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Shoulder and rotator cuff injuries

Injuries to the shoulder area and the rotator cuff can be a lengthy set back to your training....

Have you ever been working out at the gym, pushing a heavy weight and heard a popping sound in your shoulder? Or what about skiing down the slopes, and landing shoulder first in the snow at the bottom? Or maybe just having a friendly game of tennis, when all of a sudden there's a sharp pain in your shoulder?

These are all signs of the same thing; a shoulder injury. Whether you want to call it a frozen shoulder, a rotator cuff injury or a tendinitis in the shoulder, it's really all the same. Unfortunately a tear or strain in the rotator cuff muscles and tendons is usually not good news and you might be in for a lengthy treatment and recovery process.

shoulder injury rotator cuff

Anatomy of the shoulder

The shoulder joint is a truly remarkable creation. It's quite a complex formation of bones, muscles and tendons and provides a great range of motion for your arm. The only downside to this extensive range of motion is a lack of stability, which can make the shoulder joint vulnerable to injury.

The shoulder is made up of three bones, and the tendons of four muscles. The bones are called the "Scapula," the "Humerus" and the "Clavicle." Or, in layman's terms, the shoulder blade, the upper arm bone and the collarbone, respectively. The four muscles which make up the shoulder joint are called, the "Supraspinatus," the "Infraspinatus," the "Teres Minor" and the "Subscapularis." It is the tendons of these muscles, which connect to the bones, that help to move your arm.

In the picture to the left, three of the four rotator cuff muscles are visible, the supraspinatus, the infraspinatus and the teres minor. These are the muscles which are viewed from the rear, or posterior. The subscapularis is not visible because it can only be viewed from the front, or anterior and this particular view only shows the muscles from the rear, is if looking at someone's back. Anyway, enough of the technical stuff.

Causes of shoulder injury

There are two major causes of most shoulder injuries. The first being degeneration, or simply general wear and tear. Our body doesnt last forever and the areas that get a lot of use over time can wear down. This is why shoulder problems in the elderly are common.

Our body is very good at maintaining things and keeping up regular maintainence, but unfortunately the shoulder is a tendinous area that receives very little blood supply and as a result are especially vulnerable to degeneration with aging. This lack of blood supply is also the reason why a shoulder injury can take quite a lot of time to heal.

The second cause of most shoulder injuries is due to excessive force, or simply putting too much strain on the tendons of the shoulder muscles. This usually occurs when you try to lift something that is too heavy or when a force is applied to the arm while it's in an unusual or awkward position. It may be an impact injury when playing sport.

Symptoms of shoulder injuries

There are two common symptoms of a shoulder injury, pain and weakness. Pain is not always felt when a shoulder injury occurs, however most people who do feel pain, report that it's a very vague pain which can be hard to pinpoint.

Weakness, on the other hand, seems to be the most reliable symptom of a shoulder injury. Common complaints include an inability to raise your arm above your head or to extend your arm directly to the side or in front. In most cases, the larger the tear or damage to the tendons, the harder it is to move your arm and the injured area.

Treatment of shoulder injury

The earlier a shoulder injury is treated, the better, and the first 48 to 72 hours are crucial to a complete and speedy recovery. The first and most important course of action is the R.I.C.E.R. regime. Rest, Ice, Compression, Elevation and Referral.

After the initial injury has been treated with the R.I.C.E.R. regime, (for at least 48 to 72 hours) you may under the guidance of a physio or doctor move onto the next stage of treatment. As mentioned before, the shoulder joint receives very little blood supply. So, what can you do to increase blood flow, and oxygen and nutrients to the injured area?

Firstly, heat! Heat is extremely good for increasing blood flow to a particular area. Heat lamps are the most effective way to increase blood flow, while heat based creams are probably a distant second choice. Or you can buy 'wheat bags' - cotton bags filled with wheat or another grain - that can be heated in the microwave, like a hot water bottle.

Secondly, massage is one of the best ways to increase blood flow to an injured area, and of course the oxygen and nutrients that go with it. The other benefit of massage is that it helps to reduce the amount of scar tissue which is associated with all muscle and tendon, strains and tears.

Thirdly, don't stop moving. Some people will often tell you to keep the injured area still, and this may not be the best advice. Gentle movement will help to keep the blood flowing to the injured area. Of course, if pain is present, limit the amount of moving you do, but don't stop moving all together.

Lastly, keep stretching the shoulder area (as well as everything else). Inflexibility or tightness in any muscle group can cause poor posture, tracking problems, impingements, and low blood supply, so keep up the stretching. Don't force the stretch on injured areas, take it gradually.

To find out more about shoulder injury, rotator cuff injuries, core work, rotator cuff, or stretching contact us!


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