Shoulder injuries - Causes and treatment options

Shoulder injuries -
Causes and treatment options

The shoulder is a complicated and exposed joint. Even though the shoulder is protected by powerful muscles all round, shoulder injuries are frequent in sport. The symptoms of shoulder injuries are not necessarily clear and the diagnosis is a matter for specialists. It is advisable to take pains in the shoulder area seriously and have them examined.

Shoulder injuries significantly impair mobility and can have various causes which require therapy. The most common shoulder injuries in sport are:

Fractures of the shoulder blade

They are normally the result of considerable traumatic impacts, for example, due to falls when horseback riding, skiing, snowboarding or mountain biking. Injured persons often feel non-specific pressure pain in the shoulder with no swelling or bruising. A specialist must be consulted after a serious fall. The specialist will examine the function of the shoulder and the nerves endangered by a fracture of the shoulder blade.

An x-ray or computer tomography of the shoulder is required for the precise diagnosis.

In the majority of cases, the therapy consists of a short period of immobilisation in a Gilchrist bandage. Pendulum exercises can be performed depending on the pain level after one to three weeks. Complicated fractures of exposed parts of the shoulder blade with tilting or shifting may require surgical procedures.

Fractures of the humeral head

Fractures of the humeral head occur in contact sports, such as ice hockey and American football, but also due to falls when horseback riding, skiing, snowboarding or mountain biking. The main action that leads to this injury pattern is a fall on an outstretched hand or a direct trauma or an external rotational movement on the outstretched arm. Symptoms include reduced mobility and severe pain, swelling and bruising, which can appear with a delay of up to 48 hours under certain circumstances.

In three quarter of cases, the treatment can be carried out in a shoulder bandage, however, displaced fractures must be operated. If the fracture of the humeral head results in the severance of blood vessels which are important for nutrition, or if the humeral head is shattered into several parts, then an artificial shoulder joint (shoulder prosthesis) must be implanted under certain circumstances.

The physiotherapeutic follow-up treatment extends over several weeks, and often over several months.

Clavicle fractures

Clavicle fractures are the second most common bone injury in adults. They are often caused by falls on outstretched arms, e.g. from a bicycle or due to an impact or fall on the front shoulder.

Classic indications of a clavicle fracture are swelling and pain in the clavicle, bruising, malposition and pain when raising the arm. Radiographs of the clavicle in two planes serve the diagnosis.

The physician shall decide whether a clavicle fracture is treated conservatively through immobilisation with a so-called “clavicula-bandage”, or surgically, on the basis of the x-ray image.

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