Shoulder injuries are a common problem we treat at Michigan Surgery Specialists. Unlike some other conditions, injuries of the shoulder are not limited to a particular age group or demographic. They can occur in a young athlete during a sporting event, or an elderly person experiencing a slip and fall accident. In this article we will break down some of the most common shoulder injuries that we see in office and we will outline what the recovery process looks like for these conditions.
Types of Shoulder Injuries:
A shoulder dislocation occurs when the upper arm bone pops out of the socket of the shoulder. Dislocations can be a onetime injury, or can lead to frequent dislocations if left untreated. These injuries often occur due to some type of trauma, contact sports (such as a hard fall on the ice in a hockey game or during a football tackle) and slip and fall accidents (common in the winter months). Sometimes dislocations can be associated with a shoulder fracture, but that is not always the case. You can read more about Shoulder Dislocations here.
A fracture involves some kind of break in at least one of the three bones in the shoulder. These fractures are most commonly seen in events like car accidents and slip and falls, or sports injuries involving a hit and/or fall (football tackles, hockey slips or falling off a horse).
Rotator Cuff Tear/ Impingement Syndrome
Though a Rotator Cuff Tear and Impingement Syndrome are not exactly the same condition, they are related. Impingement Syndrome occurs when the outer edge of the shoulder blade rubs or pinches the rotator cuff, leading to pain and irritation. The Rotator Cuff is a grouping of muscles and tendons in the shoulder, a tear can occur from Impingement Syndrome over time or by other means more quickly. You can read more about Rotator Cuff Injuries here. Both Shoulder Impingement and Rotator Cuff tears are commonly seen in the following scenarios:
- sudden jerking of the arm
- work related injuries (generally in warehouse workers and laborers)
- Sports injuries where there is a frequent or over rotation of the shoulder, like baseball players, basketball players, weightlifters and swimmers
Labral Tears (SLAP Tears)
A Labral Tear involves a rip in the Labrum, the cartilage that lines and reinforces the ball-and-socket of the shoulder. Sudden jerking movements, repeated movements (usually seen in baseball players) and other traumatic events can lead to a Labral Tear. Labral Tears can also be referred to as SLAP tears; Superior Labrum Anterior and Posterior (meaning that the Labrum is torn in both the front and the back).
Though not EXACTLY a shoulder injury, Bicep- Tendon Injuries are characterized by pain in the front of the arm caused by a pulled bicep muscle or a tear in the tendon that reaches from the shoulder to the elbow. These injuries are common from overuse of the muscles/tendons, repeated motions in sports (like golf and tennis swings), or even more sudden injures, like reaching behind to grab something from the back seat of your car.
Treatment Methods and Recovery
There are a few different surgical methods that can take place depending on the type of shoulder injury:
- A Shoulder Arthroscopy is a minimally invasive technique used to treat problems within the shoulder. In these procedures, the surgeon will insert a camera (arthroscope) through small incisions to inspect the area, and then can insert small instruments to treat the problem. Since these are not “open procedures”, there is minimal scarring involved and often less downtime afterwards.
- Shoulder Replacement procedures are used when more conservative treatments fail or if the condition has progressed too far (depending on pathology).
- Another type of surgery that is common in the case of a Shoulder Fracture is an Open Reduction Internal Fixation, or ORIF. This is an open procedure used to stabilize and treat the broken bone.
If any surgery is deemed necessary, maximum recovery results are generally seen between 3-6 months after the procedure. Typically, the patient spends the first 4 weeks in a sling. After several weeks, the patient can begin physical therapy to work on range of motion (generally for the first 4-8 weeks of therapy) and progressive strengthening (after 8 weeks of therapy).
Of course, more conservative treatment methods are used as a first step to treat any shoulder condition. Besides resting and icing, taking anti-inflammatory medication and physical therapy are great alternatives to try before resorting to surgery. In some cases, a patient may be a candidate for a cortisone injection, a powerful anti-inflammatory shot that works quickly to reduce inflammation, relieving pain. While this can sometimes be a cure, it is often a temporary solution.
Regardless of the conservative treatment method, if surgery is unnecessary you can expect relief from your shoulder pain within a few weeks of treatment.