Mr. McKay Athletic Training References: BY. GA EUL JUNG SHOULDER INJURIES Mr. McKay Athletic Training References: BY. GA EUL JUNG

Shoulder Joint

Bones of the Shoulder Ball & Socket joint consisting of: Scapula Humerus Clavicle Sternum

Joints of the Shoulder Glenohumeral Joint (GH) Acromioclavicular Joint (AC) Sternoclavicular Joint (SC) P.157 definitions

Common Mechanisms of Shoulder Injuries Overuse Impact Improper form Prolonged injury

Muscle of the Shoulder/ Rotator Cuff SITS

Shoulder Separation Daniel Gibson Rudi Johnson

….. Prevents Physical Therapy Surgery Rehabilitations Put Ice Causes Falls directly on the shoulder Ex) Contact from another player or tumble on the shoulder. Symptoms Limited movement Swelling and bruising Possible deformity Prevents Physical Therapy Surgery Rehabilitations Put Ice Take non-steroidal anti-inflammatory drugs Physical Therapy after surgery

What does a separated shoulder look like?

Skeletal INJURIES

Fractured Clavicle Is the most commonly fractured bone of the shoulder. Mechanism: Majority occur from direct blows to the bone Result from falls on the arm/shoulder Signs & Symptoms Swelling/deformity of the clavicle Possible broken bone projecting through the skin Snapping or popping sound Severe discoloration Athlete holding the arm and unable to move it

Fractured Clavicle

Treatment for Fractured Clavicle Treat for possible shock. Carefully apply a sling and swath bandage. Apply a sterile dressing to any open wound. Bring to hospital for x-ray.

Scapula Fracture A much less common injury. Commonly occurs to football players: Mechanism: Direct blow to the scapula region Signs & Symptoms: Considerable pain Loss of function Treatment: X-ray to determine fracture Place in sling & bind for 6 weeks

Soft Tissue Injuries

Shoulder Dislocations Shane Warne Candace Parker

…… Causes Hit,Fall,or pull Symptoms Inability to move the arm Prevent Warm up proper any physical activity or practice or competition Use special equipments to protect shoulders in athlete Rehabilitation Seek medical attention to a doctor Surgery Physiotherapy Be performed by qualified personnel in a medical environment Causes Hit,Fall,or pull Symptoms Inability to move the arm Bruising or swelling Visibly displaced shoulder

Acromioclavicular Injuries Damage to the ligaments that support the acromioclaviclar joint. Mechanism- Impact or direct blow Signs & Symptoms: First & Second Degree Sprains will result in mild swelling and tenderness, and discoloration around the joint. Any movement will result in pain. Athlete may report a snapping or popping sound. With third degree sprains there will be significant deformity.

Acromioclavicular Treatment Immediately apply ice and compression over the AC joint. Use a sling and swathe method to hold ice in place Refer the athlete to a physician to be looked at.

Glenohumeral Joint Injuries Major ligaments include: capsular ligament and the coracohumeral ligament. The GH joint and the shoulder girdle allow nearly all the movements of the shoulder. The most common joint to pop out or dislocate. (HEAD OF HUMERUS out of place) Mechanism: Having the arm forcefully abducted or externally rotated.

GH Joint Injury

GH Joint Injuries Signs & Symptoms Deformity of the shoulder joint, shoulder is lost or sloping downwards. The arm of the affected side will appear longer. Athlete will be supporting the injured arm with the uninjured arm. Extremely painful for any type of movement.

Treatment Apply Ice and compression, on the front & back of shoulder. Place a towel underneath the axilla (underarm) Apply sling and swathe. Immediately refer athlete to physician. Treat for shock if necessary.

Sternoclavicular (SC) Joint Injuries Formed by the proximal end of the clavicle and the manubrium of the sternum. Ligaments include: Joint Capsule Anterior/Posterior SC ligaments Interclavicular ligament Costoclavicular Mechanism External Blow to the shoulder region, which results in a dislocation in the proximal end of the clavicle.

SC Joint Injuries Signs & Symptoms: In most cases (2nd & 3rd degree) will result in deformity. Swelling Limited movement of the shoulder girdle Snapping/Popping/Tearing sound at the SC Arm may be held closely to the body, with the head/neck tilted to the injured shoulder

SC Joint Treatment Apply ice and compress, using the sling & swathe method. Treat the athlete for shock if necessary. Bring athlete to be checked out by physician.

Strains/tendon Injuries

Biceps Tendinitis Jered Weaver

Continuing … Causes Overuse Symptoms Pain when the arm is bent and straightening Pain over the front of the shoulder Elbow painful Prevents Rest your body Increase the frequency and intensity of exercise gradually Apply ICE Rehabilitations Rest ICE Medication Stretching Strengthening

Rotator Cuff Tears

Muscles of the Rotator Cuff SITS

Rotator Cuff Mechanism Repetitive overhead motions or overhead throwing Symptoms Pain when lifting the arm Weakness when rotating the arm or lifting Cracking sensation Pain in follow through Stiffness 12 to 24 hrs later Tenderness around the humeral head

Rotator Cuff Prevention Warming up properly Do proper strength and conditioning Specific exercise that strengthens the muscles around the shoulder blade. Rehabilitation Rest and limited overhead activity Surgery Strengthening exercise and physical therapy Anti-inflammatory medication

GH Joint Related Impingement Syndrome Impinge means “upon or against Something” Syndrome means “a number of symptoms occurring together and characterizing a specific disease” GH is the most common type of impingement syndrome, occurs when a soft tissue like a bursa or tendon is being squeezed by moving joint structures.

Impingement Syndrome Commonly occurs to athletes who perform more over head motions, such as volleyball, basketball, tennis, squash, track & field events, etc. Signs & Symptoms Pain when the GH joint is abducted Loss of strength Nocturnal pain Pain felt deep within the shoulder

Impingement Syndrome Treatment Rest Ice Anti-Inflammatory Medication Physical Therapy In worst case scenario, surgery may be required to help reduce the stress and pressure beneath the arm.

Contusions of the Shoulder Commonly occur in sports, especially to the AC joint. GH joint is more protected by muscles, where as the AC joint is much more exposed. Mechanism: Blows to the shoulder region When an athlete sustains a hit like this, it is commonly referred to as a shoulder pointer.

Shoulder Pointer Signs & Symptoms: History of a recent blow to the shoulder Muscle spasms Discoloration and swelling, especially over the regions of the AC joint

Treatment of Shoulder Pointer Immediately apply ice and compression over the injured areas. In severe cases apply a sling If there is still a significant amount of swelling 72 hours later, refer athlete to a physician.

Bibliography Biceps Tendinitis http://www.leadtheway.ca/biceps_tendinitis.htm http://orthoinfo.aaos.org/topic.cfm?topic=A00026 Shoulder separation http://www.bchealthguide.org/kbase/topic/special/tw9147spec/sec1.htm Shoulder Dislocation http://www.antibodywear.com/articles/shoulder_dislocations_symptoms_and_treatment_ 02.asp http://www.shoulder-pain-management.com/shoulderdislocation.html Rotator Cuff Tears http://orthoinfo.aaos.org/topic.cfm?topic=A00064 http://72.14.205.104/search?q=cache:RNMGZQu2lpkJ:ezinearticles.com/%3FRotator-Cuff: --Exercises-and-Strategies-to-Prevent-Injury%26id%3D44386+prevent+rotator+cuff+tears &hl=ko&ct=clnk&cd=1&gl=ca