We live in a "super-active" area here in Vail, and because of the massive prevalence of skiers and snowboarders, shoulder injuries are something we see every day.

And it doesn't stop in the summer, because mountain bikers are regularly going over the handlebars and damaging the shoulder.

And, on top of that, because of the number of excellent sports medicine specialists in Vail (including Dr. Sterett, of course), we have professional and amateur athletes from all sports visiting us from all over the world to get their shoulders fixed.

What are the most common shoulder injuries?

Let's go over some of the most common shoulder injuries here today. We'll be talking about the following:

Shoulder Dislocations
Shoulder Impingement
Shoulder Separations
Rotator Cuff Tears

Remember, your particular injury will be just that (particular to you), so take the advice within this article as a general guide, and don't hesitate to visit a sports medicine specialist in your area if you are having pain!

Proper Treatment for Common Shoulder Injuries is a Necessity

Treatments have advanced significantly over the past decade, and for most of you, you'll have access to the latest and greatest when it comes to treating your shoulder injury. Whether you have a rotator cuff tear, shoulder impingement, or shoulder dislocation, consulting a sports medicine specialist is your best route.

The BioMechanics of the Shoulder

People are often surprised at the vast complexity of the body when they undergo a major injury, and the shoulder is no different.

With four total joints connecting the shoulders and arms to the chest, this fantastic anatomical group allows for the amazing range of motion that we enjoy. And when we lose this range of motion, we want it back.

The AC Joint (Shoulder) Separation

When we talk about the AC Joint Separation, we are referring to a shoulder separation. With a separated shoulder, the point where the clavicle comes into the end of the scapula, called the acromion, gets "separated" by tearing the ligaments attaching these two. Typically these do not require surgery. But the may, depending upon the degree of separation.

How Is An AC Joint Separation Caused?

The AC Joint separation is often caused by a direct blow to the shoulder. Most often, we see this injury in football and other contact sports. For instance, when a football player falls and an opponent lands upon the shoulder. With all the body-checking and slamming opponents into the boards, hockey is also rife with this injury.

Do AC Joint Separations Need Surgery?

Ok, so you separated your shoulder getting smashed into the boards at the rec league hockey game after delivering a pass Sid The Kid would be proud of. Your center backhanded the goal in. But now you are paying the price. Do you need surgery?

We need to gauge how serious the ac joint separation is. We use three grades of classification to describe the severity of this injury. What are they? Let's cover it here.

Grade 1 AC Joint Separation

A grade one AC Joint Separation is a common injury, resulting in a slight displacement of the joint. Here we see a slight stretching or partial tear of the "acromioclavicular ligament".

Symptoms of a grade 1 ac joint separation:

Joint tenderness
Joint bruising
Minor pain

Grade 2 AC Joint Separation

This is a partial dislocation of the joint. In this case, we also have an acromioclavicular ligament that is completely torn.

Symptoms of a grade 2 AC Joint Separation

Pain around the joint that can be severe
The clavicle may move when pushed
Swelling
More pain when the arm moves or when you touch the ligaments

Grade 3 AC Joint Separation

The grade 3 AC joint separation is a complete separation of the joint. Here we see a torn joint capsule, acromioclavicular ligament, and coracoclavicular ligament. This is easy to diagnose due to the bump on the shoulder caused by the upraised clavicle.

Symptoms of a Grade 3 AC Joint Separation

The elbow may need extra support (to be held) to avoid pain
Pain upon moving the arm
More pain around the joint
Swelling
"Popping" of the joint when moving it
As the joint moves, a popping sound may occur.
A bump on top of the shoulder
Instability in the AC joint

How To Treat The AC Joint Separation Without Surgery

Here's the good news. We can treat AC joint separations in grades 1 - 3 using the following:

Icing to reduce pain and swelling
Resting the injury (the higher the severity, the more rest required)
Using medications to ease inflammation and pain
Employing basic exercises at the recommendation of your physical therapist

Grade 4 - 6 AC Joint Separation

We don't often see this level of AC joint separation. When we do, we have to treat the injury surgically.

Shoulder Dislocations

Shoulder Dislocations are when the ball pops out of the socket. 90% of the time, the ball comes out the front of the shoulder, and only 10% of the time does it come out the back.

Dislocations of the shoulder are common in sports with a heightened risk of falling on the shoulder. This includes sports such as mountain biking, skiing, or even football with its high rate of impact.

Usually, this injury happens when we have the arm out overhead and behind the body, such as the "cocking" phase of throwing. In this position, a forceful external force pushing the lower arm even more rotated will cause the shoulder to lever out of the socket.

We see dislocations of the shoulder in these directions:

anterior
inferior
posterior

We want to put this shoulder back into proper position. However, don't attempt it or have anyone else attempt it unless they are medically trained to do so.

What's The Difference Between A Shoulder Separation And A Shoulder Dislocation?

We mentioned that shoulder dislocations happen when the ball pops out of the socket. Shoulder Separations, on the other hand, have nothing to do with the ball and socket joint.

Why Are Multiple Shoulder Dislocations So Dangerous For Extreme aka “Consequence Athletes”?

If you are an “extreme athlete”, have a look at this video. Dislocation the shoulder multiple times can lead to a life-threatening situation, so we need to think carefully about preventing the shoulder from dislocating again and putting you in mortal danger.

Common Shoulder Injury: Rotator Cuff Tears

If you fall hard, you may have an immediate and obvious problem with your rotator cuff. Many sudden tears of the rotator cuff will cause direct, noticeably intense pain. The result is a weakness in your upper arm that can be felt instantly.

Often, patients with rotator cuff tears come into the office complaining more of weakness, while patients with rotator cuff tendonitis (bursitis) complain predominantly of pain.

If you have any of the following, you should take the next step and consult a medical professional:

Weakness in the arm when rotating, flexing, or lifting things
A sensation of "cracking" when you move your shoulder
Consistent pain when lying or resting on the shoulder in question

Rotator Cuff Injuries May Develop Gradually

Rotator cuff tears can also develop over time, which is why we must carefully monitor young pitchers to ensure they do not over-stress the muscles and tendons of the arm and shoulders. However, you may be surprised to know that not all rotator cuff injuries are immediately apparent.

Often the injury develops over time as a result of consistent overuse. A good example of this can be seen in baseball pitchers, who consistently depend on the rotator cuff when they throw the ball at high speeds.

This is why we want to carefully monitor our young baseball pitchers, so they don't overuse the arm at an early age and develop shoulder problems.

Shoulder Impingement

Shoulder impingement may describe several symptoms, from generalized aches in the shoulder, to pain while raising or extending the arms.

Processes that compromise this normal gliding function of the shoulder may lead to mechanical impingement.

Common causes of shoulder impingement:

weakening and degeneration (form aging)
bone spurs above the rotator cuff (subacromial space)
overuse injuries.

Overuse activities that can lead to impingement are most commonly seen in athletes such as tennis players, baseball players, and swimmers.

Do You Need Surgery For Shoulder Impingement?

In most cases of shoulder impingement, surgery is not necessary. But, if symptoms persist despite adequate nonsurgical treatment, surgical intervention may be beneficial.

Surgery for shoulder impingement involves debriding (surgically removing) the tissue that is causing the irritation of your rotator cuff. This may be done with either open or arthroscopic techniques. The outcome is favorable in about 90 percent of the cases.

Now let’s talk about some of our most popular activities and the risks of shoulder injuries in these.

What are the most common shoulder injuries from working out?

Lifting weights can cause shoulder injuries, and if you work out hard with bench-pressing and other strength exercises, the result can be shoulder injuries.

Here are three of the most common shoulder injuries that happen in the gym.

Rotator Cuff Injury.
"Weight Lifter" Shoulder.
Dislocated Shoulder.

What are the Most Common Shoulder Injuries for Swimmers?

Swimming can be a high-impact sport upon the shoulders, even though there is no actual impact happening! But much like a pitcher in baseball, a swimmer will use the shoulder joint at a very high rate. We even have the term "swimmers shoulder," which refers to shoulder pain caused by connective tissue (a tendon) rubbing on a shoulder blade.

Here are some of the most common shoulder injuries for swimmers:

Shoulder inflammation
Rotator cuff tendonitis
Rotator cuff tears.
Shoulder impingement
Cartilage tears (shoulder socket)

What are the most common shoulder injuries In Yoga?

Yoga is another activity that you may be surprised to see here. But the repetitive poses of yoga can cause shoulder damage, especially if done incorrectly. Luckily, in most cases, yoga shoulder injuries won't be quite as bad as in some of our other sports. Most commonly, yoga shoulder injuries will include shoulder tendonitis that will cause a loss of strength and mobility.

What are the most common shoulder injuries in football?

Yep, football is one of our prime offenders when it comes to shoulder injuries, which is why we've mentioned it several times here already. If you play football, you are definitely at risk for the biggies:

Shoulder Tendonitis
Shoulder Dislocation
Shoulder Separation
Anterior Shoulder Instability
Rotator Cuff Injuries
SLAP Tears
Internal Impingement

What are the most Common Shoulder Injuries in Golf?

The lead shoulder can be vulnerable to shoulder injuries in golf. Common shoulder problems affecting golfers include:

rotator cuff tears
shoulder impingement
osteoarthritis, joint instability.

What Are the Most Common Shoulder Injuries?