Shoulder Instability Or Dislocations

shoulder instability anatomy

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Shoulder is the most mobile joint of the body. This allows you to lift your arm, rotate your arm and lift your arm over your head. It’s possible to have a greater range of motion with less stability.

How

Shoulder instability

This happens when the humerus head (the upper arm bone) is forced out of the shoulder’s cavity. Usually this happens as a result of a sudden traumatic injury.

Once the shoulder is dislocated, the shoulder is vulnerable to repeat. When the shoulder is loose and slips several times, it’s called a chronic shoulder instability.

The shoulder is made of 3 bones : humerus (upper arm bone), scapula (shoulder blade) and clavicle (collarbone).

Dislocation shoulder

shoulder dislocation anatomy

This may be partial, which means that the arm’s ball partially comes out from the cavity. This is called a subluxation. This can be complete which means that the arm’s ball comes out completely from the cavity.

Symptoms

Symptoms of chronic shoulder instability are :

  • Pain caused by the shoulder injury

  • Repeated shoulder’s dislocation

  • Repeated instance of the shoulder giving out

  • A persistent sensation of the shoulder that is loose, slipping out of the joint or hanging.

Diagnosis

Specific tests help assess shoulder instability (including general relaxation of ligaments). A doctor may prescribe imaging tests such as X-rays, CT Scan or MRI to confirm the diagnosis and identify other problems.

Treatment

First, chronic shoulder instability treated with nonsurgical options. If these options don’t relieve pain and instability, surgery may be needed.

Nonsurgical treatment

shoulder dislocation treatment non surgical

Generally, it often takes several months of nonsurgical treatment before success can be assessed. Nonsurgical treatments includes :

  • Activity modification

  • Non-steroidal anti-inflammatory medication

  • Physical therapy

Surgical treatment

shoulder dislocation treatment surgery bankart repair

Often, surgery is often required to repair torn or stretched ligaments so that they can maintain the shoulder joint in place.

Bankart lesions (tearing of the front labrum from the cavity) can be repaired surgically using suture anchors to reattach the ligaments to the bone.

Arthroscopy => Soft tissues of the shoulder can be repaired using tiny instruments and small incisions. It’s a procedure that is done the same day or outpatient. Arthroscopy is a minimally invasive surgery. The surgeon examines the inside of the shoulder with a small camera and performs the operation with special instruments.

Open surgery => These are patients who require open surgical intervention. This involves making a wider incision on the shoulder and performing the repair under direct visualization.

Rehabilitation

After surgery, the shoulder can be temporarily immobilized with a sling. When the sling is removed, it’s essential to do ligament rehabilitation exercises. These exercises improve the range of motion of the shoulder and avoid scarring during ligament healing. Thereafter, exercises for strengthening the shoulder will be added in the rehabilitation program.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Overuse Injuries

overuse injuries sport injury

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

There are 2 types of injuries : Acute injuries and overuse injuries. Acute injuries are usually caused by a single traumatic event. Here are some examples :

  • Wrist fractures

  • Ankle sprains

  • Shoulder dislocations

Acute injuries are less common in sport than overuse injuries. Overuse injuries are usually subtle and appear over time, making them difficult to diagnose and treat. Here is some example :

  • Tennis elbows

  • Swimmer’s shoulder

  • Pitcher’s elbow

  • Runner’s knee

  • Achilles tendinitis

  • Shin splints

Why

Human body is extraordinary to adapt to physical stress. We’re used of thinking that « stress » is bad for our emotional well-being, but physical stress is simply doing an exercise or activity. This is beneficial for our muscles, tendons, ligaments and bones. This physical stress causes an internal process called remodeling. Remodeling process involves both the breakdown and the build up of tissue. It’s necessary to have a good balance between 2, if breakdown occurs more rapidly than buildup, an overuse injury occurs.

Causes

overuse injuries sport injury gym fail

Usually, it’s training errors that cause overuse injuries. These errors are too fast acceleration of intensity or duration or activity frequency. These injuries can also happen to people who return to the sport/activity after an injury. They try to make up for lost time as quickly as possible to reach the level they had before the injury. Doing an exercise with a good technique is important to avoid overuse injuries. When the exercise’s technique is bad, it creates overuse injuries. It’s for this reason that coaches, athletic trainers and teachers can play a preventive role so that athletes avoid overuse injures.

There are people who more easily have overuse injuries. An unbalance between strength and flexibility around certain joints predisposes some people to have this type of injury. Body alignment, such as knock-knees, bowlegs, unequal leg lengths and flat or high arched feet, also impact overuse injuries. There are also people who have weak links because of old wounds, incomplete rehabilitation of wounds or others anatomy factors.

Other factors must also be taken into account as equipment such as the type of running shoe or ballet shoe and terrain (hard versus soft surface in aerobic dance or running).

Diagnosis

Generally the diagnosis is based on the athlete’s history and physical examination. It’s recommended to make a diagnosis with a sports medicine specialist with a specific interest and knowledge of your sport. In some situations X-rays, bone scan and MRI may be necessary.

Treatment

overuse injuries sport injury ice

Here are some recommendations for treating an overuse injuries :

  • Cutting back the intensity, duration and frequency of an activity

  • Adopting a hard/easy workout schedule and crosstraining with other activities to maintain fitness levels

  • Learning about proper training and technique from a coach or athletic trainer

  • Performing proper warm-up activities before and cool down after

  • Using ice after an activity for minor aches and pain

  • Using anti-inflammatory medications as necessary

If symptoms persist, a sport medicine specialist may create a more detailed treatment plan for your specific condition. This may involve an exam of your training program and an evaluation of predisposing factors.

Prevention

Majority of overuse injuries can be avoided with a proper training program, common sense and learning to listen your own body. The quote : « No pain, no gain » doesn’t apply here. The 10% rule helps a lot to get things to the next level.

In general, you should increase the training’s intensity to a maximum of 10% per week. This allows your body to have enough time for recovery and response. This rule should be used to increase pace or milestone for walkers or runners. Or for the weights amount to increase for strength training programs. In strength training, add flexibility exercises and core stability exercises help tremendously to minimize overuse injuries.

It’s recommended to seek advice from sports medicine specialist or athletic trainer to prevent chronic or recurring problems. Your training program can also be modified to maintain fitness levels safety while you recover from your injuries. You must return to the sport only if an authorization is granted by a health professional.

Remember, it’s very important to warm-up before training and cool down after training.

Stats

3.5 millions of children are treated for overuse injures every year.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food. Click here .

Acromioclavicular Problems

acrominioclavicular problem

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Frequent bodybuilding’s athletes are often confronted with acromioclavicular diseases.

This doesn’t happen in the same way as with sports like rugby, football, riding or combat sport with projections where the shoulder joint can be damaged by a fall or violent contact which leads to acromioclavicular dislocation with a ligament tear.

In bodybuilding, it’s micotraumatism caused by excessive, repetitive and poorly controlled work of the shoulder joint.

The pain happens little by little and after a while, pain prevents doing exercises like bench press or dips.

When doctors examine the acromioclavicular joint, it’s painful to pressure and slightly swollen.

It’s a problem without real gravity but the cure is long. The joint capsule and ligaments stretched because of inflammation, which give play to the joint. It takes some times for the entire articulation to return to its inital size.

Firstly, it’s necessary to stop the upper body training for 2 weeks

Note : from a bone view’s point, the upper limb connected to the bust by the clavicle which goes from the sternum to the scapla. In bodybuilding workouts, clavicular joints are often over-solicited and this create inflammatory pathologies of wear and tear.

Back to train

When upper body workout starts again, it’s necessary not to do bench press, dips and all movements with pushed down for at least 2 months. This is important to avoid re-stretching acromioclavicular ligaments.

Military press with barbell/dumbbell, inclined bench press and all movements with pusched up are allowed as they stabilize acromioclavicular joint. These movements limit the risk of ligament stretching.

If these tips aren’t respected. The joint inflammation will continue causing intra-articular calcifications and seriously compromising a sport career.

acrominioclavicular problem

Prevention :

These acromio-calvicular inflammations often occur after excessive training with the bench press due to a poorly controlled movements, with a too rapid descent, rebounding on the torso, sets too long and jerky.

The bench press in powerlifter’s style can also trigger inflammatory pathologies.

It’s for this reason that, at the least suspicious pain, it’s necessary to stop these movements for a time and to replace them by cable chest fly, dumbbells movement with a certain inclinaison of the bench for continue working chest.

Share this articles if you think it can help someone you know. Thank you.

-Steph

Shoulder Injury (Part 1)

shoulder

I read a Frederic Delavier’s book « Strength Training Anatomy » and there is good stuff.

Shoulders injuries are frequent in bodybuilding because we want develop all deltoid muscles. To do this, we must perform a signigicant number of repetition and movements thus multiplying the risk of injury.

It’s worth remembering that, in comparison with the solid hip’s articulation where the femur head is deeply embedded in the pelvic cavity of the pelvis, shoulder’s articulation, which must be very mobile to allow arms to move in all direction, is very little embedded.

Shoulders can thus be defined as a joint to muscular fixation, the maintenance of the humerus head on the scapula’s glenoid cavity is mainly ensured by a complex musculo-tendinous ensemble.

Although in bodybuilding most injuries occur during shoulders training, it’s rare to see this muscle directly injured. The wound are generally much deeper and appear most often during a false movement or after a long wear by friction of tendon structure reinforcing the articular capsule.

While in other sports of violent contact (such American football) or rapid arms movements (such as throwers) can result in serious injuries with dislocations and enven tendon pull. The main lesion observed is what we call subacromial bursitis.

Some people when performing elevated arm movements, such as back press or lateral raise, the supra-spinous tendon is rubbed and compressed between humerus head and osteoligamentous vault formed by the underside of the aromion and the coracoacromial ligament.

Consequence

shoulder anatomy

The result is an inflammation which generally begins with the synovial bursa, which normally protects the supra-spinous tendon from excessive friction. And it continue by the supra-spinous tendon itself and ends, if this inflammation isn’t treaed, by touching the adjacent tendons of the infraspinatus at the back and the long portion of the biceps at the front.

Arms elevation becomes extremely painful and there may be an irreversible deterioration of the supraspinatus tendon with calcification and sometimes even rutpure. The latter being observed in general only with people over 40 year old.

The space between the humerus and osteoligamentous vault can vary from one individual to another. Some athletes will not be able to lifte their arms laterally without generating excessive friction. These individuals must therefore avoid all back press, lateral raise to high and also when they train back, pulldown behind the neck.

All exercices with barbell for shoulders should be done in front of, with elbows slightly forward. With dumbbells lateral raise, the correct working angle should be sought, the right movement being the one that is realized painless.

It’s interesting to note that for the same shoulder injury all individuals don’t respond in the same way. Some people can perform all sort of arms raise, compressing and sometimes even deteriorating their tendons without ever triggering a painful inflammatory process. Thus, in the course of an examination, some people have discovered a rupture of the supra-spinous muscle’s tendon without ever having complained of any pain.

Another cause of shoulder pain may be due to an imbalance in the distribution of muscle tension around the joint capsule. Recall that the humerus head is firmly held against the scapula’s glenoid cavity by a muscular system with tendons adhering or passing through the articular capsule. This set is composed at the front by the subscapular, a little more on the outside by the long portion of the biceps, above by the supra-spinous and finally at the back by the infraspinatus and the teres major muscle. Spasm, hypertonicity or, on the contrary, a lack of tonicity of one or more of these muscles, can lead to a bad position of the shoulder joint. This bad position will be the cause, during the movements of the arm, of friction likely to generate inflammatory pathologies.

Exemple : A contracture or a spasm of the teres major muscle and infraspinatus will cause an external rotation of the humerus head which will generate during the movements of the arm, friction in the front of the shoulder joint. And with the time can injure the tendon of the long portion of the brachial biceps.

It will therefore be necessary to ensure to train in a balanced way all the muscles of the shoulder avoiding all the exercices where one will feel a discomfort, a pain or a friction.

Note : Hand massage or better with a vibrator, as well as electostimulation, give very good results to diminish and eliminate spasms and contractures of teres major muscle and infraspinatus.

-Steph

P.S. Do you want a free workout programs ? Click here 

Free smartphone apps:

To track my calories, I use MyFitnessPal

To track my workout program, I use Jefit