Shoulder Injuries

The shoulder is a very important joint in many sports such as racquet sports, swimming and ball sports.  It is an extremely mobile joint and relies on good muscle control to maintain stability.

Repetitive movements such as throwing a ball, swimming or serving in tennis place considerable stress on the shoulder, and can lead to injuries through incorrect technique or biomechanics.  The shoulder is also easily injured in contact sports such as football where it can be dislocated.  As with all injuries, it is imperative that shoulder problems be treated early, as the longer they are left the more difficult rehabilitation becomes.

The most common injuries that occur at the shoulder are:

Tendinopathy
One of the most frequent causes of shoulder pain, tendinopathy can occur due to overuse or repeated use of shoulder muscles with the arm at or above shoulder level. Tendinopathy occurs as a result of overuse or poor biomechanics.  Treatment will involve avoiding the aggravating activity, ice, and massage.  If biomechanics are to blame, this must be corrected.

Impingement 
Occurs commonly in tennis players, swimmers (Swimmers Shoulder), weight lifters, or any athlete who does repetitive, stressful movement of the shoulder joint.  Impingement occurs when there is a trapping of the tendons of the rotator cuff between the humerus and the end of the collar bone.  The problem can be further complicated by irregular bony outgrowths which are often present in older people.

When the arm is moved upwards and rotated inwards (e.g. freestyle swimming) the soft tissues are compressed.  Repeated movement and compression leads to inflammation and swelling, which further increases the impingement.

This condition can be prevented by a proper warm-up and stretches, appropriate strength training, and decreasing repetitive shoulder movements. Treatment of impingement is similar to that of tendons, with a greater emphasis on correction of biomechanical problems.

The causes of Shoulder Pain are numerous, and injuries need to be accurately diagnosed before the appropriate treatment can be implemented.  In addition to this, any technical or biomechanical problems should be fully assessed by your physiotherapist in consultation with your coach.