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The use of our hands in everyday activities requires great mobility of our shoulders. Athletic endeavors require strength as well as movement. This mobility comes at a price, as the shoulder is the most frequently dislocated joint in the body.
The shoulder depends on both static and dynamic stabilizers to maintain shoulder stability and function. The dynamic stabilizers are the array of muscles that surround the shoulder joint. Best known is the rotator cuff. Other muscles include deltoid, pectoralis, and latisimus. They contribute to shoulder stability when actively contracted. Muscle weakness or imbalance can lead to instability and shoulder injury.
The static stabilizers are the glenohumeral ligaments and labrum. These are known as the capsulolabral complex. The capsulolabral complex provides inherent constant stability to the shoulder. Without the static stabilizers, the shoulder could dislocate once the dynamic stabilizers fatigue.
Injuries may occur to both the dynamic and static stabilizers of the shoulder. This can result in shoulder pain, weakness, and limited range of motion. Common injuries to the rotator cuff include tendonitis and rotator cuff tears. Common ligament injuries include labral and capsular tears. These injuries can result from falls, car accidents, sports, repetitive stress, and over activity.
Initial treatment should focus on reducing the inflammation from injury. Rest, ice, and anti-inflammatories help reduce the acute inflammation and pain. Once the acute injury has subsided, activity is gradually resumed. If pain and stiffness persist, a cortisone injection to further decrease the pain and inflammation may be indicated. Physical therapy should be started to regain strength and range of motion. If the patient fails to respond to these conservative measures, further work-up is indicated with x-rays and MRI. Referral to an orthopedic specialist may be necessary to rule out a surgical condition. |
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· Shoulder |