Feeling comfortable in your routine life means you can move freely and perform you daily chores and needs without restrain, definitely without a pain. A shoulder joint injury will prevent you from enjoying your freedom of movement. Shoulder injuries is one of the most common reasons that bring a patient to a traumatologist. Frequent injuries occur due to a joint’s structure and complexity of movements performed but it.
A shoulder joint rests on an arm bone head, a glenoid cavity and an acromion. A joint also has an articular cavity. There are other supportive structures around a joint, which job is to provide stability and protect a shoulder from excessive loads– rotator cuff muscles (supraspinous, infraspinatus, round and subscapular muscles) and an articular lip, which amplifies area of a glenoid cavity. Their job is to protect a shoulder joint and to prevent popping out of a shoulder bone head during fast and strong movements. A shoulder allows movements in three axis and three planes:
- external and internal pivoting
- circular movements
Shoulder joint injuries can occur in young people such as athletes suffering from traumas and senior people who suffer shoulder conditions due to degenerative processes in bones and joints on account of aging.
What shoulder joint traumas are most common?
A shoulder is a complex and a massive structure and one of the most prone to traumas at the same time. Its proneness to traumas is explained by its structure consisting of several surfaces, which wary considerably in size. The most widespread shoulder injuries include:
- Shoulder impingement injury
- Rotatory cuff injuries (impingement syndrome) and lip rupture
- Joint capsule rupture
- Dislocation of shoulder
- Upper arm bone fractures, in particular, fractures to a surgical neck and an anatomical neck, and a greater tubercle
All types of injuries have different diagnostics approach and treatment.
Usually occur as a result of an impact on a joint by a mechanical force. It could be a fall on a contracted arm, an impingement against a door or a dresser, light bodily injuries caused by beating. They are diagnosed at an initial examination by a traumatologist.
A shoulder impingement manifests as a pain in a joint that amplifies with active movements, however, does not restrain them. Under-the-skin hematomas or scratches are possible. In order to confirm a diagnosis, a doctor usually orders a shoulder X-ray to exclude bone-traumatic deformities.
Treatment usually includes restraint of movements in a joint, immobilization and a painkilling therapy.
Shoulder ligaments sprains, injuries to a rotatory cuff (an impingement syndrome), lip and capsule ruptures
Those types of ruptures occur as a result of application of excessive payloads to a shoulder joint. Structures that work as a holding frame for a shoulder have a lot of mobility, meaning they are agile and vulnerable to sprains and ruptures at the same time.
Clinical picture manifests as an acute pain, restrained shoulder mobility, impossibility to make active movements in one or several pivotal axes, depending on what structure is injured. Injuries to a biceps muscle of an arm manifest in building up of a tight muscle roll, which is a contracted muscle. If there is a suspicion of a shoulder sprain an X-ray is normally carried out in order to exclude a bone injury. Next step would be an ultrasound examination of a shoulder joint and a rotatory cuff. In rare cases when a reading of an ultrasound examination is too obscure, a magnetic resonance imagery is carried out.
Treatment includes immobilization, restraint of physical mobility and a painkilling therapy if there is a need for it. In case of a capsule rupture, a treatment will include a surgical procedure – an arthroscopy of a shoulder joint.
An incomplete dislocation and a dislocation of a joint
Is the most widespread trauma of a joint due to a specific anatomical built. A joint is dynamically unstable because of its freely moving capsule, which, on one hand, allows a wide aptitude of movements but, on the other hand, presents a risk of injuries. Traumas usually happen as a result of a sharp movement in either of pivotal axis. When this happen, joint surfaces become uneven, and a shoulder bone head pops out of a shoulder cavity. An incomplete dislocation means that joint surfaces not quite completely mismatch each other.
Dislocations of the shoulder are:
Shoulder dislocations can be:
- Frontal – dislocation of a shoulder bone to the front, which is the most common
- Rear – dislocation to the rear part of a shoulder
- Low – a dislocated limb needs external support and it is impossible to put it back in its natural position.
A particular type of a dislocation is diagnosed based on a clinical picture and an X-ray imagery of a shoulder joint. Other symptoms include visible deformities of a shoulder, pain in a shoulder joint, restrained active and passive movements, swelling and a hematoma. A clinical picture of an incomplete dislocation is the same albeit less obvious.
Treatment includes a closed repositioning or putting back a joint into its axis followed by mandatory application of a sling and a bandage and a painkilling therapy.
In some cases, a dislocation of a shoulder reoccurs and develops into a shoulder-slip. Then a surgical procedure is required to treat a pathology.
Shoulder bone fractures
Fractures appear as a result of a short time strong mechanical impact such as falling on a straight arm, rapidly pulling heavy weights, falling from some height or shoulder impacts. Shoulder’s most vulnerable areas are an anatomical and surgical necks and a greater tubercle. Fractures of a greater tubercle come as a result of large pressure application during shoulder pivoting in its axis. A shoulder bone fracture is diagnosed if any of the following signs are present:
- Acute and strong pain in a shoulder
- Paraarticular structures’ swelling
- Limb deformities
- Feeling of broken bones crackling
- Bones sticking from a wound; limb deformities - in the event of open fracture
An X-ray normally will be needed in order to specify a nature, a location and a damaged area. In some complex cases a computer tomogram might be required.
Treatment will depend on a type of fracture.
Sometimes a displacement of a shoulder bone during a dislocation or broken bone parts can damage a vascular-nerve tract. This can manifest as:
- Paleness or hyperemia of upper arm skin or a hand
- Limb coolness
- Feeling goose bumps and “pin bites”
Why to go to Rudenko Clinic for a treatment of a shoulder injury?
If you suspect a shoulder injury the most important is to make an accurate diagnostic and to start treatment without a delay. Strictly following your doctor’s guidance will ensure your fast recovery.
In our clinic we employ highly professional and experienced traumatologists; we have all professional equipment and an individual approach to every patient; in our diagnostics and treatments, we follow international protocols. We will provide you with a full cycle treatment so that you do not have to worry about anything.
Should you have any questions you can always ask calling our number: +38(066)8678727.
Stay healthy, look after yourself and we will take care of the rest.