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SHOULDER PAIN
One of the most common problems that I deal with in my sport medicine practice is shoulder dysfunction. In this article I will review some of the common shoulder problems and discuss ways of treating and preventing them.  The shoulder is a complex joint which attaches the upper bone of the arm
(the humerus) to the body via the shoulder blade (scapula). Playing a
crucial role here is the rotator cuff, which is a group of tendons that
arise from muscles on the scapula and wrap around the “ball” at the top of
the humerus. This structure provides the shoulder a wide range of motion
while still providing strength and stability. Unfortunately, like any
mechanism with a lot of small parts, the shoulder does have a tendency to
cause trouble.Injuries to the shoulder can result from sudden trauma or from gradual repetitive strain and overuse. The most severe injuries, for example falling while skiing, can lead to shoulder dislocations and/or fractures of the upper end of the arm. Prevention of these can be difficult but it does help to keep your arms at your side if you fall, and to avoid landing on an outstretched hand. Much more common is shoulder pain  and stiffness resulting from repetitive
strain on the rotator cuff, through activities such as hitting tennis
serves or throwing baseballs. This condition, called rotator cuff
tendonitis, is often made worse by a deterioration of the blood supply to
the tendons. The symptoms usually come on gradually, and are particularly
noticeable when the arm is above shoulder height. They are also more
pronounced at night. Treatment of rotator cuff tendonitis requires a number of approaches. Temporary avoidance of the triggering activity is important. Anti-inflammatory medications are sometimes helpful. Early physiotherapy, which can include acupuncture, plays an important role in decreasing the pain, as well as maintaining strength and range of motion. If the symptoms persist, a shot of cortisone can be a very effective and safe option. Prevention involves improving shoulder strength and flexibility, warming up prior to throwing or hitting, and starting the season slowly while gradually building up intensity. One final problem that deserves mentioning is “frozen shoulder”. The hallmark of this condition is a fairly rapid onset of shoulder stiffness associated in the early stages with a lot of pain. If not treated quickly, a frozen shoulder takes many months to heal and sometimes leaves a permanent loss of motion. In my experience, cortisone injections combined with aggressive physiotherapy can be extremely effective in alleviating pain and stiffness and shortening the course of this condition. If you develop shoulder symptoms don’t just wait and hope they will go away. Get them assessed and treated early. See Also Rotator Cuff Injuries in Baseball and Softball |