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SHOULDER
The shoulder allows us to control our hands and function properly at work, play and all other activities of daily living. The shoulder must stay in proper shape in order to continue a normal lifestyle. Some common injuries that disrupt the proper functioning of the shoulder are:
Rotator Cuff Injuries: The shoulder joint is surrounded by muscles and tendons, which make up the rotator cuff. One main injury of this area is tendinitis. Tendinitis is inflammation (redness, swelling, soreness) of the rotator cuff and/or biceps tendons. This inflammation is commonly caused by pinching of the tendons against other structures. If the inflammation is very severe the tendon may thicken and become trapped. Squeezing of the rotator cuff is known as impingement syndrome. Another injury of this area is a rotator cuff tear. This happens when tendinitis in the rotator cuff is very severe and causes a hole to form in the tendon.
This can also occur from falling onto an outstretched hand, or overuse with extreme lifting. Most people feel pain at the top and outer side of the shoulder, especially when the arm is extended or raised. An activity as simple as getting dressed can be painful with this type of injury. Most rotator cuff problems can be treated with rest, medication, or low intensity exercises. However, if the pain persists over 2 weeks a physician should examine the injury. Doctors may not be able to determine if the injury is a torn rotator cuff without the use of x rays or an MRI.
Frozen Shoulder: This type of injury typically occurs from extended periods of lack of use of the arm do to severe pain. Doctors refer to this injury as adhesive capsulitis. In this injury, arm movement is restricted due to the formation of adhesions (abnormal bands of tissue) between the joint surfaces. These bands make sliding between the arm bone and socket very rough and painful causing stiffness. The joint may become so stiff and tight that even simple movements such as raising the arm can become difficult. Some people may be more prone to this injury if they have diabetes, stroke, accidents, lung disease, and heart disease. The main treatment for this injury is started by the administration of anti-inflammatory drugs and heat application, followed by gentle stretching exercises. If these treatments do not work then nerve stimulation may have to be used.
Shoulder Separation:This injury occurs whenever ligaments that hold the collarbone (clavicle) and shoulder blade (scapula) together, become partially or completely torn. The collarbone may slip out of place disabling it to connect to the shoulder blade. The most common causes of this injury are due to a blow to the shoulder, or falling on an outstretched hand. Symptoms include: shoulder pain or tenderness, occasionally a bump in the middle of the top of the shoulder may appear. A separation may be detected through the use of an x-ray. Shoulder separation can be treated with rest and through wearing a sling. Ice may be applied soon after the injury to reduce swelling and pain. Therapy may be required in order to return the arm to full use again. Only in severe cases is surgery needed.
Shoulder Fracture: A fracture is a partial or total crack through a bone. Impact injuries (a large blow to the arm or a severe fall) are usually the cause of a break. A fracture of the shoulder usually occurs in the collarbone or the neck portion of the arm (the area right below the ball). Shoulder fractures after a major injury usually cause severe pain. Redness and bruising may be present around the fractured area soon after the injury. A fracture may be obvious in certain cases where the bones appear to be out of position. X- rays can determine severity of the fracture. Doctors treat a fracture by placing the bones in a position that will start healing and restore movement of the arm. A fractured clavicle will require the patient to wear a sling. A doctor may require a patient to perform strengthening exercises after the sling is removed. Certain clavicle injuries will require surgery. A fracture of the neck of the arm bone is also treated with a sling. If bone are out of position, surgery may be necessary.
Sprains and Strains:
Sprain - an injury to a ligament (stretching or tearing)
Strain - an injury to either a muscle or a tendon. The severity can range from a simple overstretch of a muscle or tendon, or it can result in a partial or complete tear.
Sprains occur by falling onto an outstretched arm. This causes an overstretch or tear of the ligament supporting that joint. Some common symptoms of a sprain are pain, swelling, bruising, and loss of the ability to move and use the joint. Some people feel a pop or tear when the injury occurs.
There are different intensities to a sprain:
Mild - causes overstretching or slight tearing of the ligaments. A person with this injury usually has slight pain, swelling, and minimal loss of function.
Moderate - causes partial tearing of the ligament and is characterized by bruising. There is a loss of function associated with this injury. An x-ray or MRI may be needed.
Severe - Complete tear or rupture of the ligament. Pain, swelling and bruising are severe, and the patient has almost complete loss of function of this area. X-rays are usually taken to rule out a broken bone.
Strains are caused by twisting or pulling a muscle or tendon. Some strains can be caused by an injury or trauma such as a blow to the body or by improperly lifting heavy objects.
Another cause of strains is prolonged overuse of the muscles and tendons. People with a strain usually experience pain, muscle spasms and muscle weakness. Swelling, cramping, or inflammation of the injured area may also occur. In some cases loss of muscle function may occur. Pain and weakness is usually present when the injured area is moved. Severe strains that cause partial or complete tearing are often very painful and disabling.
ELBOW
The elbow is both a hinge and pivot joint that allows a person to bend, extend, and rotate the arm. It connects the end of the upper arm bone to the bones in the forearm with ligaments, tendons, and muscles. Elbow injuries can be minor or serious and may include symptoms such as pain, swelling, numbness, tingling, weakness, or decreased range of motion. Some of the more common elbow injuries are:
Acute Injuries are caused by a direct blow, penetrating injury, or fall. Injuries can also result from twisting, jerking, jamming, or bending the elbow abnormally. Acute trauma to the elbow is likely to involve a fracture, dislocation or tendon rupture. Swelling, bruising and/or loss of elbow function may be experienced with this injury.
Elbow Dislocation is one of the more serious elbow injuries. This occurs when the bone is pulled or pushed out of place. Range of motion may be decreased or lost in combination with acute pain over the elbow surface
Elbow Fracture (Broken Elbow) can be caused from trauma or a fall on an outstretched hand. This may result in pain, swelling, bruising, and joint deformity. Some patients may complain of numbness or tingling in the fingers and/or hand. Surgery is often required for a severely displaced bone.
Olecranon Bursitis (Elbow Bursitis) is inflammation of the bursa which is the tissue surrounding the joint space. It is caused by overuse of the joint or a previous injury such as a fall. Acute pain and/or swelling may be present on the tip of the elbow.
Lateral Epicondylitis (Tennis Elbow) is the result of small tears and scarring of a tendon on the outer side of the elbow. This results from overusing the elbow for wrist extension and results in outer elbow pain.
Medial Epicondylitis (Golfer's Elbow) is the result of chronic wrist flexion. It causes inflammation of the muscles and a tendon in the forearm. Anyone who must hold their wrist still and extend backwards for long periods of time are susceptible. Some examples are using a computer mouse, performing a back hand, or painting a ceiling.
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