The
shoulder is a common area where injuries occur. They are of an acute (happens
as the result of one episode) or chronic (occuring over a longer period of time)
nature and can be very debilitating. A skier falling on an outstretched arm or
a volleyball player being blocked unexpectedly during a spike are examples of
acute injuries. Chronic injuries would be a baseball pitcher with a painful shoulder
after playing three games in a row or a tennis player with symptoms after a few
very long matches. The
shoulder is a complex ball and socket joint which relies on muscles and tendons,
and to a lesser degree the capsule and ligaments for stability. Some
of the more common injuries to the shoulder that we see in our clinic include
muscle strains, capsule tears, bursitis/tendonitis, and separated and dislocated
shoulders. Muscle
strains can be the result of acute, explosive injury or a chronic condition
that can be attributed to faulty mechanics or overuse. Partial
or complete tears of any of the rotator cuff musculature is very debilitating
and warrants immediate attention so as to not increase symptoms. Ice, rest from
activities that reproduce pain, and (if range of motion is limited) prompt referral
to a specialist physician is imperative. Muscles and tendons have good healing
capabilities, but proper guidance through a rehabilitation program is essential.
Additional specific information about rotator cuff injuries and repair can be
found by clicking here. Capsule
tears can also be of an acute or chronic nature. Acute episodes of capsule
tears are the result of excessive torque placed upon the joint, usually in a rotational
manner. Chronic tears can be the result of too much stress on the joint over a
prolonged period of time. For example, baseball pitchers, javelin throwers, and
gymnasts are vulnerable to capsular lesions because of their activity. Conservative
treatment consists of strengthening of the surrounding structures in such a way
that does not aggravate the area. Treatment should also be symptomatic and consist
of icing when inflammed, modification of activities that exacerbate symptoms,
and rest when irritated. Bursitis/tendonitis
are chronic conditions that signal overuse and/or poor mechanics. Poor posture,
anatomical disposition, muscle imbalance, and faulty overhead lifting mechanics
are some of the causes of these conditions. Once the bursa sack and/or tendon
has been impinged under the acromion arch repeatedly, it becomes inflammed. Once
it is inflammed, it becomes easier to impinge and the cycle continues. Postural
education, stretching of chest muscles, and strengthening of upper back muscles
all aid in reducing symptoms. As always, modification of aggravating activities
is essential to allow for proper healing. Two
other common injuries that we see in our facility are separated and dislocated
shoulders. A
separated shoulder is typically done by falling or getting hit on the apex
of the shoulder, tearing the ligament that holds the clavicle (collarbone) to
the acromion. As with any sprain, there are varying degrees of tears. The level
of dysfunction is directly related to the degree of tear, which means that the
more disability following the injury typically means it is more severly injured. Shoulder
dislocation, on the other hand, is when the ball comes out of the socket joint.
This is followed by immediate disability and usually some attempt to relocate
it by the patient. This injury should be promptly seen by a physician. Proper
reduction of the dislocation is imperative so that no further injury to the surrounding
tissue, nerves, and blood supply occurs. The shoulder is typically protected in
a sling for 1 - 2 weeks following injury. During this time, wrist, forearm, and
elbow exercises are performed and gentle range of motion exercises of the shoulder
are prescribed to decrease stiffness. Information
about specific physical therapies, surgeries, transplantation, and hundreds of
articles, links, and additional resources available for patients and physicians
about knee injuries and care can be found at our web site at StoneClinic.com,
or you may contact us at the address, phone, or email below to arrange
individual medical consultation or care.
ABOUT KEVIN STONE M.D., Founder of The Stone Clinic Dr.
Stone is an orthopaedic surgeon who specializes in sports medicine with a special
interest in knee injuries. Dr.
Stone is a physician for the Lawrence Pech Dance Company, Alonzo King's Lines
Ballet, Smuin Ballet, and Marin Ballet. He has served as a physician for the U.S.
Ski Team, U.S. Pro Ski Tour, The Old Blues Rugby Club, the United States Olympic
Training Center. He
was educated at Harvard College and earned his M.D. at the University of North
Carolina at Chapel Hill. He trained in Internal Medicine at Harvard's Beth Israel
Hospital, General Surgery at the Stanford University Medical Center, and Orthopaedic
Surgery at the Harvard University Combined Orthopaedic Residency Program in Boston.
Dr. Stone's training also includes a Knee Surgery and Sports Medicine Fellowship
and a visiting Research Fellowship at the Hospital for Special Surgery in New
York. He
received the Albert Trillat Young Investigator's Award from the International
Society of the Knee, the Cabaud Award from the American Orthopaedic Society for
Sports Medicine, the Resident's Essay Award from the Arthroscopy Association of
North America, and has more than 40 U.S. patents for his work since 1989. He has
been the principle investigator on two N.I.H. grants. Dr. Stone is regularly sought
out as an expert for publications ranging from The Wall Street Journal and Newsweek
to Men's Journal and Elle Magazine. He has also contributed to a variety of segments
for television shows such as ESPN's "Treating Athletes in the New Millennium,"
The Discovery Channel, and FOX News' special segments on alternative treatments
for knees, as well as others. He is the author of numerous scientific articles
and is often asked to share his research and teach new surgical procedures internationally
at leading forums and symposia. He has lectured around the world as an expert
in cartilage and meniscal growth, replacement, and repair. Dr.
Stone is the co-founder of ReGen Biologics, Inc., a medical device company that
produced the first collagen scaffold for meniscus regeneration; founder and CEO
of CrossCart, Inc., a medical device company that removes the antigens from pig
tissues to make pig ligaments, bone, and cartilage available for human use; and
founder and CEO of Joint Juice, Inc., a glucosamine-enriched beverage company.
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