Shoulder Injury

BRACHIAL PLEXUS INJURY

A brachial plexus injury occurs when the nerves that send signals from your spine to your
shoulder, arm, and hand are stretched or torn. This typically happens when your shoulder
is pressed down forcefully while your head is pushed in an upward direction away from
the shoulder. These injuries are common in contact sports, but can also result from falls,
auto accidents, inflammation, and tumors. Babies sometimes have this injury when they
are born. For less severe brachial plexus injuries, the body may repair itself, but for more
severe injuries, surgical repair may be necessary.

Symptoms of Brachial Plexus Injury

Symptoms of brachial plexus injury vary greatly and depend on their severity and the
location of the injury. Usually only one arm is affected. For less severe injuries, minor
damage occurs during contact sports, like wrestling or football in which the brachial
plexus nerves get stretched. These injuries can cause numbness and weakness in your
arm as well as a feeling like a burning sensation or electric shock shooting down your
arm. For more severe injuries, symptoms result from injuries in which a rupture or tear
of the nerves occur. The most serious of these injuries occur when the nerve root is torn
away from the spinal cord. Some symptoms of more serious injuries include severe pain,
lack of movement and feeling in your arm, ability to use your arm and not your fingers,
and the ability to use your fingers but with no control of your elbow muscles and
shoulder. This injury can cause disability or permanent weakness. If you have recurrent
stingers or burners, neck pain, weakness in your hand or arm or symptoms in both arms,
you need to see a doctor.

Causes of Brachial Plexus Injury

 The nerves that construct the
brachial plexus leave your spinal cord close to the point where your neck and shoulder
join. They pass behind the collarbone and divide and recombine while they travel down
your arms until they reach the tips of your fingers. The nerves that are higher in your
neck serve your elbow and your shoulder, and the nerves that are located lower in your
neck serve your hand and your forearm. The damage to your upper nerves usually occurs
when your shoulder is forced down, and this causes your neck to stretch up and away
from the shoulder that has been injured. The lower nerves have a greater chance of
becoming injured when your arm is forced above your head. This type of injury can
occur in many ways.

Athletes participating in contact sports, such as football may experience burners or

stingers, which occur when the nerves of the brachial plexus are stretched beyond their
limit when there is a collision with another player. With difficult births, newborn babies
can sustain brachial plexus injuries when there are problems during the birth, like a
prolonged labor or breech presentation. Sometimes an infant's shoulders will get wedged
within the birth canal and so force may be used in order to pull the baby free. This can
also damage the nerves. Commonly the upper nerves are injured, which is called Erb's
palsy. Total brachial plexus birth palsy will occur when the upper and lower nerves are
both damaged. Another cause may be trauma. This happens in motorcycle, vehicular,
and boating accidents that result in this type of injury. Additionally knife, bullet, or
animal bite wounds can damage the brachial plexus.

Treatment of Brachial Plexus Injury

Stretched nerves have a good chance of recovering on their own, but at times the healing
process will will form scar tissue that needs to be removed surgically in order to improve
the function of the nerves. Surgical repair is necessary when there is a good amount of
surrounding scar tissue. In many situations, the surgeon will take less important nerves
from other locations of your body to restore the arm's function. With a nerve graft, the
damaged portion of the brachial plexus is removed and then replaced with portions of
nerves that are cut from other parts of your body. In a nerve transfer, a less important

nerve that is still attached to the

spinal cord can be hooked into the nerve that isn't attached any longer. In many cases, the
surgeons will be able to perform this technique at a level that is close to the targeted
muscle in an attempt to speed up the recovery instead of doing a repair graft farther away
from the muscle. Nerve tissue does grow slowly, only about an inch a month, which
means that it can take a few years to recover after surgery. While recovering, you have to
keep your joints flexible through exercises. Additionally splints may be used in order to
keep your hand from curling in an inward manner. Surgery to repair brachial plexus
nerves should occur within three to six months of the initial injury. The rate of success
does drop quickly if the surgery occurs more than a year after the injury. If your muscles
begin to deteriorate, the surgeon will be able to remove a less important tendon or muscle
from another portion of your body and then transfer it to your arm. The pain from the
most severe forms of brachial plexus injuries has been described as a constant burning or
crushing sensation. A variety of medications may be used in order to handle the pain.

Preventing Brachial Plexus Injuries

You cannot prevent the damage to the brachial plexus, but you can help reduce your risk
of complications. It is therefore important to have regular physical therapy for yourself
or your child in order to prevent joint stiffness and to keep the muscles strong and
healthy.

DISLOCATED SHOULDER
Your shoulders have your body's most mobile joints; however, the ability to move in a
number of directions can leave your shoulders prone to different injuries. A dislocated
shoulder occurs when the upper arm bone pops out of the socket in a cup shape that is in
part of your shoulder blade. A dislocated shoulder involves damage to ligaments of the
joint where the top of the shoulder blade will meet the end of the collarbone. If you think
you have a dislocated shoulder, seek medical attention right away. Most people will be
able to use their shoulder normally within a few weeks of experiencing the dislocated
shoulder. Once you have had a dislocated shoulder or joint, it may be prone to more
dislocations in the future.

Symptoms of a Dislocated Shoulder

Some of the symptoms of a dislocated shoulder include intense pain in the shoulder area,
an inability to move the joint, swelling, bruising, and discoloration, and a clearly out of
place shoulder. A dislocated shoulder can also cause weakness, numbness, and tingling
near the site of the injury, such as down your arm or in your neck. The muscles of the
shoulder may also spasm due to the disruption, which will increase the intensity of the
pain. If a dislocated shoulder has occurred, medical attention is needed, but while you
are waiting for the medical attention, do not move the joint and be sure to ice the injured
joint.

Causes of a Dislocated Shoulder

The shoulder joint is the most commonly dislocated joint in your body. This joint is able
to move in many different directions, completely, partially, backward, downward, and
forward. Also, the fibrous tissue that joins the bones of your shoulder are able to be torn
or stretched, sometimes complicating the dislocation. A
sudden blow of your shoulder dislocates the shoulder, pulling the bones in your shoulder
out of place. The extreme rotation of your shoulder joint can pop the ball of your upper
arm bone out of your shoulder socket which is a portion of your shoulder blade. A partial
dislocation can also occur in which your upper arm bone is partially in and out of your
shoulder socket. One possible cause of a dislocated shoulder is a fall. You can dislocate
your shoulder when you fall. Additionally, trauma can occur related to sports,
particularly in football, hockey, sports that involve contact and falls, like gymnastics,
skiing, and volleyball. It is also possible that the trauma could be unrelated to sports,
such as during a motor vehicle accident.

Most commonly, dislocated shoulders occur in people who are between the ages of 18
and 25 since these people usually have higher levels of physical activity. Adults who are
older also tend to be more susceptible to shoulder dislocation since their joints and
surrounding ligaments are weaker. Older people also tend to fall more often, which can
increase their chances of having a dislocated shoulder.

Treatment of a Dislocated Shoulder

The treatment of a dislocated shoulder involves putting the shoulder bones back into their
place. Your doctor may use some gentle maneuvers, called closed reduction to help move
the bones into the proper position. This may require a muscle relaxant or sedative. Once
the shoulder bones are back in place, the severe pain will improve right away. Your
doctor may immobilize your shoulder using a special sling or splint for a few weeks.
How you wear the splint or sling will depend on the nature of the dislocation of the
shoulder. Your physician may prescribe a pain reliever or a muscle relaxant in order to
keep you comfortable while your shoulder is healing.

Once your sling or splint is removed, you will begin a rehabilitation program that is
meant to restore your range of motion and strength to your shoulder joint. You should try
to avoid strenuous activity that involves your injured shoulder until you can regain full
movement and normal strength as well as stability in your shoulder. Trying to resume
your physical activity too early can reinjure your shoulder. Surgery may be needed if
your dislocated shoulder is unable to be manipulated into the correct position. In this
case, surgical manipulation may be necessary.
In order to ease the discomfort you feel in your shoulder and to encourage your shoulder
to heal, there are some home remedies you can try. First, be sure to rest your shoulder
and avoid painful movements. You should certainly limit any heavy lifting or overhead
activity until your shoulder is feeling better. Second, it is important to apply heat and
ice. Applying ice to your shoulder will help reduce the pain and inflammation. Using a
cold pack for 15 to 20 minutes every couple of hours for the first day or two will help
with the inflammation. Using a heating pad may help to relax tight and sore muscles, but
be sure to limit the application of heat to about 20 minutes at a time. Pain relievers, such
as ibuprofen, Aspirin, or Tylenol may help you with pain or inflammation. You should
not stop moving your shoulder altogether. Gentle exercises, as directed by your doctor or
physical therapist will help to maintain your shoulder's range of motion. Stiff joints can
be caused by total inactivity.

Prevention of a Dislocated Shoulder

To prevent a dislocated shoulder, you should take precautions to avoid any falls, wear
protective gear when you play contact sports, and exercise regularly in order to keep
strength and flexibility.

ROTATOR CUFF INJURY

Your rotator cuff consists of muscles and tendons in your shoulder. These tendons and
muscles connect your upper arm bone and your shoulder blade. These muscles and
tendons also help hold the ball of the upper arm bone in your shoulder socket. A rotator
cuff injury will include any type of damage or irritation to your rotator cuff tendons or
muscles. The causes of a rotator cuff injury may be lifting, repetitive arm activities, and
falling. Fortunately a rotator cuff injury will heal on its own with some self-care
measures or some exercise therapy.

Symptoms of Rotator Cuff Injury

Some of the symptoms of rotator cuff injury may include a loss of the ability to move
your shoulder completely and wanting to keep it inactive, weakness in the shoulder, and
pain and tenderness in your shoulder, particularly when you are reaching overhead,
reaching behind your back, lifting, pulling, or even trying to sleep on the affected side.
The most common of symptoms is pain. This pain may be felt when you try to move the
shoulder into a new position, such as reaching up or back. If your injury is severe, you
may experience muscle weakness and continuous pain. If you are feeling severe shoulder
pain, especially pain that has lasted for more than a week or you are unable to use your
arm, you need to see your doctor.

Causes of Rotator Cuff Injury

Rotator cuff injuries are caused by an irritation or damage to your rotator cuff muscles or
tendons. One of those causes is tendinitis. Tendinitis occurs when tendons in your
rotator cuff become inflamed because of overload or overuse, particularly if you are an
athlete who performs many overhead activities, such as racquetball or tennis. Another
cause is bursitis, which occurs when a fluid-filled sac that is between your shoulder joint
and rotator cuff becomes irritated and inflamed. When a

strain or tear is left untreated,

tendinitis can weaken a tendon, leading to chronic tendon degeneration or a tear in the
tendon. Additionally, stress from overuse of the tendon can cause it to tear. At the age of
forty, normal wear and tear can lead to a breakdown of collagen in the rotator cuff's
muscles and tendons. This can put them at higher risk of injury and degeneration. Age
can also cause calcium deposits to develop within the cuff or arthritic bone spurs that
pinch or irritate your rotator cuff. Poor posture, such as slouching your neck and
shoulders forward can cause the space where the rotator cuff muscles are to become
smaller. This may cause a muscle or tendon to become pinched under your shoulder
bones. Falling can bruise or tear a rotator cuff tendon or muscle. Lifting or pulling an
object that is too heavy or lifting it improperly can cause a strain or tear to the muscle or
tendon. Finally, repetitive stress in which you have repetitive overhead movement of
your arms can lead to inflammation and tearing. This can occur with pitchers in baseball,
tennis players, and swimmers, but also can occur in the carpentry and painting industry.

There are several risk factors for developing rotator cuff injuries. First, age is a factor as
you get older they become more common, particularly in adults over 40 years old. Being
an athlete also increases your risk of having a rotator cuff injury. Working in
construction, such as in painting or carpentry can increase your risk. Poor posture and
having weak shoulder muscles also increases your risk of developing rotator cuff
injuries.

Treatment of Rotator Cuff Injuries

In most cases, rotator cuff injuries are resolved through exercise therapy. This will help
to heal your injury and improve the flexibility of your shoulder muscles and rotator cuff.
Physical therapy may take between three weeks and several months depending on how
severe your injury is.

Other treatments for your rotator cuff injury may include steroid injections, surgery, and
arthroplasty. Arthroplasy can include severe arthritis. In this case, the doctor may
recommend partial shoulder replacement or even total shoulder replacement. If you have
a large tear, it may be necessary for you to have surgery in order to repair the tear.
Sometimes this surgery may require a bone spur or calcium deposits to be removed.
Steroid injections may be necessary in order to relieve inflammation and pain due to the
rotator cuff injury.

There are also some treatments you may want to try at home. First, it is important to rest
your shoulder, so you should avoid the activities that cause pain to your shoulder. Putting
ice on your shoulder will help you to reduce any pain and inflammation you may be
feeling. This is recommended for 15 to 20 minutes at a time for every couple of hours for
the first day or two. After about two or three days and the pain and inflammation
improving, hot packs or a heating pad may assist you with relaxing sore and tightened
muscles. You should only use these heat applications for about twenty minutes at a time.
Third, over the counter pain relievers that are anti-inflammatory may also help reduce
your pain. Keeping your muscles limber is also important. A daily regiment of
prescribed shoulder stretches and shoulder strengthening exercises may help prevent the
injury from reoccurring.

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