Common Shoulder Injuries

More than 7 million people go to the doctor's office each year for a shoulder problem, including shoulder and upper arm sprains and strains. More than 4 million of these visits are for rotator cuff problems.

Shoulder injuries are frequently caused by athletic activities that involve excessive, repetitive, overhead motion, such as swimming, tennis, pitching, and weightlifting. Injuries can also occur during everyday activities such washing walls, hanging curtains, and gardening.

Warning Signs of a Shoulder Injury
If you are experiencing pain in your shoulder, ask yourself these questions:

  • Is your shoulder stiff?
  • Can you rotate your arm in all the normal positions?
  • Does it feel like your shoulder could pop out or slide out of the socket?
  • Do you lack the strength in your shoulder to carry out your daily activities?

If you answered "yes" to any one of these questions, you should consult an orthopaedic surgeon for help in determining the severity of the problem.

Common Shoulder Injuries
Most problems in the shoulder involve the muscles, ligaments, and tendons, rather than the bones. Athletes are especially susceptible to shoulder problems. In athletes, shoulder problems can develop slowly through repetitive, intensive training routines.

Some people will have a tendency to ignore the pain and "play through" a shoulder injury, which only aggravates the condition, and may possibly cause more problems. People also may underestimate the extent of their injury because steady pain, weakness in the arm, or limitation of joint motion will become almost second nature to them.

Orthopaedic surgeons group shoulder problems into the following categories.

  • Instability

Sometimes, one of the shoulder joints moves or is forced out of its normal position. This condition is called instability, and can result in a dislocation of one of the joints in the shoulder. Individuals suffering from an instability problem will experience pain when raising their arm. They also may feel as if their shoulder is slipping out of place.

  • Impingement

Impingement is caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade, called the acromion.
Impingement problems can occur during activities that require excessive overhead arm motion. Medical care should be sought immediately for inflammation in the shoulder because it could eventually lead to a more serious injury.

Rotator Cuff Injuries
The rotator cuff is one of the most important components of the shoulder. It is comprised of a group of muscles and tendons that hold the bones of the shoulder joint together. The rotator cuff muscles provide individuals with the ability to lift their arm and reach overhead. When the rotator cuff is injured, people sometimes do not recover the full shoulder function needed to properly participate in an athletic activity.

Treatment of Shoulder Injuries
Early detection is the key to preventing serious shoulder injuries.

Shoulder Exercises
Often, an orthopaedic surgeon will prescribe a series of exercises aimed at strengthening the shoulder muscles.

Here are some easy shoulder exercises that you can do to strengthen your shoulder muscles and prevent injuries.

  • Basic shoulder strengthening

Attach elastic tubing to a doorknob at home. Gently pull the elastic tubing toward your body. Hold for a count of five. Repeat five times with each arm. Perform twice a day.

  • Wall push-ups

Stand facing a wall with your hands on the wall and your feet shoulder-width apart. Slowly perform a push-up. Repeat five times. Hold for a count of five. Perform twice a day.

  • Shoulder press-ups

Sit upright in a chair with armrest, with your feet touching the floor. Use your arms to slowly rise off the chair. Hold for a count of five. Repeat five times. Perform twice a day.

Other Treatment
Anti-inflammatory medication also may be prescribed to reduce pain and swelling. 

Dr. Paul Abbott is an orthopaedic surgeon with Vail-Summit Orthopaedics. He specializes in shoulder problems, sports medicine, and trauma fractures and dislocations.

Save your knees!

Knee pain or injury is one of the most common reasons people see their doctors. Your knee is the largest joint in your body and one of the most complex. It is also vital to movement.

Because you use it so much, it is vulnerable to injury. Because it is made up of so many parts, many different things can go wrong. 

Common Knee Problems

Meniscal Tear
Meniscal tears can occur when twisting, cutting or pivoting. Direct contact, like a tackle, is often involved.

Anterior Cruciate Ligament (ACL) Tear
A quick cutting maneuver or awkward landing from a jump can tear your ACL. Athletes often hear a “pop” at the time of injury.

Medial Collateral Ligament (MCL) Tear
These types of tears often occur as the direct result of a blow to the outside of the knee. MCL tears are common in skiing and contact sports, like soccer or football.

Osteoarthritis
With aging comes a gradual wearing away of the articular cartilage lining our joints. This is called osteoarthritis and most often cases pain and stiffness in the knee.

Posterior Cruciate Ligament (PCL) Tear
The PCL is often injured when an athlete receives a blow to the front of the knee or makes a simple misstep on the playing field. 

Treatments
Not all patients and not all knee conditions are the same. That’s why for most orthopaedic diseases and injuries, there is more than one form of treatment.

To make sure your treatment matches your needs, your doctor will consider several things, most importantly, your age, activity level, and general health.

Working together, you and your doctor will find the treatment that is right for you. 

Keeping Healthy
Having strong, flexible muscles is the best way to keep knees healthy and prevent further injury.

Strength
Strengthening the muscles that support your knee will reduce stress on your knee joint. Strong muscles in the front of your thigh (quadriceps) and back of your thigh (hamstrings) help your knee joint absorb shock. The less strain on your knee, the better the chances are for pain relief and preventing further injury.

Flexibility
Stretching the muscles that you strengthen is an important part of preventing injury. Strengthening exercises build muscle to help support your knee, but can also tighten the muscles. Tight muscles are more prone to injury. Gentle stretching after strengthening exercise reduces muscle soreness and will keep your muscles long and flexible.

How do I start exercising?
Your doctor or physical therapist will tell you which exercises are right for you.
Start slowly. Building muscle strength takes time. As you get stronger, gradually increase the number of exercise repetitions or add weight to an exercise.

Do not ignore pain. You should not feel serious pain during an exercise. You might feel discomfort because you are challenging your muscles, but not pain. If an exercise hurts, stop the exercise.

Do not overdo it. You should not feel serious pain after exercise. It is typical to feel stiff or a bit sore the day after you exercise. If you feel so sore that it is difficult to move, then you have overdone your exercise. Rest is the best thing for your sore muscles.

Ask questions. Talk to your doctor or therapist if you have any pain or are unsure of how many exercises to do, or how often to do them. 

Dr. Richard Cunningham is a Sports Medicine Orthopedist with Vail-Summit Orthopaedics.