The Shoulder Injury

If I could come up with an INSTANT cure for all my patients who present with a shoulder injury I would be a very happy (and rich) man. Out of all the injuries I have treated the shoulder injury is well up there in terms of its prevalence, its pain and its problem factor. In a nutshell they are common; irritating and debilitating.

What I will do here is discuss the commonest conditions affecting this amazing joint.




BASIC ANATOMY

The shoulder is a complex of joints although we talk about it as one joint. Just like the rest of the body it is a purpose designed functional unit with an amazingly complex movement mechanism that is easily damaged.

It is prone to injury because it is designed for movement at the expense of structural stability

The shoulder complex is made up of the following joints:

The gleno-humeral joint.This is the major joint or articulation between the ball on the top of the arm and the socket on the edge of the shoulder blade.

The acromio-clavicular joint. This is a small joint between the ends of the shoulder blade and the collar bone. It can be felt as a bony lump on the top of the edge of the shoulder.

The sterno-clavicular joint. This is the small joint joining the end of the collar bone on to the breast bone, just at the lower end of the neck.

The scapulo-thoracic joint. This describes the underside of the shoulder blade as it moves over the rib cage at the back of the shoulder region.

The acromio-humeral joint. This is where the ball on the top of the arm moves against the edge of the shoulder blade bone above it.


There are enormous texts describing in intricate detail the anatomical complexities of the shoulder but here we are going to consider only the relevant points related to shoulder injury and leave the rest to the purists.

The most important of the joint for us here is the gleno-humeral joint. This is formed importantly by a small shallow saucer shaped socket into which fits the ball or rounded end of the humerus or upper arm bone. The socket is smaller than the ball and sits basically vertically so there are some fine and important mucles that help to hold the ball in the socket.

These muscles are commonly known as rotator cuff muscles. They are not power muscles but have the job of holding and steadying the ball against the shallow socket to allow accurate arm movement.

There are four small muscles that make up the rotator cuff complex. It is not vital you know all about them individually. They are best considered as a group. However for the information hungry they are: supraspinatus; infraspinatus; subscapularis and teres minor.

They are relatively delicate in certain situations and are frequently damaged. The mechanism of shoulder injury here is often a seemingly innocuous incident to a rotator cuff group that has been weakened over time by previous minor injuries and general degenerative changes.

Other problematic structures in the shoulder can be the cartilage rim of the socket and fluid filled sacs that reduce friction in various parts of the joint.

Next you will find details of the commonest shoulder problems. The vast majority of people suffering a shoulder injury at this joint will have one of the following:

Frozen Shoulder (Adhesive Capsulitis)

Rotator Cuff Injury.

Dislocated Shoulder.

Fracture Around The Shoulder

Tendonitis.

We will look at each one in detail but again if you cannot find what you are looking for please let us know by using our information request page.