Sore shoulder: for those who think they are sports professionals

You may have overdone it this weekend either at the gym or playing for your favorite weekend team, but is that sore shoulder something that needs an x-ray?

It's the bottom of the ninth with two outs, bases loaded. You stare into the catcher's mitt, hoping that your arm has enough juice left for your old fastball. You shake your right arm a few times, but you can feel twinges in your shoulder. Tomorrow, that sucker's gonna hurt.

The shoulder is a wonder of muscles and tendons that pull across many bones. It holds your humerus, or the bone in your upper arm, to your clavicle, or your collarbone, to your scapula, or your shoulder-blade. Any breakdown or over-extension of these muscles can leave you with a very sore shoulder. That's why it is so important to warm up your muscles, especially your shoulder, before engaging in any sporting activities.

Off the cuff: dealing with a rotator cuff injury

A common cause of soreness in the shoulder is injury to the rotator cuff. This refers to four small muscles and their related tendons, according to the American Academy of Orthopedic Surgeons. These muscles keep your shoulder together and help your arm move through smooth, circular motions. Most commonly, the tendons which hold the muscles to the bones will become inflamed due to repetitive motions or stress. This is called tendonitis. Sometimes, small, fluid filled sacs called bursas can become inflamed and cause pain in the rotator cuff area. This is known as bursitis. Treatment for rotator cuff injuries focus on resting the joint and changing the physical activities that led to the sore shoulder. Medication, such as non-steroidal anti-inflammatory drugs, or NSAIDs, are often used in the short-term, and surgery is used only as a last resort for this type of injury.

A separate piece: separated shoulders

A separated shoulder is usually caused by a blow to the shoulder, like you would take in a football game, or a fall on your shoulder. It is when your collarbone moves away from your shoulder-blade and stretches the ligaments, or elastic cords, that hold the joint together in that place. This is a painful injury, but it is not one that usually requires surgery unless it is severe, according to the Mayo Clinic. Instead, you will rest your shoulder, most likely with a sling to keep your arm immobilized to protect the joint. You can use ice to keep the swelling down and NSAIDs for pain. If the injury is severe, you might need to see a physical therapist to help you with some exercises to rehabilitate the muscles in your shoulder.

No need for cold to have a frozen shoulder

A frozen shoulder is when you literally cannot move your shoulder joint. Called adhesive capsulitis by your doctor, it is caused by a thickening of the capsule that lines the shoulder joint. It tends to happen more to people who have had their arm immobilized for one reason or another, such as after a fracture. Physical therapy is a popular treatment for frozen shoulder, but other, more aggressive treatments may be necessary. Steroid injections into the shoulder are a possibility to decrease pain and encourage movement, and manipulation of the shoulder under general anesthetic is also tried to loosen up the joint. However, surgery is sometimes the only resort. This surgery is often performed arthroscopically, which is through a small incision with a lighted camera, and the scar tissue is broken up and removed to restore movement to the joint.

References:

• American Academy of Orthopedic Surgeons; Shoulder Pain; December 2010
• Mayo Clinic; Separated Shoulder; February 2011
• Mayo Clinic; Frozen Shoulder; April 2011

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