The shoulder is the body's most mobile joint, and also one that is frequently unstable in athletes and non-athletes alike. Consisting of 3 bones, 4 joints and multiple muscles, tendons, and ligaments, the shoulder provides 180 degrees of movement at the glenohumeral (GH) joint.
It is this very mobility that creates opportunity for injury. The GH ( ball and socket) joint provides about 2/3 of the movement, with the remaining 1/3 coming from the scapular segment.
The infamous "rotator cuff" muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) are responsible for initiating motion and aligning the shoulder.
According to Doug Carlan, M.D., an upper extremity expert whom works with the Tampa Bay Rays, the most common ailment he treats is some type of impingement on the rotator cuff caused by the acromion rubbing against it. Often seen in " overhead" athletes, such as volleyball or baseball players, this condition can produce anterior and lateral pain, tenderness, and loss of ROM. Initial treatment includes stretching and strengthening.
Surgical intervention is termed " subacromial decompression" and involves shaving off the anterior edge of the acromion and removal of bursal tissue.
Dr. Carlan also treats many rotator cuff injuries, 95% of which involve a full or partial tear of the supraspinatus. Acute tearing Can take place due to a fall, and chronic overuse also produces injury.
Reduced bloodflow to the area causes tendon dysfunction. This reduced bloodflow can be due to mechanical, environmental, or age-related issues. Partial tears can be asymptomatic and allow for normal function. Over 40% of tears enlarge, however, and 80% of these become symptomatic over time.
If surgery is required, one will spend six weeks in a sling, 4-6 months regaining about 85% function, and up to a full year to return to "normal."
All the more reason to work with your fitness professional to strengthen and stabilize this complex joint to prevent these injuries from occurring. Also, discuss issues of biomechanical inefficiencies and correct these before heavy loading.
"Put your head on my shoulder, whisper in my ear, baby..."
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