ACJ injury:
ACJ – Short for acromioclavicular joint, is the small joint at the front of the shoulder where the collar bone meets the acromion (a bony point of the shoulder blade). It has an important role in maintaining normal shoulder function and movement. Damage to the joint is most often associated with the ligaments that are responsible for maintaining the joint’s stability.
How?
The most common mechanism of injury is through direct impact to the shoulder, usually through falling on to the shoulder. This frequently occurs in rugby or football. The impact most often strains the ligaments creating instability that could also lead to dislocation of the joint.
The AC joint is also vulnerable to overuse injury especially in sports that require overhead movements like waterpolo, baseball and weight training.
Where is the pain?
Pain will be felt at the front corner of the shoulder. In more serious cases, the pain may be reproduced with shoulder movements, particularly as the arm is elevated closer to shoulder height and above your head. Reaching across your body towards the opposite shoulder will also cause pain. There may also be a sensation of instability at the front of the shoulder, a feeling of the arm drifting forwards. Immediate management includes keeping the shoulder elevated and supported by a sling.
Can physio help? YES!
Physiotherapy will alleviate pain symptoms, improve range of motion and encourage a return to normal function. Conservative management with a comprehensive rehabilitation program is paramount. Establishing scapula (shoulder blade) stability with exercise will provide the best possible chance of preventing injury reoccurrence and further complications. Shoulder movement patterns will be altered to ensure the joint is stable.
Dislocated shoulder:
Injury to the upper arm that involves the bone of the upper arm (the humerus) moving out of the shoulder joint.
Shoulder dislocations occur as a result of a direct blow from one of four directions. The most common sends the shoulder backwards and sideways, pushing the humerus out of the circular ring of cartilage that lines the shoulder joint.
Previous injury to the shoulder does increase the risk of dislocation.
Where is the pain?
Pain may not be localised to a small point of the shoulder, depending on the severity of the injury surrounding muscles and nerves may also be injured causing pain and inflammation that radiates away from the shoulder. Altered sensations in the arm, hand or fingers is not uncommon with nerve irritation in the shoulder. Movement will be painful immediately after injury.
Can physio help? YES!
Physio plays a very important role in re-establishing normal shoulder function after injury in both sports people and the general public. There are several key factors that must be addressed – pain-free range of motion, joint stability and joint strength. Joint stability is a particularly important component to address – as there is damage to the ligaments and possibly the muscles surrounding the joint, the ability to sense joint stability is negatively impacted and needs to be corrected with targeted stability exercises. If left untreated dislocations will be re-occur and the risk of more complicated injury will increase.
Rotator cuff tears:
The rotator cuff is a collection of muscles that provide stability to the shoulder joint during movements. Injury to one or more of these muscles often creates an imbalance in the joint integrity leading to complaints of pain, clicking sensations, loss of movement and more.
How?
Tears can occur as a result of a variety of movements: landing awkwardly on the shoulder, the arm being caught and pulled awkwardly like in a tackle, or repetitive overuse of the shoulder causing degenerative changes to the structure of the shoulder joint.
Where is the pain?
Initially, pain will be quite localised to the shoulder and upper arm with varying restrictions in shoulder movement and strength. Depending on severity, overhead activities may be the only aggravating movement. Stiffness may also be associated with the pain. It is not unusual for symptoms to change over a period. Referral into the upper arm, forearm and hand may occur as the integrity of the shoulder joint changes and muscular dysfunction becomes a cause of secondary injury.
Can physio help? YES!
A full orthopaedic assessment is key to identify movement limitations, the severity and number of structures injured. Treatment will target pain and inflammation management. Once movement returns, a comprehensive rehabilitation program will be developed to improve muscle weakness and imbalance. The primary goal is to have the joint mobile but stable.
If you are suffering with any of the above call 01279 414 959 today and book an appointment!
OCT
2019