformity. • Swelling • Limited movement of the shoulder girdle • Snapping/Popping/Tearing sound at the SC • Arm may be held closely to the body, with the head/neck tilted to the injured shoulder

28. SC Joint Treatment • Apply ice and compress, using the sling & swathe method. • Treat the athlete for shock if necessary. • Bring athlete to be checked out by physician.

29. Strains/tendonInjuries

30. Biceps Tendinitis Jered Weaver

31. Continuing … Causes • Overuse Symptoms • Pain when the arm is bent and straightening • Pain over the front of the shoulder • Elbow painful Prevents • Rest your body • Increase the frequency and intensity of exercise gradually • Apply ICE Rehabilitations • Rest • ICE • Medication • Stretching • Strengthening

32. Rotator Cuff Tears

33. Muscles of the Rotator Cuff • SITS

34. Rotator Cuff Mechanism • Repetitive overhead motions or overhead throwing Symptoms • Pain when lifting the arm • Weakness when rotating the arm or lifting • Cracking sensation • Pain in follow through • Stiffness 12 to 24 hrs later • Tenderness around the humeral head

35. Rotator Cuff Rehabilitation • Rest and limited overhead activity • Surgery • Strengthening exercise and physical therapy • Anti-inflammatory medication Prevention • Warming up properly • Do proper strength and conditioning • Specific exercise that strengthens the muscles around the shoulder blade.

36. GH Joint Related ImpingementSyndrome • Impinge means “upon or against Something” • Syndrome means “a number of symptoms occurring together and characterizing a specific disease” GH is the most common type of impingement syndrome, occurs when a soft tissue like a bursa or tendon is being squeezed by moving joint structures.

37. Impingement Syndrome • Commonly occurs to athletes who perform more over head motions, such as volleyball, basketball, tennis, squash, track & field events, etc. • Signs & Symptoms • Pain when the GH joint is abducted • Loss of strength • Nocturnal pain • Pain felt deep within the shoulder

38. Impingement Syndrome Treatment • Rest • Ice • Anti-Inflammatory Medication • Physical Therapy • In worst case scenario, surgery may be required to help reduce the stress and pressure beneath the arm.

39. Contusions of the Shoulder • Commonly occur in sports, especially to the AC joint. • GH joint is more protected by muscles, where as the AC joint is much more exposed. • Mechanism: • Blows to the shoulder region • When an athlete sustains a hit like this, it is commonly referred to as a shoulder pointer.

40. Shoulder Pointer • Signs & Symptoms: • History of a recent blow to the shoulder • Muscle spasms • Discoloration and swelling, especially over the regions of the AC joint

41. Treatment of Shoulder Pointer • Immediately apply ice and compression over the injured areas. • In severe cases apply a sling • If there is still a significant amount of swelling 72 hours later, refer athlete to a physician.

42. Bibliography Biceps Tendinitis • http://www.leadtheway.ca/biceps_tendinitis.htm • http://orthoinfo.aaos.org/topic.cfm?topic=A00026 Shoulder separation • http://www.bchealthguide.org/kbase/topic/special/tw9147spec/sec1.htm Shoulder Dislocation • http://www.antibodywear.com/articles/shoulder_dislocations_symptoms_and_treatment_02.asp • http://www.shoulder-pain-management.com/shoulderdislocation.html Rotator Cuff Tears • http://orthoinfo.aaos.org/topic.cfm?topic=A00064 • http://72.14.205.104/search?q=cache:RNMGZQu2lpkJ:ezinearticles.com/%3FRotator-Cuff:--Exercises-and-Strategies-to-Prevent-Injury%26id%3D44386+prevent+rotator+cuff+tears&hl=ko&ct=clnk&cd=1&gl=ca