SHOULDER

Hombro

The shoulder is one of the most complex parts of the human body in design and functionality and is considered the joint with the greatest range of motion.

It allows us to perform simple actions like lifting objects or scratching our back as well as large, complex movements like swimming, climbing, and throwing objects long distances. Many different structures play a role in the process of granting us such mobility; these same structures open the door to a wide range of possible injuries.

The shoulder is formed by the humerus, shoulder blade, and clavicle, however this is only the bony frame. The joint’s functional mobility is due to a complex musculotendinous unit, which is why the shoulder suffers such a high rate of sports-related injuries or degenerative injuries caused by daily activities. The main culprit behind shoulder injuries is mechanical. That is to say that what went wrong, be it in the part of the shoulder that creates stability or mobility, is due to trauma, a fall, or from overuse.

The type of injury depends as much on the activity the patient is engaged in as on the patient’s age and timeframe in which the injury developed.

 

SPORTS INJURIES DUE TO OVERUSE

Some specific injuries, as described above, manifest in athletes due to overuse at the level of the long biceps tendon. However injuries may occur in other structures.


Rotator Cuff Injuries in Athletes

In spite of the fact that rotator cuff injuries are nor characteristic of young patients, some cases of overuse may trigger temporary inflammatory processes like tendinitis; inflammation of the tissue that separates the tendons of the rotator cuff from the acromion (the bone directly above it) as in Bursitis, and in less frequent cases, if the inflammatory process continues, it may result in a tear in the tendon, producing pain and limited movement.

The inflammatory processes respond properly to the treatment of medication, physical therapy, and, if necessary, anti-inflammatory infiltration.

In the event the rotator cuff is torn, it must be repaired according to the nature of the injury. (See Rotator Cuff Tear)

 

Scapular dyskinesia

This is an alteration of the muscles that stabilize the scapula (shoulder blades) and normally manifests as muscular pain in the posterior region of the shoulder near the scapula due to muscular overuse.

Once shoulder girdle injuries have been discarded, the treatment focuses on achieving apropriate muscular balance.

Less frequently, scapular dyskinesia appears due to acute secondary nerve damage from falls, trauma to the neck, or other injuries. In these cases, nerve conduction studies are necessary.

 

Fractures

Resulting from contusions, falls, or accidents, the bone structures can lose their continuity. The most frequent fractures in athletes are found in the clavicle due to direct trauma, falls involving the shoulder, or a direct contusion.

 
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