Athletic injuries of the shoulder

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The shoulder is the most mobile and least stable large joint in the body. With little built-in mechanical stability, the shoulder depends on muscles, tendons, and ligaments for stability.1 These qualities predispose the shoulder to athletic injury.

Those who treat athletes are not surprised that 20% of athletes’ injuries relate to the shoulder girdle. This incidence is greater in baseball, wrestling, and track and field events such as shot put, discus, and pole vault. Various injuries to athletes are reviewed.

Soft tissue trauma

Contusion or bruising with hemorrhage is the injury most often associated with direct trauma. Localized pain, tenderness, and swelling are always present in the area of the blow. Initial treatment (within 24 to 36 hours) consists of an immobilization pressure bandage with or without foam rubber over the area, and an ice pack to prevent further local hemorrhage. After the first 48 hours heat may be applied. Range of motion and muscle strengthening exercises are soon added. The athlete may return to competition after pain and tenderness have subsided and muscle strength and shoulder motion are normal.

Myositis ossificans or traumatic exostosis, known as “blocker shoulder,” may develop as an unfortunate sequela of direct contusion. This diagnosis should be considered when pain and limitation of motion continue. A palpable mass is usually located in the area of the deltoid tuberosity of the humerus. Confirmation by roentgenography is essential. The area of the myositis or traumatic exostosis should be protected with padding to prevent further injury.2 Surgery is . . .



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