Common Shoulder Injuries

The shoulder is a complex shoulder joint, primarily because it is structured to be able to rotate in almost all directions and perform complicated movements. Due to this structure, the muscles, ligaments and tendons surrounding the shoulder, are prone to injury. Overuse shoulder injuries are common in overhead sports such as baseball, tennis, weightlifting and swimming. Acute traumatic shoulder injuries are common in contact sports such as hockey and football. In addition, shoulder injuries are prevalent in daily life and work activities that involve repetitive or overhead positions, such as painting, renovations, yardwork and factory work. Shoulder injuries may include strains, sprains or tears of ligaments, tendons and muscles. They can also include tendonitis, tendinopathy, impingement, dislocations and separations.

Rotator Cuff Tendonitis or Tendinpathy

Inflammation or chronic degeneration of the tendons of the rotator cuff. The rotator cuff is the group of tendons and muscles that surround the shoulder joint to help with shoulder movement and stability. Typically caused by overuse especially with overhead motions especially in throwing or racket sports; can also be caused by trauma. But may also be related to anatomic abnormalities with shoulder impingement (LINK). Symptoms include pain typically at the outer (lateral) side of the shoulder, difficulty raising arm up or throwing. Besides acute injury management (LINK), treatment includes physiotherapy, shoulder blade stabilization exercises, other types of therapy (e.g., chiropractic, massage), shockwave therapy, throwing or racket technique changes, specialized injections and occasionally surgery.

Rotator Cuff Tear

Tear in the tendons surrounding the shoulder that help with shoulder movement and stability. Typically caused by trauma in younger people, but very common in older people without any traumatic injury. Symptoms include pain and weakness, especially with overhead movements or activities. Besides acute injury management (LINK), treatment includes physiotherapy, shoulder blade stabilization exercises, injections and may require surgery especially if tear is severe.

Impingement Syndrome

Very related to rotator cuff tendonitis or tendinopathy. Involves anatomic abnormalities that result in pinching of the rotator cuff tendons between the bones in the shoulder. Pinching may also occur from abnormal shoulder motion or muscle imbalances. Symptoms include pain, mainly on overhead movements, as well as with throwing or racket sports. Besides acute injury management (LINK), treatment includes physiotherapy, shoulder blade stabilization exercises, other types of therapy (e.g., chiropractic, massage), shockwave therapy, throwing or racket technique changes, specialized injections and occasionally surgery.

skeleton of upper body with shoulder in red

Shoulder Bursitis

Inflammation and swelling in a bursa (fluid-filled sac) in the shoulder that is commonly associated with rotator cuff tendonitis (LINK). Typically caused by overuse especially with overhead motions especially in throwing or racket sports. May also be related to anatomic abnormalities with shoulder impingement (LINK). Symptoms include pain typically at the outer (lateral) side of the shoulder, difficulty raising arm up or throwing. Besides acute injury management (LINK), treatment includes physiotherapy, shoulder blade stabilization exercises, anti-inflammatory cream, throwing or racket technique changes, specialized injections and occasionally surgery.

Shoulder Dislocation

Occurs when the arm bone of the shoulder joint (the “ball” part of the joint called the humeral head) completely displaces out of the shoulder socket (glenoid fossa). Caused by a traumatic fall or sudden strain on the shoulder that forces the shoulder into an extreme position of abduction (arm moved to the side), external rotation and overhead position. Common in contact sports such as hockey and football. Symptoms include severe pain, feeling like shoulder is “out of joint”, visible deformity of the shoulder, and decreased range of motion. Besides acute injury management, treatment includes putting the shoulder back into place (“reducing” the dislocation) as soon as safely possible followed by a period of immobilization in a sling; this is followed by physiotherapy and a shoulder strengthening program; sometimes requires surgery to prevent recurrent instability.

AC Joint Separation (Shoulder Separation)

Very different injury from a shoulder dislocation. Typically caused by a traumatic blow to the tip of the shoulder such as a hockey player getting hit hard shoulder first into the boards. Involves the spraining or tearing of the ligaments that connect the collarbone to the acromion bone (part of the shoulder blade). Symptoms include pain, swelling, a visible bump or deformity at the top of the shoulder and a lack of range of motion. Besides acute injury management, treatment includes using a sling initially, then physiotherapy to regain range of motion and strength. Occasionally a brace is used, and in severe rare cases surgery is needed.

Labral Tear

The labrum is the rim of cartilage (rubbery shock absorber) around the shoulder socket. The labrum can get injured or torn from trauma such as a shoulder dislocation, direct impact, severe twist, or sudden forceful throwing or other overhead motion. Shoulder labral tears may also occur from overuse in sports such as baseball. Symptoms include pain, decreased range of motion, instability and mechanical sensations (clicking, catching, snapping, etc.). Besides acute injury management, treatment includes physiotherapy, other types of therapy, special injections and sometimes requires surgery.

SLAP Tear (Superior Labrum Anterior to Posterior)

A special type of labral tear (LINK) in which the upper (superior) part of the labrum is torn. May be associated with biceps tendonitis because the biceps tendon attaches to that part of the labrum. Typically caused by trauma and repetitive overhead motions such as throwing in baseball. Symptoms include pain, decreased range of motion and mechanical sensations (clicking, catching, snapping, etc.). Besides acute injury management, treatment includes physiotherapy, other types of therapy, special injections and sometimes requires surgery.

Biceps Tendonitis

Inflammation of the biceps tendon which functions along with the rotator cuff to move and stabilize the shoulder joint. Typically caused by repetitive overhead motions or activities such as throwing and racket sports. Symptoms include pain at the front (anterior) part of the shoulder, swelling and sometimes clicking. Besides acute injury management, treatment includes physiotherapy, shoulder blade stabilization exercises, topical anti-inflammatories, shock wave therapy, other types of therapy and specialized injections.

Frozen Shoulder (Adhesive Capsulitis)

Inflammation and tightening of the capsule that surrounds the shoulder. The cause is unknown and is not particularly linked to sports or physical activities, but can be associated with certain conditions such as diabetes. Symptoms include severe pain and tightness with a very limited range of motion, and can last up to two years. Also various types of treatment are often tried (e.g., analgesics, anti-inflammatories, physiotherapy, massage therapy, etc.), the main treatment is a corticosteroid (cortisone) injection.

man holding his shoulder
female holding painful shoulder

Individual treatments may vary based on the specific diagnosis and severity of the injury. Seeking professional medical advice for an accurate diagnosis and a tailored treatment plan is recommended for optimal recover.

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