The shoulder is a joint with a lot of mobility and susceptible to injuries due to its anatomy and because its static / dynamic components taken to the functional and structural limit.
During competitive sport, the athlete's shoulder is often subjected to extreme forces and tension, especially during sports involving repetitive throwing activities or above the head.
The frequency of injuries depends on the age of the athlete and the level of competition. Athletes can suffer muscle, ligament, capsular and neurovascular injuries.
A throwing athlete has a certain degree of hyperlaxity or softening of the anterior capsule and a contracture of the posterior capsule at the articular level, that are required to perform this type of movement with the arm above the head.
The structures that we can find involved in these lesions are: the clavicle, the acromioclavicular joint, the acromion, the rotator cuff and the glenohumeral joint with its dynamic and static stabilisers.
To perform all these normal functions, the shoulder complex requires the coordination of the movement of five joints, of which three are anatomic: Glenohumeral, acromioclavicular and sternoclavicular, and two are physiological: subacromial and scapulothoracic.
Type of Shoulder Injuries
Intrinsic or Internal Processes: the origin is the anatomical or functional alteration of the shoulder structures.
- Osteoarticular (affect the joint itself)
- Glenohumerales: arthritis, osteoarthritis, tumors, osteonecrosis.
- Acromioclavicular: trauma, osteoarthritis.
- Scapulothoracic: fibrositis, bursitis belongs to the group of sisarcosis (joints whose joint surfaces are formed by muscles).
Extrinsic or External Processes: they are pain radiated to the shoulder due to injuries of structures close to it.
- Cervical spine: trauma, cervicoarthrosis, inflammatory processes, discopathies, tumors, postural alterations.
- Neurological processes:
- Intradural: syringomyelia, intramedullary tumors, meningitis.
- Radicular: extradural tumors, radiculitis, compression syndromes.
- Peripherals (plexus)
- Neurovascular: thoracic outlet syndromes
- Invasive (cancer): Pancoast tumor
Around the Joint
- Rotator cuff injuries
- Frozen shoulder syndrome: the capsule is retracted, it is a retractable adhesive capsulitis.
- Calcific tendonitis
- Long biceps tendon injuries
Pain referred to the shoulder as a manifestation of alterations of distant organs.
- Cardiovascular: coronary pathology, aortic aneurysms.
- Mediastinum: pneumonia, tumors, esophageal lesions.
- Subphrenic viscera: hepatopathies, subphrenic abscesses, gallbladder