Damage to the ligaments of the shoulder joint: causes, diagnosis and treatment

The shoulder joint is susceptible to injury due to its anatomical features and functions. The most common possible shoulder injuries are:

• bruises and dislocations;
• intra-articular fractures;
• sprains and ligament tears.

Ligaments are the most susceptible to injury because they control joint movement. Their purpose is to limit joint movements during unnatural and dangerous movements and ensure minimal risk of injury. Ligament injuries are often caused by exceeding permissible loads.

A shoulder ligament injury involves excessive stretching or partial tearing of the fibers. The damage is of a closed mechanical nature. Due to a ligament injury, some movements may be limited or cause pain. In this regard, it is recommended to seek qualified help as quickly as possible if you suspect that not everything is in order with the ligaments.

Causes of ligament damage

The most common injuries to the shoulder ligaments occur in athletes. Due to excessive stress on the joints, the strength of the tendons is reduced, which leads to stretching or rupture.

But shoulder ligaments can be damaged not only by playing sports. Injuries also occur in everyday life, in accidents. For example, tears and sprains occur with sudden movements, twisting the arm outward, falling on the upper part of the shoulder or outstretched arm, hitting the front of the shoulder, etc.

But sudden movements of the hands or strong blows do not always lead to damage to the ligaments. In many cases, additional factors that contribute to the weakening of the tendon-muscular system play an important role, for example:

• age - over time, ligaments lose their properties, the likelihood of damage increases;
• osteophytes - growths that affect bone tissue;
• metabolic disorder;
• poor nutrition – due to a lack of vitamins and other nutrients, the condition of the ligaments may worsen;
• excess weight – increases the load on the joints;
• lifestyle - smoking or drinking alcohol can affect the elasticity and firmness of the ligaments;
• the presence of a disease that requires hormonal therapy;
• birth defects, joint abnormalities, etc.

Injuries associated with sprained or torn ligaments of the shoulder joint are a fairly common type of injury, regardless of the patient’s age.

Shoulder joint injury treatment

Damage to the labrum of the shoulder joint

Any damage to the labrum of the shoulder joint requires immediate treatment, as well as elimination of the consequences of the injury or the factors that caused it. Initially, the patient must limit the movements of the joint so that bones that move incorrectly do not harm the soft tissues. After this, the victim of a dislocation must immediately undergo a magnetic resonance imaging procedure, which will show whether damage has occurred to the rotator cuff of the shoulder joint or whether the injury is purely ligamentous in nature. The doctor who examines the patient must be a qualified specialist, since the correctness of the diagnosis and the timeliness of treatment measures taken, the damage can be eliminated relatively quickly, and the health of the joint will not be affected.

Symptoms of a sprained or torn ligament

When the shoulder ligaments are damaged, the following symptoms often occur:

• shooting pain in the shoulder when moving your arms up or to the side;
• swelling in the injured area - usually a couple of hours after the injury;
• increased temperature on the surface of the edema;
• hematomas and tumor;
• limited shoulder mobility.

If a child is injured, the joint may move unnaturally, which is also a symptom of a sprained or torn ligament.

Pain is the main symptom that appears immediately after injury. Over time, the pain may change to aching or dull.

To provide first aid if a ligament rupture or sprain is suspected, it is necessary to immobilize the injured limb and apply a cold compress. If the pain is severe, the victim can be given a painkiller. After which it is necessary to take him to the hospital.

It is not recommended to treat joint ligament injuries on your own - this can be dangerous for the injured arm and lead to negative consequences.

Types of damage

There are traumatic (simultaneous) deformities that occur during a strong sharp blow, fall or dislocation, and degenerative ones associated with impaired blood supply, when even minor movements lead to injury to the cuff.

The following forms of rotator cuff injury may occur:

1. Complete rupture of the rotator cuff - in this case, the patient loses the ability to abduct the arm and rotate outward.
2. Incomplete rupture of the cuff - retraction is possible when pain is eliminated.
3. Chronic degenerative changes (tendinosis) – muscle wasting and limited mobility are observed.
4. Impingement syndrome is a pinched rotator cuff muscle.
5. Subacromial bursitis is an inflammation of the synovial bursa.

Diagnosis of shoulder ligament lesions

To properly diagnose an injury, a doctor needs to know the symptoms, timing, and circumstances of the injury. For an accurate examination, it is important to establish the nature of the pain in order to determine the extent of ligament damage. The specialist may also ask about past injuries, if any, and methods of treating them.

When examining the patient, the specialist determines:

• presence and degree of edema;
• degree of shoulder mobility;
• intensity of pain.

In order to exclude the presence of dislocations, cracks, fractures and other mechanical damage, the patient may be prescribed an X-ray examination. It is done when the doctor suspects that the shoulder ligaments are injured.

Additional diagnostic methods are usually used:

• arthroscopy – minimal surgical manipulation using special equipment;
• Ultrasound – examination using ultrasonic waves;
• MRI – visualization of a joint using a magnetic field.

Only a specialist can correctly determine the nature and extent of damage to the shoulder ligaments. In addition, the symptoms of their sprains are similar to other possible shoulder injuries, so it can sometimes be difficult to determine what kind of injury the victim suffered.

Rehabilitation

The rehabilitation period after a shoulder joint rupture takes a long period of time and can last up to 6 months. After surgery, the shoulder and arm are completely immobilized using an orthopedic splint (for about 2-3 weeks), but the duration of immobilization is still determined individually. The splint reduces the risk of re-tearing the ligaments.

After the splint wear period has expired, physiotherapy, massages, electrophoresis, magnetic therapy, mud applications, and rehabilitation exercises are prescribed. The load is dosed so as not to disrupt the fusion process. In total, rehabilitation is divided into 3 periods:

• complete immobilization of the hand;
• rehabilitation exercises to develop range of motion;
• restoration of strength.

During the rehabilitation process, it is important to follow the treatment plan and medical recommendations. The period of complete recovery of the shoulder joint ligaments depends on the regenerative ability of the body and the age of the patient.

Author of the article:
Vyacheslav Samoilov

Treatment of shoulder ligament lesions

First of all, it is necessary to exclude any movement of the shoulder joint. It is advisable to apply a fixing bandage for a while so that the shoulder, tendons and ligaments are in a state of calm.

As for medications, the doctor usually prescribes painkillers to reduce pain and swelling, as well as vitamins. The diet must be balanced - the treatment process will speed up if you add hyaluronic acid, chondroitin and glucosamine to the diet.

In more severe cases, they resort to procedures such as:

• cold compress on the damaged area;
• limb fixation;
• electrophoresis with anti-inflammatory drugs;
• magnetotherapy – a procedure using a magnetic field;
• balneotherapy – treatment with mineral waters;
• paraffin therapy is a method of heat treatment using paraffin.

Surgery is usually not performed for sprained or torn shoulder ligaments. They are indicated only in rare cases, for injuries with complications.

As the final stage of treatment, the patient needs to undergo a massage session in order to fully recover from the injury. Health-improving physical education with control of moderate loads is also recommended.

To prevent injuries to the ligaments of the shoulder joint, it is necessary to exercise regularly, control nutrition and weight, observe the necessary technique during training, etc.

Treatment of rotator cuff injuries

Conservative treatment with the use of non-steroidal anti-inflammatory drugs and intra-articular injections provides relief to the patient, but only for a short time. Surgical treatment of patients at a relatively young age is carried out in almost all cases, since it is possible to restore joint function and eliminate pain. Arthroscopy is currently the most effective and safe method for treating rotator cuff injuries. With this minimally invasive operation, the risk of injury to surrounding tissues is reduced, good intraoperative visualization of the process is provided, and there is an extensive possibility of fixation and restoration of damaged structures.

The variability of operations is enormous, since no two pathologies are identical. However, general principles of surgical procedures include:

• subacromial decompression (removal of the subacromial synovial bursa, removal of osteophytes (pathological bone growths) and partial removal of the ligaments and the acromial end of the clavicle;
• fixation of the cuff tendon either edge to edge or to the bone tissue of the shoulder;
• tenotomy or tenodesis (fixation) of the tendon of the long head of the biceps to the humerus.

In the postoperative period, immobilization of the upper limb is necessary for some time. Then rehabilitation measures are recommended, including kinesiotherapy, mechanotherapy, physiotherapeutic procedures and much more. Rehabilitation after arthroscopy is faster and easier than after open joint surgery.

Symptoms of subacromial syndrome

Clinical manifestations of the disease occur with a gradual increase. Pain in the shoulder area and along the muscles is the main symptom. At the initial stage, pain occurs after exercise, then gradually becomes permanent. Movement in the joint is limited. Raising your hand becomes sharply painful. Local swelling of the shoulder may be observed. At a later stage, atrophy of the muscles of the shoulder girdle becomes visually noticeable. A clicking sound may be heard when you lower your hand. If the tendon has not ruptured, then patients, as a rule, do not consult a doctor for a long time, making a mistake. After all, in case of advanced disease, only surgical treatment is effective.

Dislocation[edit | edit code]

Shoulder dislocation
The most dangerous shoulder injury is a dislocation. In this condition, the head of the humerus comes out anteriorly, while at the same time the arm rotates outward in an abducted position. This is a typical form of dislocation that occurs in 95% of all cases. Other types of dislocation will not be described in this article.

Read the main article:

shoulder dislocation

Signs of dislocation[edit | edit code]

Shoulder dislocation occurs at the moment of maximum load during the exercise. A sharp pain appears, sometimes a crunch is felt, the shoulder joint changes its shape as shown in the figure. The patient cannot abduct or rotate the arm.

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