A common overuse injury in Sports Medicine

by rwilkerson June 16, 2010
Written by James W. Berk M.D.

The number of musculoskeletal injuries is on the rise in the last decade partly due to the increased participation in recreational exercises. Our society has become much more aware of the benefits of routine exercise in the prevention of common diseases such as coronary artery disease, hypertension, hypercholesterolemia, arthritis and a number of cancers. The majority of these injuries occur because of improper technique or training. One such common injury is called rotator cuff tendonitis/impingement syndrome:

The shoulder is truly an amazing joint in the fact that it is a highly mobile joint capable of significant power, speed and precision. It allows a person to be able to serve a tennis ball or throw a baseball at speeds greater than 100 miles an hour. The anatomy of the shoulder is complex and sometimes makes a diagnosis of specific injuries difficult. Briefly, the shoulder is composed of three joints (glenohumeral, acromioclavicular and sternoclavicular), 2 sets of muscle groups superficial (deltoid, biceps, pectorialis major and trapezoid) and a deep rotator cuff (supraspinatus, infraspinatus, teres minor and subscapularis) and 3 ligaments (glenonumeral, coroclavicular and corocoacromnal). As you can see there are many soft tissue constraints to the shoulder joint movement. This is the reason why the shoulder is often injured. The muscle and ligaments have the "work" of keeping the arm in socket while allowing significant mobility.

Impingement Syndrome" is the term we use to describe pain in the shoulder when the soft tissues (rotator cuff, bursa) are being "pinched" by the shoulder blade (acromion). It is very common in anyone who does a lot of overhead activities (tennis, baseball, volleyball, weightlifting). In the older population it may be associated with arthritis and degenerative "bone spurs". Your physician is often able to diagnosis this with simple x¬rays and physical exam. Initial treatment in patients with this disorder is aimed at strengthening the rotator cuff muscles and improving glenohumeral flexibility. A course of physical therapy is often prescribed. Drugs called non-steroidal anti-inflammatories (nsaids) such as Advil or Aleve are often used for pain control. Patients with continued symptoms may need an injection into the shoulder of a steroid to help relieve pain and inflammation. The severe case of impingement, which is often associated with rotator cuff tears, will need surgery to remove part of the shoulder blade and repair the rotator cuff.


Pain | Shoulder


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