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Shoulder Injuries

Shoulder injuries are most frequently soft tissue injuries involving the muscles, ligaments and tendons, suffered as a result of activities that require repetitive overhead motion. Sporting activities such as swimming, pitching, weightlifting and tennis can be the cause of this, so can household activities, such as cleaning windows and gardening.


1) Rotator Cuff Injury

Rotator Cuff injury is damage to one or more of the muscles or tendons that make up the Rotator Cuff and is a common cause of shoulder pain. The Rotator Cuff is a group of four muscles which keep the shoulder stable.

Rotator Cuff injury will present in the form of inflammation which is often referred to as Rotator Cuff tendonitis. Other symptoms include shoulder pain (which worsens during overhead motion), shoulder weakness and impaired shoulder movement. The patient should be referred to a physiotherapist as tendonitis responds well to such treatment.

If left untreated Rotator Cuff tendonitis can develop into a partial or complete Rotator Cuff tear. Rotator Cuff tears require surgical repair.


2) Shoulder Separation Injury

A Shoulder Separation injury is medically termed an Acromioclavicular joint sprain, and is predominantly caused by a fall directly onto the shoulder, which injures the ligaments surrounding the shoulder joint.

This injury can take on differing degrees of severity. It can range from a mild but painful sprain on the AC ligament, or it can become quite severe where the AC ligament is torn and the coracoclavicular CC ligament is also sprained or torn, causing the collarbone to become misaligned.

Shoulder Separation Injury is usually recognisable where there is deformity, in the shape of a lump. However, a mild sprain to the AC ligament may not be enough to cause this. Shoulder pain will be present, particularly at the end of the collar bone. Shoulder movement will be restricted and it will be particularly difficult to move the arms above the head.

Mild injuries usually respond well to rest and the application of cold therapy. Immobilisation in a sling is important to decrease movement which eases pain and prevents further damage. Anti-inflammatory medication may be prescribed by a doctor. Physiotherapy may be required once the pain has decreased. Surgery is only required in the case of a complete ligament rupture.


3) Shoulder dislocation

The shoulder joint is a mobile joint which allows the arm a wide range of movement. However compared to sturdier hinge joints such as the elbow or knee, this mobile design also makes the shoulder joint more vulnerable to dislocation.

A shoulder dislocation can be identified by the sudden onset of severe shoulder pain and an inability to move the shoulder. The shoulder’s rounded appearance may be replaced with a slightly squared-off edge.

The joint will be repositioned back into place by a doctor, through a process called Reduction. The shoulder may then be immobilised in a sling for two to three weeks. A course of physiotherapy treatment is recommended to help restore range of movement and stability to the joint, which should help to prevent recurring dislocations. 


4) Collar Bone Fracture

A broken collarbone or clavicle fracture is usually caused by a direct blow to the shoulder or a fall onto an outstretched hand.

Such an injury is characterised by a sagging shoulder, severe pain, an inability to move the arm, a deformity (bump) over the site of the break and swelling and bruising over the collarbone.

Course of treatment depends on how the bones have fractured. If the two parts of the clavicle are still relatively well aligned then immobilising the affected arm in a sling or a figure-of-eight wrap, should provide the support and restriction needed to allow the injury to heal. If the break is more severe and the bones are displaced, surgery may be required to realign the fragments.


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