Shoulder injury


Q: Hello, im 27 and about 9 years ago my shoulder was injured, the pain went away that same day.However about 2 years later when i was doing incline dumbell press, my arm went completely numb and it fell straight behind (like when your holding your arm foreward only in reverse) and it felt as if my shoulder dislocated, and ever since ive noticed that something had changed in the joint, thou nothing painful. However, since yestoday ive had the felling whenever i relax my shoulder i get the feeling that its slowly disloacting even when i know thats not the case, there is some minor pain at the back of the deltoid. Any idea whats causing this?


A:    Possibly overuse at gym with the  shoulder, has produced both a rotator cuff injury and probably a labrum tear.The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during weight lifting, when playing sports with a lot of throwing, after repetitive use over a long time or suffer degenerative changes with the aging process. Typically, the pain worsens at night, with abduction over 90 degrees, it is a dull ache in the upper outer arm and shoulder, it results from mechanical compression of the rotator cuff tendon beneath the antero inferior portion of the acromion (one of the bones of the shoulder joint), causing changes in the distal part of the rotator cuff tendon, which is at risk due to poor blood supply. On the other hand, the shoulder joint is a ball and socket joint, extremely shallow, and thus inherently unstable, this means that the bones of the shoulder are not held in place adequately, and therefore extra support is needed. To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. The labrum circles the shallow shoulder socket (the glenoid) to make the socket deeper. This cuff of cartilage makes the shoulder joint much more stable, and allows for a very wide range of movements (in fact, the range of movements your shoulder can make far exceeds any other joint in the body). The labrum is made of a thick tissue that is susceptible to injury with trauma to the shoulder joint. When you sustain a shoulder injury, it is possible that you may have a labral tear. The labrum also becomes more brittle with age, and can fray and tear as part of the aging process. The treatment of a torn labrum depends on the type of tear that has occurred. Most labral tears do not require surgery; however, if as your case, you are having persistent symptoms, despite more conservative treatments, surgery may be necessary. It is very important to complete a intensive and comprehensive Rehabilitation program after the surgery to ensure that you strengthen and balance the muscles around the shoulder joint giving  stability, improve range of motion, prevent scarring as the ligaments heal and teach you which movements and / or activities you should  stability, improve range of motion, prevent scarring as the ligaments heal and teach you which movements and / or activities you should avoid.

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