The shoulder is made up of three bones and various muscles and tendons. Rotator cuff tears are the most common shoulder injury, often caused by repetitive motions or wear and tear. Treatment options include rest, medication, and surgery. Other shoulder injuries include tears in the labrum and bicep tendons. Diagnosis is made with an arthroscopic camera. Treatment options vary depending on the severity of the injury.
The shoulder is made up of three bones: the scapula, or scapula, the clavicle, or clavicle, and the humerus, or upper arm bone. The glenoid is the shallow socket where the upper arm rests on the shoulder and the humerus is stabilized by a glenoid labrum, which also serves as the attachment point for several muscles and tendons. The rotator cuff is a covering over the top of the humerus made up of four muscles that hold the humerus in place and allow the arm to move and rotate. A shoulder injury is an injury to any component of the shoulder.
A rotator cuff tear is the most common shoulder injury. This can occur following an acute injury and is usually accompanied by a loud popping sound and sudden, sharp pain. More frequently, however, rotator cuff tears are the result of repetitive shoulder motions, such as repetitive throwing and lifting in athletic efforts, or simple wear and tear injuries that appear after age 40. Symptoms of a gradual rotator cuff tear in the shoulder usually include increased pain when raising or lowering the arm, atrophy of the shoulder muscles, and decreased range of motion of the arm.
Nonsurgical treatment of rotator cuff tears includes resting the arm in a sling for a period of time, steroid injections, anti-inflammatory drugs, and rehabilitation exercises. If these methods fail, surgery may be required. Surgical options are arthroscopic surgery, mini-open surgery, and open surgery, depending on the location and severity of the injury. Post-operative treatment involves stabilizing the arm in a sling over a period of weeks followed by physical therapy.
A shoulder injury can also occur along the glenoid labrum or the rim around the shoulder socket. A tear on the upper lip is called a SLAP lesion, while a tear on the lower edge is known as a Bankurt lesion. In the past, these injuries were extremely difficult to diagnose because the labrum is made up of soft tissue and cannot be seen with a traditional x-ray. Diagnosis is now made with an arthroscopic camera that can take pictures of the inside of the joint. Nonsurgical treatment includes stabilization of the arm, treatment of inflammation, and therapy, although arthroscopic surgery may be required in some cases.
A shoulder tear can also occur in the labrum. The labrum is a thick cuff of cartilage that forms a cup and surrounds the shoulder socket. While labral tears can occur from blunt trauma injuries, they are usually the result of age and wear and tear, as the cartilage becomes brittle over time. Symptoms can include pain inside the shoulder and a catching sensation when the shoulder moves.
Tendons attach muscles to bones. The bicep is attached to the shoulder by two tendons. The longer tendon attaches above the glenoid, or socket of the shoulder, and the shorter tendon attaches to a bump on the scapula called the cortacoid process. A biceps tendon shoulder injury is more likely to start with a scramble and then gradually increase in size. A hard fall or lifting a heavy object can cause tears, although most are likely to happen over time and with repeated use.
Symptoms of a biceps tear can include a high-pitched sound accompanied by sudden pain, the inability to turn the hand from palm up to down, bruising in the middle arm near the elbow, and weakness. A complete tear is usually easy to diagnose because the biceps will bunch together like a “Popeye” muscle. Partial tears are harder to see, but are indicated when a person experiences pain when trying to flex the biceps muscle. If there has been no damage to any other component of the shoulder, this type of shoulder injury is usually treated with ice, anti-inflammatory drugs, rest, and physical therapy. Surgical repair is less likely, although it may be an option if the patient has an occupation that requires full recovery to full strength.
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