What is the anatomy of the shoulder?
The shoulder is one of the most mobile joints of the body, enjoying a wide range of motion. This is due to the ball and socket joint configuration that finds the humeral head centered within the glenoid fossa. The joint is stabilized by four rotator cuff muscles, namely the supraspinatus, infraspinatus, teres minor, and subscapularis. Aside from this, the shoulder also serves as an attachment for numerous muscles such as the deltoids, rhomboids, trapezius, among others.
How is the shoulder injured?
Due to its mobility and frequent use, the shoulder is at risk of injury. There are numerous conditions that can affect the shoulder, ranging from degenerative conditions to acute traumatic injuries. Athletes and people in professions involving frequent shoulder movements are at greater risk for shoulder injury.
How is a shoulder injury diagnosed?
While the specific presentation of symptoms will vary with each injury, most will manifest with pain and limited range of motion. The opinion of a top Beverly Hills or Los Angeles shoulder doctor is key to determining the proper diagnosis and treatment. The diagnosis is made after a complete medical history and physical examination. Additional imaging studies may be requested, such as X-rays, Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) scans, when necessary.
What are some examples of shoulder injuries and how are they treated?
The following is a sample of shoulder injuries and a discussion of their treatment. Note that this should not replace consult with a physician.
- Tendinitis – refers to the inflammation of the tendons, typically from repeated wear and tear, leading to progressive micro-trauma to the tendon. This manifests as progressive pain and limitation of movement. This is treated with rest and treatment with non-steroidal anti-inflammatory drugs (NSAIDs).
- Sprains – refer to tears in the tendon. This may be partial or full-thickness. The preferred treatment option is immobilization and rest, followed by a program of physical therapy and rehabilitation. Surgery is reserved for the more severe cases that are unresponsive to conservative measures.
- Impingement – tissues and nerves can be pinched against the bony tip of the shoulder blade (the acromion), leading to irritation and inflammation. This manifests as pain and limited movement, particularly when the shoulder is unstable. Physical therapy is the preferred option, although steroid injections may be used to reduce swelling and inflammation. Surgery is not typically done, although this may be warranted in some cases.
- Dislocation –refers to the displacement of the humeral head from the glenoid socket. A condition of instability refers to the frequent dislocation of the shoulder, due to excessive laxity of the joint. Closed reduction will put the humeral head back in place. One of the biggest risk factors for dislocation is a history of previous dislocation, and it is recommended that patients undergo strengthening and conditioning of the rotator cuff muscles.
- Fracture – refers to a break in the bones of the shoulder. This typically follows a history of acute trauma. Older patients are at greater risk for suffering fractures.
- Separation – refers to the misalignment of the acromioclavicular joint, typically after tears to the ligament. This is normally treated with immobilization and rest, followed by a program of physical therapy and rehabilitation.