A SHOULDER ... TO CRY ON!

Miami Heat Magazine, Vol. II, No. 7, May 1991

Injuries to the shoulder are very common in athletes.  Injuries can usually be divided into two categories:  the injury that occurs from a sudden traumatic event and the one that comes from overuse.  Most sports-related shoulder injuries are overuse injuries, caused by repeating the same activity thousands and thousands of times.

The common type of overuse injury is called shoulder impingement syndrome.  This commonly affects basketball players, weight lifters, swimmers, pitchers and jai alai players.  The rotator cuff tendinitis and bursitis that results from overuse affect the athletes when attempting to raise their arm upwards and outwards.  Occasionally, if the inflammation is severe enough or the trauma great enough, the rotator cuff may actually tear.

Usually overuse problems in the athlete can be treated with a rehabilitation program directed at decreasing the pain in the shoulder, improving the motion of the shoulder, and strengthening the shoulder in a pain-free arc of motion.  Frequently, a muscle imbalance may exist between the shoulder internal and external rotations, and this, too, can be re-trained with a carefully supervised rehabilitation program.

Certain injuries to the shoulder can be the result of significant trauma.  A basketball player that falls or a wide receiver that is tackled, both landing on their shoulder, may experience a separated shoulder or a dislocated shoulder.

A separated shoulder is not an actual injury to the ball and socket joint of the shoulder.  It's an injury to the joint above the shoulder called the acromioclavicular joint.  Separated shoulders result in pain, swelling and deformity at the level of the acromioclavicular joint.

The vast majority of separated shoulders can be treated with a brief period of rest, and then a physical therapy and rehabilitation program.  Although occasionally a "bump on the shoulder" may be permanent, most athletes can return to highly competitive sports, weight training and throwing activities without surgical intervention.

Shoulder dislocations are very common in young athletes.  When an athlete's shoulder "pops out of joint," it can be extremely painful.  Many times, the athlete may require treatment at an emergency room and the shoulder put back in place by their doctor.  The key point to remember with dislocated shoulders is that prompt treatment is necessary.  If the same shoulder dislocates on more than two occasions, the likelihood of recurrence is greater than 95%, and most athletic individuals will require surgical treatment to prevent further dislocations and shoulder symptoms.  Fortunately, the success rate of these surgeries is very high and in many circumstances now, arthroscopic surgery alone can repair the athlete's shoulder problem.

Shoulder problems are very common in sports.   Recent advances in sports medicine have allowed our understanding of shoulder problems to be much greater and have expanded our treatment options for both overuse injuries and traumatic injuries.  Most important, early attention to any shoulder problem makes the treatment much easier and allows the athlete in most circumstances to recover more quickly and return to sports, not only faster, but with less likelihood of re-injury.