Shoulder Injuries2020-09-07T11:08:09+00:00

Shoulder Injuries

Shoulder injuries belfast

Shoulder injuries are common in sport. 

They can result from direct contact from a tackle or falling to the ground.  

They can also occur in non-contact sports such as weight lifting, basketball or baseball.  

The shoulder is a ball and socket joint.  The stability and function of the joint depends upon the ligaments, rotator cuff and cartilage.  

Any injuries to these structures will result in shoulder symptoms of pain, stiffness and loss of flexibility.  

A Physiotherapy assessment will identify what is causing your symptoms and how best to fix them.  

Keep reading to find out about common shoulder injuries:

Shoulder Impingement

This one of the most common shoulder injuries we come across.  

The term shoulder impingement is a general one used to describe the shoulder getting ‘pinched’ during overhead movements.  

There is a gap between the ball of the shoulder and the end of the clavicle (collar bone), known as the subacromial space.  

Within this space lies the tendons of the rotator muscles.  

There are several reasons why these muscles get impinged during overhead movements:

  • Bony spurs 
  • Bursitis
  • Thickened rotator cuff tendons (tendinopathy)
  • Calcification of rotator cuff tendons
  • Shoulder joint instability 
  • Abnormal scapular movement 

Rotator Cuff Tendinopathy

Rotator cuff tendinopathy is a common cause of shoulder pain and impingement. 

The tendons become thickened and weaker, usually as a result of too much training i.e. swimming and tennis.  

The symptoms are present when lifting the arm above head height.  

Treatment consists of reducing aggravating movements for a period of time and strengthening the rotator cuff. 

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Rotator Cuff Strains or Tears

The tendons of the rotator cuff can be strained and are often felt as a sudden twinge during activity.  

The degree of these shoulder injuries can range from a partial or complete tear.  

Partial tears are managed through rehabilitation exercises to strengthened the tendon.  

Complete tears usually require surgery and a period of rehabilitation, before returning to sport.  

Rotator Cuff Calcification

Calcium may form within the rotator cuff tendons, leading to shoulder pain and stiffness.  

The calcification can be seen on x-ray or MRI scans.  

The condition is usually managed through Physiotherapy but people may require surgery to remove the calcified deposit.  

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Glenoid Labral Shoulder Injuries

There is a thick ring of cartilage deep within the shoulder joint, called the labrum.  

It acts to cushion the joint and provide stability.  

We see this injury mainly in rugby players and CrossFit athletes.  

Symptoms include pain, reduced movement and noises such as popping, clicking or clunking during certain movements.  

People also sometimes report an unstable feeling within the joint.  

Labral injuries are defined in 2 groups:

  1. SLAP (superior labrum anterior to posterior) tear
  2. Non-SLAP tear 

A physiotherapy assessment can help to identify this issue and an MRI scan is sometimes required to check the extent of the injury.  

A period of rehabilitation is usually undertaken but if this proves unsuccessful, surgery is indicated to repair the labrum.

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Shoulder Dislocations

Shoulder dislocations occur when the joint is forced out of position.  

It can happen when someone lands heavily onto their arm.   

Shoulder dislocations most commonly come out of the joint in a forward direction (anterior shoulder dislocation), or less commonly in a backwards direction (posterior shoulder dislocation). 

This results in severe pain and an inability to move the arm.  

A visit to Accident and Emergency is required to get the shoulder placed back into position and to get an X-ray to check for fractures.  

A Shoulder Consultant will assess and determine if surgery is required immediately or a period of rehabilitation should be commenced first.  

The edge of the shoulder socket can be chipped off during the dislocation, resulting in a ‘Bankart lesion’. 

The ball of the shoulder joint can be compressed into the joint, resulting in a ‘Hill-Sachs’ lesion’.  

A Bankart and Hill-Sachs’ lesion can occur individually or together.  

Depending on the extent of injury, you may be advised to wear a sling for 1-3 weeks.  

You will also be advised to start basic isometric strengthening exercises from the beginning and then gradually progressing to other exercises after 3 weeks.  

The shoulder joint depends heavily on strong muscles and tendons to provide stability.  

The sooner rehabilitation begins, the better the recovery and quicker return to sport.  

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Frozen Shoulder or Adhesive Capsulitis

A frozen shoulder can occur following an injury, or spontaneously.  

Symptoms include stiffness and pain.  

Spontaneous frozen shoulder is more common in people with diabetes and thyroid issues.

It can also occur following shoulder surgery or injury.  

Stiffness and pain can last between 1-2.5 years. 

Rarely surgery is required but some people benefit from a cortisone injection to settle inflammation and pain.  

Physiotherapy helps to manage symptoms and restore flexibility as the condition improves over time.  

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Fractured Clavicle

The clavicle or collar bone can fracture during a heavy fall onto the shoulder or outstretched hand.  

It occurs in sports such as rugby, horse riding and cycling.  

Pain is usually severe and movement is limited.  

There may also be an obvious dip along the clavicle.  

Bruising and swelling occurs over the following hours and days.  

Treatment involves wearing a sling for 4-6 weeks and carrying out a specific rehabilitation programme to restore movement and strength.  

Surgery is required if the fracture does not heal as anticipated.  

Acromioclavicular Joint (ACJ) Injury

The acromioclavicular joint is situated at the end of the collar bone, where it meets the shoulder joint.  

The mechanism of injury is either a direct blow to the shoulder or a fall onto an outstretched hand.

There are several ligaments which hold the joint in place. 

The degree of injury depends on the severity and amount of ligaments that get overstretched.

More severe injuries result in the end of the collar bone being prominent.

Recovery involves a gradual rehabilitation programme focusing on strength and flexibility exercises.  

Surgery is rarely required for these injuries. 

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