Q&A Topic: Sports-Related Shoulder Injuries
Evan H. Karas, MD, FAAO
Q. What are some of the more common sports-related shoulder injuries?
A. I’ve seen a higher rate of shoulder injuries among throwing athletes and athletes involved in sports that require chronic and repetitive overhead arm use. Many throwing athletes, such as pitchers, develop glenohumeral internal rotation deficit (GIRD). With GIRD, ligaments in the back of the shoulder tighten due to repetitive overhead use. This restricts the athlete’s ability to rotate the arm internally, causing shoulder impingement due to constant stress on the rotator cuff and the labrum.
Q. How can athletes prevent damage to the shoulder?
A. Preventive fitness is key. It’s important to focus on stretching programs with an emphasis on stretching the back of the shoulders. A strengthening program for the rotator cuff muscles and periscapular muscles is equally as important. Rowing exercises, weighted shrugs and/or wall pushups help build these muscles and may also aid in posture, adding to overall shoulder strength and stability.
Q. If I already have chronic shoulder issues, should I consult an orthopedist?
A. If you’re experiencing shoulder stiffness, weakness, or pain, especially at night during sleep, it’s time to see a doctor. In order to make a diagnosis, an orthopedist will document your symptoms and perform a physical exam. An X-ray and/or an MRI scan may be part of the evaluation. At Northern Westchester Hospital, we generally recommend a six-week rehabilitation program that emphasizes stretching and strengthening to restore the biomechanics, or normal function, of the shoulders. If pain is severe, a cortisone injection to reduce inflammation may also be given
.Q. What are my treatment options if an X-ray shows a complete tear in the shoulder?A. Surgery is typically required when a vital structure of the shoulder is completely torn. A full thickness rotator cuff tear or labrum tear that results in instability of the shoulder will require surgery. Today’s shoulder surgeries are arthroscopic procedures done on an outpatient basis and allow a faster return to work, school, and sports.Because the shoulder is such a complex joint, at least three months of physical therapy is required following surgery. The first six weeks focuses on preserving the shoulder’s range of motion. The goal of the following six weeks is to restore the biomechanics of the shoulder.Q. How can an athlete prevent new injury when they’re back in the game?
A. Maintain a stretching and strengthening program for the shoulders in order to prevent a new injury. Engage in sport-specific, pre-game warm up exercises such as calisthenics. Finally, consider securing the expertise of a coach or trainer who can analyze your movements and posture, recommend adjustments to techniques, and develop exercises to prevent new injuries.
Co-Chief, Orthopedic Surgery
Co-Director, Orthopedic & Spine Institute
Northern Westchester Hospital
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