SPORTS INJURIES OF SHOULDER

The shoulder is at risk for injury in many sports. Some of the common shoulder injuries among athletes are:

1. Rotator cuff tendinitis: It is common in overhead sports such as baseball, tennis, volleyball, and swimming.

2. Rotator cuff tears: These can occur if the tendons are overloaded in weight lifting or football.

3. Bankart's lesion: A Bankart lesion is an injury of the anterior glenoid labrum due to repeated (anterior) shoulder dislocation. It can be caused by repetitive overhead throwing, lifting heavy objects below shoulder height or catching heavy objects, or falling onto an outstretched arm. A Bankart lesion is an indication for surgery and often accompanied by a Hill-Sachs lesion, damage to the posterior humeral head.

4. Dislocation and subluxation: A mild amount of instability will allow the shoulder to slip part way out of socket causing subluxation. When the shoulder comes completely out of its socket, it results in a dislocation. Subluxation or dislocation can occur with nearly all sport activities.

5. SLAP lesion: A SLAP (superior labrum anterior to posterior) tear occurs when the cartilage of the shoulder (labrum) delaminates from glenoid. It may be caused by repeated stress of overhead throwing in sports such as baseball and softball. Very few patients with SLAP lesion injuries return to full capability without surgical intervention. Very rarely physical therapy can strengthen the supporting muscles in the shoulder joint to the point of reestablishing stability. For all other cases the choice is do nothing or have surgery to reattach the labrum to the glenoid.

6. Clavicle fractures: These are common injuries seen frequently in sports where speed or contact are involved.

7. AC joint injuries: The clavicle or collarbone meets the shoulder at the acromion where a small joint is found. This joint can be injured to varying degrees in a fall onto the outside part of the shoulder. Injury to the AC joint is called an AC separation. AC separations occur in contact sports and are frequently seen in skiing and biking falls.

8. Labral tears: The glenoid labrum usually tears as a result of a trauma such as a fall onto an outstretched arm causing pain during motion. Labral tears are treated with physical therapy and sometimes surgery.

9. Instability: Ligaments in the shoulder hold the shoulder bone in its socket. The shoulder has a very large range of motion, and needs some flexibility of the ligaments to allow for that range. But if the ligaments become stretched or torn, this can lead to instability.

10. Osteochondral injury: Osteochondral injuries are an important type of musculoskeletal trauma that can lead to disabling arthritis if not recognized and treated appropriately in the early stages.

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