Common injuries of the Shoulder
COMMON INJURIES OF THE SHOULDER
The shoulder is susceptible to:
Traumatic Injuries
Overuse Injuries, (including 8–13% of all sport-related injuries)
Dislocation
Glenohumeral
Acromioclavicular
Rotator Cuff Injuries -Shoulder impingement syndrome
Rotational Injuries
Subscapular Neuropathy
DIFFERENCE
Dislocation??
“Complete separation of articular surfaces with soft tissue damage”
Subluxation??
“Incomplete separation of articular surfaces with or without soft tissue damage”
GLENO HUMERAL JOINT DISLOCATION
Glenohumeral Joint
most commonly dislocated joint in body
Reason
loose structure of glenohumeral joint enables extreme mobility but provides little stability
Direction of Dislocation:
Anterior
Posterior
Inferior
DISLOCATION
Superior direction
Strong coracohumeral ligament prevents displacement in the superior direction.
Mechanism of dislocation:
Glenohumeral dislocations occur when humerus is abducted and externally rotated.
Antero-inferior dislocations more common than those in other directions.
Factors that predisposes the joint to dislocations include:
Inadequate size of glenoid fossa
Anterior tilt of the glenoid fossa
Inadequate retroversion of humeral head and deficits in rotator cuff muscles
Once the joint has been dislocated, the stretching of the surrounding collagenous tissues beyond their elastic limits commonly predisposes it to subsequent dislocations.
Glenohumeral capsular laxity due to genetic factors; Individuals with this condition should strengthen their shoulder muscles before athletic participation
DISLOCATION
Dislocated shoulders tend to occur more often in males than in females. This is probably because of association with contact sports.
In men, the peak age is 20-30 years and in women it is 61-80 years (due to susceptibility to falls).
Repeated episodes of dislocation should raise the possibility of hypermobility or Ehlers-Danlossyndrome being present.
Ehlers-Danlos syndrome (EDS) is a rare inherited condition with disruption of the integrity of structural proteins in skin, ligaments, cartilage and blood vessels, leading to fragility of connective tissues.
MECHANISM OF INJURY
v Anterior dislocation – Fall with abduction and posteriorly directed force on arm.
v Fall on out stretched hand – common in elderly
CAUSES OF DISLOCATIONS
Dislocation may results from large external force. During accident , during contact sports such as wrestling and football.
laxity of glenohumeral joint capsule due
to genetic factors.
ACROMIOCLAVICULAR JOINT DISLOCATION
Dislocations or separations of acromioclavicular joint
Sports: common among wrestlers and football players.
Mechanism:
When a rigidly outstretched arm sustains force of a full-body fall, either acromioclavicular separation or fracture of clavicle is likely to result.
ROTATIONAL INJURIES
Structures involved forceful rotation at shoulder:
Tears of labrum
Rotator cuff muscles
Biceps brachi tendon
Sports including forceful rotational movements
Throwing, serving in tennis, and spiking in volleyball
OTHER PATHOLOGIES
Calcification of soft tissues of joint.
Degenerative changes in articular surfaces.
Bursitis:
“Inflammation of one or more bursae, is another overuse syndrome, generally caused by friction within bursa
