Injuries S ports of The Shoulder

Margarita Gurevich

The shoulder is a common joint that is injured during sports, particularly those involving the use of the upper limbs, such as tennis, swimming and others. In this article we will look at several sports injuries of the shoulder and the available physiotherapy treatments.

It’s important to realise that the shoulder is one of the more complex joints in our body. If we look at the knee as a comparison, there aren’t many variations in movement direction. You can bend it or you can straighten it. The shoulder, however, being a ball and socket joint, can move in a large number of ways, especially when you combine movements (such as lifting your arm and then rotating to serve during tennis or perform a stroke during swimming). As a result, there are a lot of ways in which the shoulder and its associated structures can become injured.

1. Rotator cuff tears.

The rotator cuff is a group of muscles which stabilise the shoulder and control certain movements. Partial and full tears can occur in any of these muscles as a result of trauma, overuse or as a secondary issue following some other pathology of the shoulder region.

2. Shoulder impingement.

Shoulder impingement describes the ‘trapping’ or ‘compression’ of the shoulder’s rotator cuff tendons during normal shoulder movements. This abnormality results in injury to the tendons, leading to pain, inflammation and reduced shoulder function.

3. Bursitis.

Bursitis is a condition defined by inflammation of the bursa. A bursa is a lubricated sac of fluid which helps reduce rubbing or chafing of various structures as they move past one another. They can be found in many joints throughout the body. Bursitis can be caused by overuse or due to a single major trauma.

4. Referred pain.

As with any presentation of pain or dysfunction, it is important to consider that the site of the pain may not always be where the root of the problem exists. Our nerves run from our spinal cord, out through the various spinal levels and peripherally into our limbs, all the way to our fingertips and toes. Therefore, any disruption along the way can lead to pain which is experienced further down the track. A bulging disc in the neck, spinal canal stenosis or nerve impingement at the facet joint are just a few examples of ways in which nerves can be affected. Your physiotherapist will be able to perform a thorough diagnostic assessment which will determine the exact cause of your shoulder pain and subsequently recommend an appropriate treatment plan.

HERE ARE THE TREATMENTS FOR SPORTS INJURIES OF THE SHOULDER.

1. Symptom and pain relief.

In general, symptom relief and pain relief, is the first point of call. This can be achieved by avoiding aggravating activities, use of hot and cold modalities, electrotherapy, ultrasound, drug phoresis, SENAR therapy and gentle exercises if appropriate.

2. Regaining function with exercises.

The next phase of recovery should focus on regaining function of the shoulder.

This will likely involve an exercise program which is gradually progressed, comprising of assisted range of motion exercises, postural exercises, active range of motion exercises, strengthening and stretching. Clinical Pilates is a very effective exercise treatment tool.

3. Practice functional movements and tasks.

Finally, the focus should shift towards more functional tasks. In sports rehabilitation this includes practicing specific components of each sport, such as swinging a tennis racquet above your head when serving or practicing a swimming stroke. It is important to note that the ‘shoulder’ encompasses not only the ball and socket joint, but also the scapula (shoulder blade) and therefore any rehabilitation will likely involve a focus on the rotator cuff and postural muscles as well.

Sports injuries of the shoulder can be treated with successful rehabilitation of the shoulder joint and surrounding muscles.

Margarita Gurevich is Senior Physiotherapist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialises in sports injuries, women’s health (including incontinence) and gastrointestinal issues.

Margarita may be contacted via her website.