The shoulder joint is one of the five main body areas in which sports accidents take place. Athletes who overuse their shoulder in throwing or over-the-counter sports like cricket bowlers, volleyball and Javelin throw after a fall both of them face shoulder injury. It may be wounded by falling on the arm or by traction, as in contacts such as football. In this article we will describe the different forms of shoulder injury and the mechanisms around it.
Here are some salient features of its anatomy for a better understanding of the various injuries.
The shoulder of the human body is the most mobile joint, but the most vulnerable. This ball and socket connect together with the blade of the shoulder of the top of the arm bone (humerus) (scapula). It is encircled with the capsule, a pocket like the tissue. The rotating cuff is closely associated with the shoulder of a pair of tendons. They double as complex limitations. The ball's curvature radius and socket are divided and theoretically make the shoulder unstable. It is similar to a tea-hanging golf ball. By soft tissue restrictions, osteooriente and negative suction force between components, this intrinsically unstable joint is made stable.
Closely related to the joint are important nerves and blood vessels of the upper limb in their course downwards from the chest to the arm.
The upper ball of the arm bone slips either entirely (dislocation) or partly from its socket (subluxation). This is happening in sports as the hand is extended. The consequence of an outright dislocation is sudden agony as the ball emerges from the joint. It mostly appears at the front. The arm is placed as though it is paralysed, until the player or hospital is directly positioned. This is a case that is dramatic. Once the shoulder has dislocated, young sportsmen under 25 years of age tend recurrently to dislocate. This ability to dislocate again needs recovery and surgery.
Arthroscopic stabilization Provides a minimally invasive procedure to certain sportsmen. The outcomes of this surgical mode correspond to the old Open Stabilization "gold standard." During arthroscopic surgery rehabilitation is easier because of lower pressure. Instability does not always come from falling, it's necessary to note. This can also happen with sportsmen who use their bodies to play overhead sports such as football, volleyball, and Javelin. The joint will not be dislocated honestly in such sportsmen, but a sense of dead arm or discomfort occurs. The cricket fielder who has discomfort and must throw the ball overhead from the border refuses this and throws it down.
Instability usually takes place on the front ward, but can take place on the back or several directions (multi directional). They are less prevalent. Front and back instability requires surgical stability by arthroscopic means ideally. However, a recovery phase is better handled with multidirectional dysfunction (in more than one direction)
Tendonitis refers to tendonitis around the shoulder inflammation. Because of overload/fatigue, trauma and age-related improvements, the rotary cup or semen of the biceps may get inflamed. Swelling and crowding of the tendons below the ossic arch will contribute to so-called imposition. During overhead operations, discomfort is felt in this state. In advanced conditions, evening pain is present while the shoulder is sitting on.
Impingement is a condition in which the rotating mango (a collection of tendons) rub with the underlying shoulder blade projection of the bony acromion (crow like). Tendons broken with tears are not effective in stabilising the arm joint, which migrates upwards in the overhead arch to pinch already injured tendons. It may be due to rotator cuff fatigue or dysfunction, as mentioned above. In instability the capsule stretching allows the ball to move upward again. In instability, the extension of the capsule allows the ball to go up again creating imperfection. It can be difficult to differentiate between equilibrium and impingement, and professional acumen is essential. Internal impingement is in the baseball pitch as in the image in which the arm is thrown out.
In the young patient tears of the rotator cuff are due to trauma. In the elderly citizen, tears are due to degeneration like grey hair. Tears result in weakness and pain during overhead activities. Usually these tears are poorly cured and particularly in the young sportsman. They must be healed spontaneously. In the older patient a trial of conservative treatment with analgesics and one or two cortico-steroid injections may be useful before embarking on surgery.
The joint is formed in a shoulder blade on the outside end of the collar bone. After a spill on the elbow, dislocation occurs. The collar bone is separated by the shoulder blade and the collarbone is upwards. This results in pain and distortion. While the minor varieties can be carefully processed, the main forms require surgery.
The labrum is a circular cartilage band attached for deeper depth to the glenoid cavity. Sportsmen who use their arm to throw, serve, break, dive, etc. may tear it. Pain is noticed on the shoulder's front. Clicking or locking may be the other signs. Instability, partial rotating mango tears may be associated with it. The only alternative is arthroscopic procedure. Simultaneously addressing any related anomalies.
This arises when they suddenly contract an unforeseen resistance. Pectoralis major is commonly ruptured muscles on the front wall of the arm pit and the biceps.
The brachial plexus can result in complete or partial paralysis of the upper limb. The brachial plexus is also dislocated. In most cases, brachial plexus wounds are temporary, although an electromyogram can require examination.
Diagnosis and management of shoulder injuries in sportsmen is best done by an Orthopaedic surgeon treating these problems and exposed to arthroscopic surgery. A physiotherapist, rehabilitation expert and sports psychologist also have their important role to play to rehabilitate these sportspersons and make them return to competitive sport. Such skilled manpower and equipment exists in India and vast amounts of money need not be spent on overseas treatment.
Dr. Siddharth Aggarwal, MBBS, MS, M.CH (ORTHOPAEDICS), Arthroscopy & Sports Surgeon is a board-certified orthopedic doctor and surgeon who specialises in Sports Injuries and Arthroscopic Surgeries of Knee, Shoulder and Ankle. He has outstanding experience in providing treatment for various trauma and joint replacement conditions. Throughout his career, Dr. Siddharth Aggarwal has gained the trust and respect from his patients and peers due to his outstanding professionalism, considerable knowledge, and impressive skills.
Recovery from shoulder surgery is no longer a painful ordeal as expert anesthetists provide effective anesthesia and pain relief to inpatients. There are well qualified physiotherapists to help you recover quickly from surgery.
We have had the pleasure of treating many renowned sports persons across the country not only for shoulder problems but for many other reasons including ACL, PCL, Knee replacement and many more.