Shoulder injuries are a very common injury that occurs in most sports. All injuries and the rehabilitation done to the injured shoulder are based on the anatomy and structures of the shoulder. Doctors have developed different tests for evaluating the degree and seriousness of injured shoulders. Some have also developed different phases a person must go through to properly rehabilitate the shoulder.

The shoulder is a ball and socket joint which allows it a flexion and extension motion.

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The shoulder is made up of two bones: the ball end called the humerus and the socket end called the scapula. It is held together by a semi complex series of muscles and tendons. As is found throughout the body, in the shoulder joint, there is a network of nerves that when injured they trigger pain, numbness, and other discomfort throughout the arm. Because the shoulder joint is made of many different parts it has many areas that may be injured.

As with any injury to the body, a doctor or trainer has to examine and assess the severity of the injury in order to correctly diagnose and treat the injured athlete. Doctors are constantly developing new technology and new physical tests an injured person must go through to help them better understand the injury. Advanced Ultrasound Imaging LLC is using their Ultrasound technology to better detect rotator cuff shoulder injuries. Previously MRI’s were commonly used. There is a mixed reaction to the technology between orthopaedic surgeons and radiologists. Some embrace it, while others are still being slow to put it in to practice. Advantages of having an ultrasound range from it being a more accurate picture to not having to lie down for 45 minutes as a patient would if he were having an MRI. Another important improvement is, you can see the rotator cuff tear in motion because the patient can move his arm. The biggest difference is if a surgeon looks at an MRI it looks like a shoulder but if a surgeon looks at an ultrasound it may look like a snow storm.

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.’s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.

*insert article* attachedThere are four phases a patient must undergo to properly manage an injured should. The first phase is only rest and pain control. That is accomplished by obviously resting and using ice and possibly medications to control pain. Phase two is the strengthening phase. During that phase the focus is on the rotator cuff and scapular stabilizer muscles such as the pecs, lats, and the serratus anterior. Strength building begins with Isometric exercises (strengthen without using full range of motion) and progresses to Isotonic exercises (strengthen using full range of motion). There are about 20 different weight-lifting exercises that can be used to strengthen the shoulder muscles. Phase Three begins an endurance program in addition to the strengthening exercises. The goal is to reach 90 percent strength as compared to the uninjured shoulder. This phase also includes increasing patients activity to sport and/or work related activity. After going through all four phases a patient should be in a healthy enough physical state that he/she may resume normal life and activity barring any unforeseen circumstances.

*insert article* attachedDuring the rehabilitation phase of a shoulder injuries a patient may undergo various different treatments. A popular treatment among physical therapists is ultrasound therapy and many therapists believe in its effectiveness however a recent study conducted by Dutch scientists reveals it may not work. The therapy is used to alleviate pain and loosen up inflames tissue. The scientists split 80 people with bad shoulders into four groups. Some received either no treatment, ultrasound and electrical stimulation, a mix of active and dummy care, or all fake treatment. After they ended treatment, the same amount of people (40 percent) said they were feeling better. Therapists say they do not want to give up the treatment but believe it may need to be re-examined.

*insert article* attachedEven after going through the different phases of rehabilitation and treatment, a patient must continue to exercise and strengthen his/her shoulder. An exercise Developed by Dr. Gavin Hopper designed to improve flexibility of the shoulder to reduce shoulder injuries can also be applied to a previously injured shoulder as a precautionary measure. Dr. Hopper suggests before exercising an athlete should stretch his shoulders by grabbing the elbow of his injured arm with his opposite hand and then pull it across the chest. The athlete should then hold the stretch for ten seconds and repeat it four times. During the next stretch the athlete should pull the playing arm higher up, just beneath the chin and again hold the stretch or ten seconds and repeat four times. This stretch should help prevent any further injuries to the previously injured shoulder and should also be used by athletes to prevent any injuries from ever occurring to their shoulders.

*insert article* attachedShoulder injuries are commonplace injuries in most sports especially those with a high level of contact. To prevent and treat these injuries many different technologies have been and are being developed to aid in properly diagnosing these patients injuries. Programs have been designed to create optimum health and return to normal life in those who have been diagnosed with shoulder injuries and much time and money is spent on new studies to help test applied treatments and design new ones. With sports becoming increasingly popular, the number of shoulder injuries is sure to increase and the need to prevent and care for these injuries will be on the upswing.


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