Why does the shoulder pop out?
The shoulder joint has a complex structure. It is formed by the articular cavities of the clavicle and acromion. The head of the humerus extends into the glenoid cavity. It has a spherical shape, which provides sufficient range of movement in the shoulder.
The stability of the shoulder is achieved due to the cartilaginous lips, which are localized along the edges of the glenoid cavity and increase its depth, a strong connective tissue capsule, ligaments, and muscle tendons. Also, some muscles (supraspinatus, infraspinatus, subscapularis, teres minor) that pass near the glenoid cavity form a cuff, which further increases stability. When one or more of the structures that provide strength are weakened, the head of the humerus systematically pops out.
Main reasons
Shoulder instability is a polyetiological pathological condition that develops due to the influence of various causative factors, which include:
Main types
Bandages can be used for various purposes, so there are several types: Restrictive. Looks like a vest with small sleeves. Provides complete immobility of the joint; if necessary, the range of motion can be adjusted with straps. Children's. In childhood, special attention should be paid to the musculoskeletal system. After surgery on the shoulder, it is recommended to wear a children's bandage; it looks like an adult fixation bandage, but is made of natural materials and has appropriate sizes, which are regulated by special Fixation belts. This brace secures the shoulder in the desired position. The patient cannot lift or move the arm. Made of semi-rigid material, it performs its function perfectly. Clavicular. Provides reliable fixation of the shoulders - they are laid back. This product is shaped like a figure eight. Prescribed for damage or fracture of the collarbone in the initial post-rehabilitation period. Supportive. Indicated for shoulder instability. Prevents dislocations and other injuries; as a rule, such bandages are worn for preventive purposes. Made of soft fabric material, does not restrict movement.
Symptoms
Clinical signs indicating a dislocation include:
- Pain in the area where the head of the humerus emerges varies in intensity - with chronic shoulder dislocation it is less severe than with acute dislocation.
- A change in the shape (deformation) of the shoulder area, the severity of which depends on the severity of the dislocation.
- Limitation of mobility, manifested in a decrease in volume, amplitude of active and passive movements. Characteristic is the appearance of “springy” movements of the hand when it is passively abducted to the side or raised upward.
The intensity of clinical manifestations depends on the frequency of dislocations. The more often the shoulder pops out, the less severe the symptoms (an exception is deformity of the shoulder joint). In case of acute dislocation, significant stretching of the capsule is possible with damage to nerve fibers, which is manifested by impaired sensitivity of the skin of the upper limb.
Features of shoulder surgery
Arthroscopy of the shoulder joint is a minimally invasive operation that allows you to accurately diagnose the pathological process and eliminate it. During surgery, the doctor makes small punctures in the shoulder area and inserts an arthroscope. This tool is equipped with a minimally sized camera, which allows you to magnify the image several times. Arthroscopy is prescribed for frequent shoulder dislocations, bursitis, tendon injuries, arthrosis or arthritis. With the help of this operation, it is possible to relieve the patient of pain and restore motor activity.
Diagnostics
Diagnostics
Based on the patient’s complaints and clinical examination data, the doctor prescribes an objective diagnostic study, including techniques for visualizing the internal structures of the shoulder. These include x-ray examination, ultrasound, computed tomography or magnetic resonance imaging, arthroscopy.
Arthroscopic diagnosis is an invasive method in which, using a thin tube with a camera and lighting, inserted into the joint cavity through small incisions, the doctor examines its internal structures. It also allows you to perform tissue plastic surgery using special manipulators under visual control on a monitor screen.
First aid
Proper implementation of first aid measures for a dislocated shoulder includes immobilization (immobilization) of the joint using available means (scarf, bandage, scarf, clothing), as well as ensuring its functional rest. If there is severe swelling of the soft tissues, cold is applied to the shoulder area (a napkin moistened with cold water, an ice pack), which will reduce the inflammatory reaction, after which the shoulder will hurt less.
The next step of assistance is to transport the injured person to a trauma center or call an ambulance. If habitual shoulder popping develops, a person can straighten it himself or with the help of people around him. In the case of a primary dislocation, it is not recommended to perform a reduction on your own, as this can cause various serious complications, including damage to large vessels with severe bleeding, rupture of the capsule, and large nerve trunks.
Causes of shoulder arthrosis
The cause of pain in the shoulder joint is degenerative processes in the area of the rotator cuff of the shoulder joint, arthrosis of the shoulder joint or acromioclavicular joint, adhesive capsulitis is idiopathic (an independent disease, the causes of which are currently unknown), subacromial bursitis of the shoulder joint.
The degenerative process is the process of destruction of tissues as a result of disruption of their nutrition. Eating disorders occur for several reasons:
- overload, which leads to inflammation and spasm of muscles, tendons and ligaments
- a sedentary lifestyle, which leads to atrophy of tendons, muscles, ligaments and, accordingly, disruption of their nutrition
- imbalance of rotator cuff muscle tone, which occurs due to forced posture
- idiopathic (independent, for unexplained reasons) inflammation of the joint capsule “adhesive capsulitis”
To understand the cause of pain, you need to understand the anatomy of the shoulder joint and rotator cuff. To make it clear, let’s draw an analogy with an ax, since the shoulder joint is very similar to it.
The difference is that the humerus (axe) is not rigidly attached to the shoulder blade (axe), but with the help of a hinge. The shoulder blade with the humerus is “tied” to the back with the help of muscles, and in front with the help of the collarbone to the sternum. The hinge itself is attached to the scapula by the rotator cuff, a muscle that starts at the vertebral edge of the scapula (the ax blade) and ends at the top of the “axe handle.” Directly above the hinge is the acromion of the scapula, this is the spine of the scapula (a bone that can be felt on the back) passing into a process that covers the top of the shoulder joint in the form of a visor.
So, the muscles of the rotator cuff provide movement in the shoulder joint, and when they are damaged, the shoulder joint really turns into a real ax, since movements in the joint become impossible. This type of shoulder is called “frozen”.
The rotator cuff muscles not only provide movement in the joint, but also, due to uniform tension, center the head of the humerus in the glenoid cavity, ensuring its uniform movement without compression.
For example, an auto mechanic or electrician with his arms raised above his head constantly holds in tension the upper group of muscles of the rotator cuff, which are responsible for abducting the arm in the shoulder joint and raising the head of the shoulder upward, while the lower group of muscles is not loaded and atrophies, releasing the head of the shoulder upward or vice versa a person at a desk or desk, leaning on the table with his elbows, pushes the head of the humerus upward, stretching and atrophying the lower muscle group, which pulls the head of the humerus down.
This leads to increased pressure from the acromion of the scapula on the humeral head. Between the acromial process of the scapula and the shoulder are the subacromial bursa, the supraspinatus muscle and the long head of the biceps. Increased pressure on them leads to their inflammation - bursitis of the shoulder joint, tendinitis of the long head of the biceps, tendonitis or damage to the supraspinatus muscle, and glenohumeral periarthritis.
Conservative therapy
Conservative therapy
Treatment of habitual popping of the shoulder joint without surgical intervention is carried out as monotherapy or during preoperative preparation. It includes the use of non-steroidal anti-inflammatory drugs, limiting the functional load on the shoulder or its immobilization (immobilization), physiotherapeutic procedures (ozokerite, mud baths, electrophoresis with medications).
An alternative option for conservative strengthening of shoulder structures is the intra-articular injection of platelet mass containing biologically active compounds “growth factors”.
Surgery
Surgery is performed when there is severe damage to the structures responsible for the stability of the shoulder joint. The operation can be performed using an open approach (wide tissue dissection is performed to access internal structures) or using arthroscopy.
Today, arthroscopy is the technique of choice, since it causes less tissue injury. If it is impossible to perform plastic surgery of ligaments, capsules, tendons or muscles, implantation is performed. This operation is often performed with an open approach.
What is a bandage for and what is it?
A bandage is an orthopedic product that partially or completely fixes the motor activity of the shoulder joint and upper limb. These structures are used in therapeutic or prophylactic settings; they are also used after operations and perform a supporting function. In the postoperative period, the product is used to accelerate the healing of damaged tissues.
Material of manufacture
Any type of bandage is made of high-density elastic material. The unique composition of the material allows for a tight fit of the bandage to the shoulder. Restrictive types of products may contain additional fixation systems, for example, belts or plates. The material used can be natural or synthetic. The first option is most preferable for children, but it wears out quickly, so its service life is shorter than that of synthetic products. Synthetics are more practical and easy to care for, suitable for adults and children.
Peculiarities
During surgery on the shoulder joint, damage to surrounding tissue occurs. The bandage is designed to prevent sprains or damage to the integrity of ligaments or muscles. The fixing function of this product reduces pain in the postoperative period and speeds up the recovery process.
Fixation degree
Depending on the complexity of the operation and the severity of the disease, bandages of different fixation may be prescribed. They are classified into three groups: Lungs. They will be useful after simple operations, for example, those caused by a sports injury. Sometimes such bandages are used to prevent injury. Fixing structures with weak fixation prevent tension in the muscles and ligaments of the shoulder joint and create optimal conditions for tissue healing. Semi-rigid. Prescribed in the initial post-rehabilitation period, mainly for arthritis or arthrosis. Tough. Indicated after major operations or fractures. The shoulder joint is securely fixed in a stationary state.