My Aching Shoulder!

The complex ball and socket joint of the shoulder endures various injuries, including dislocations, separations and torn rotator cuffs.

There is nothing fun about a shoulder injury. Because of the wide range of motion your arm requires to do its work, the shoulder is the most movable joint in your body. That wide range of motion results in instability that can make your shoulder vulnerable to painful injuries.

Robert Coale, MD, is an orthopedic surgeon on the Medical Staff at Southwest General and Medical Director of Southwest General’s Sports Medicine Program

Rotator cuff tears, arthritis and dislocations are the three most common major shoulder problems, according to Robert Coale, MD, medical director of Southwest General’s Sports Medicine Program and an orthopedic surgeon the Medical Staff at Southwest General. The shoulder humerus – or upper arm bone – connects to your shoulder blade. The joint consists of a round “ball” at the top of the humerus, which fits into a shallow socket on the scapula (one of the bones of the shoulder).

Dr. Coale compares it to a golf ball sitting on a tee. The rotator cuff is a group of four muscles and their tendons that hold the joint together.

“Rotator cuff injuries are one of the most common shoulder problems I see,” say Dr. Coale.

Rotator cuff injuries typically involve a tear in the supraspinatus muscle (a relatively small muscle of the upper arm) or its tendon and can be caused by trauma or wear and tear, Dr. Coale explains.

Swimmers and baseball pitchers are particularly susceptible to rotator cuff injuries because of the repeated, forceful overhead motion of their arms.

“A rotator cuff tear can be very painful and result in a loss of normal function of the arm,” Dr. Coale says. “For example, reaching around to grab the seatbelt in your car can be very difficult.”

About half of the rotator cuff patients are treated with rest and physical therapy, and possibly steroid injections to promote healing. In other cases, surgical repairs are required, usually using sutures and anchors to reinforce the attachment of the tendon to the bone.

“The idea is to put the rotator cuff back where it belongs so the body can heal it,” Dr. Coale says.

A dislocation–one of the other most common shoulder problems–is a condition in which the ball of the humerus is pull out of the socket. Symptoms of a dislocation can include severe pain and tremors in the arm and the inability to move the arm. A dislocation is almost always treated in the Emergency Room (ER), usually under anesthesia.

“It is very rare that a person can pop his or her own arm back into place, nor is it recommended,” Dr. Coale explains. “We urge patients to go to the ER or to their physician as soon as possible to have it treated properly.”

The most common dislocation occurs when the arm is thrown upward and backward, and usually affects people who tend to have stretchy tendons. People who experience more than one dislocation may have surgery to tighten the shoulder joint to reduce the chance of further episodes. Additionally, dislocations can result from trauma, such as a fall on the shoulder or an automobile accident.

Many people confuse dislocations and separated shoulders. A separated shoulder is a stretch or tear in a ligament that connects the top of the shoulder blade to the end of the collarbone.

“It usually results from a collision in sports or a fall where you land on your shoulder.” Dr. Coale says. “A separated shoulder rarely requires surgery and is usually treated by rest and physical therapy.”

Athletes who suffer a rotator cuff injury or a dislocation can usually expect to fully recover after surgery, Dr. Coale promises. “Getting back to 100 percent of their normal function is our goal,” he says. “Patients can typically expect to be in a sling for about six weeks while doing physical therapy, and it can take up to a year to get completely back to normal.”

“Don’t try to suffer through shoulder pain,” Dr. Coale says. “Call an orthopedic physician, or your general practitioner, and get help today.”

This Article Written by Ken McEntee

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