Common Swimming Overuse Injuries

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Article featured on Physiopedia

Swimming is a great sport enjoyed by all age groups at all levels of ability. It is a unique sport, in that it combines upper and lower extremity strength exercises with cardiovascular training in a non-weight bearing environment. Swimmers are unfortunately prone to injuries. Most swimming injuries are classed as overuse injuries and relate to faulty biomechanics. The most common swimming injury regions are the shoulder, neck, lower back and knee.

Swimming overuse injuries usually arise from one or a combination of the below:

  • Poor stroke mechanics
  • Poor breathing technique
  • Poor flexibility or range of motion of neck or lower back
  • Hyper flexibility of joints with insufficient muscular stabilisation
  • Decreased rotator cuff or scapular muscle strength
  • Insufficient core strength/stability
  • Decreased hip muscle strength
  • Overtraining
  • Insufficient rest periods

Stretching is important for swimming because of the great range of muscles used when you’re in the water.  Unprepared muscles don’t perform as well as muscles which have been warmed up ahead of exercising. A good stretching regime including at a minimum:

  • posterior shoulder stretch
  • pectoral stretch
  • long head biceps stretch
  • upper thoracic spine mobility stretch
  • latissimus dorsi

Note – The above list gives a guide to what to look for in each of the specific conditions listed below. This page does not give full physiotherapy procedures, instead providing great links to the sites that will have relevant information.

Swimmers Shoulder

Shoulder pain is the most frequent orthopaedic injury in swimmers, with a reported prevalence between 40% and 91% in elite swimmers. Swimmer’s shoulder is a condition with a gradual onset due to repetitive activity and can be classified as microtrauma. Swimmer’s shoulder usually presents as subacromial impingement involving the rotator cuff tendon, bicipital tendon, or subacromial bursa.

Primary subacromial impingement involves compression of these structures between the acromion and greater tuberosity (due to usually a tight posterior capsule causing the humeral head to migrate anteriorly) or abnormal acromial morphology. However, primary impingement syndrome is less common in competitive swimmers than secondary impingement.

Secondary impingement occurs through a series of impairments, usually in a swimmer with increased anterior glenohumeral laxity (shoulder ROM in swimmers often exhibit excessive external rotation and limited internal rotation). This shift in ROM towards increased external rotation is an adjustment to the demands on the glenohumeral joint allowing anterior laxity and greater demand on the rotator cuff and the long head of the biceps to reduce humeral head elevation and anterior translation.

Chronic swimmer’s shoulder can result in pathology of the rotator cuff, glenoid labrum, and long head of the biceps.

Swimmers Back

The spine is also a recognized site predisposed to injury in the elite swimmer, mainly associated with butterfly swimmers ( 33.3%-58%) and breaststroke swimmers (22.2%- 47%), figures varying from differing studies.

As swimming athletes are positioned horizontally in the water, gravity and buoyancy forces are traveling through the body with the potential to cause changes at the lumbar spine. Due to the undulating motion (lumbar extension) utilised in butterfly and breaststroke, there is potential for developing pain secondary to stress on the joints.

Causes include:

  • Hyperextension of the lumbar spine during freestyle and butterfly
  • poor kick technique
  • stress fractures are a potential cause in young swimmers
  • disc degeneration and facet joint degeneration in the older swimmer. A 2007 study hypothisising that “Excessive competitive swimming activities accelerate lumbar disk degeneration” this activity may exaggerate lumbar intervertebral disk degeneration, especially in the L5-S1 intervertebral segment.
  • improper timing of this butterfly stroke increases strain on low back the possibility of neck, shoulder, or back pain.
  • poor flexibility of the spine and low back
  • insufficient core strength to maintain straight alignment of body in water
  • aggressive weight training using poor techniques
  • overuse of devices e.g. paddles on hands, fins, kick boards- exposing the open kinetic chain of swimming to different loads and exaggerating lumbar lordosis
  • tightness in the hip flexors or inadequate body roll during swimming may lead to compensation at the lumbar spine.

Swimmers Knee

Knee pain figures range from 34% to 86% for a single knee episode, being highest in breaststrokers.

Knee pain is caused mainly during breaststroke swimming. Repetitive stress is placed on the medial knee produces pain during the whip-like motion. The breaststroke kick is a high valgus load produced during sudden flexion-extension, adduction and external rotation of the knee against the hydrodynamic environment, resulting in stress to the medial compartment. Hence a strain occurs to the medial collateral ligament and compression on the lateral knee (possibly causing sprain on the MCL; irritation of the medial plica; bursal irritation at the muscular insertions of the adductor and hamstring muscles). Strain injuries may also present in the adductor muscles (adductor magnus and brevis, especially). Other knee injuries include patellofemoral pain, and medial synovitis. Treatment will focus on elimination of inflammation. Rehabilitation should focus on stabilisation exercises for hypermobile joints, postural correction, strengthening and flexibility.

A 2008 study found the 200 – 400 m breaststroke events increase the risk for knee overuse injuries more than other strokes or distances. Additionally training for more than four times a week increases the risk twofold for knee and fourfold for shoulder overuse injuries.

A 2004 study looking at competitive swimmers interestingly reports that breaststroke swimmers are at significant risk of: groin injury; groin injury is positively correlated with increased magnitude of breaststroke training; and groin injury may prevent participation in practices and competitions. So take the time to assess then groin and complete length of hip adductors, not just distally.

Swimmers Neck

Neck pain is mainly seen in the older athlete It may be due to facet joint arthritic change, and disc degeneration +/- nerve root irritation.  Muscle innervation and sensation to the shoulder region is predominantly derived from the C5/C6 nerve roots.  If these nerve roots are irritated due to degenerative change in the neck, shoulder complaints can arise.  Arthritic change may limit neck rotation making correct breathing patterns difficult.  Swimmers who unilaterally breath are more prone to neck pain.  Looking forward rather than directly downward and extending the head too high when taking a breath increases the load on the neck and create pain.

Conclusion

Swimming can be a great sport for recreational swimmers up to elite swimmers. As a physiotherapist help swimmers overcome their injuries and liaise with trainers, coaches and physicians for the best results.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What You Need to Know About Your Shoulder Instability

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Article featured on OrthoUnited

Shoulder instability is a condition that can significantly impact your daily life, making even the simplest tasks difficult. Whether you’re an athlete, someone with an active lifestyle, or someone who has experienced an injury, understanding shoulder instability is essential. This blog post will provide an overview of shoulder instability, how it occurs, its diagnosis, and the various treatment options available.

What Is Shoulder Instability?

Shoulder instability occurs when the shoulder joint is too loose and frequently slips out of place. The shoulder is a ball-and-socket joint, where the ball (the head of the humerus) fits into the shoulder blade’s socket (the glenoid).

When the ligaments, tendons, and muscles surrounding the shoulder joint are stretched or torn, they can no longer keep the joint in place. This condition can lead to partial or complete dislocations and a sensation of the shoulder “giving out.”

People suffering from shoulder instability often experience pain, weakness, and a limited range of motion. The condition can be a result of trauma, repetitive use, or a structural abnormality of the shoulder.

How Does It Develop?

Shoulder instability can occur in several ways:

  • Trauma: The most common cause is a traumatic injury, such as a fall or a sports-related incident that forces the shoulder out of its normal position. Once the shoulder has been dislocated, it becomes more susceptible to repeated dislocations or subluxations (partial dislocations), leading to chronic shoulder instability.
  • Repetitive Strain: Another cause of shoulder instability is repetitive overhead movements, often seen in athletes like swimmers, baseball players, or tennis players. These activities can stretch and weaken the ligaments over time, leading to what is known as atraumatic shoulder instability.
  • Genetic Factors: Certain genetic factors can also contribute to shoulder instability. Some individuals are born with naturally looser ligaments, making them more prone to dislocations and subluxations. This condition is known as congenital shoulder instability.

How Is It Diagnosed?

Diagnosing shoulder instability begins with a comprehensive medical history and physical examination. Your healthcare provider will ask about your symptoms, previous injuries, and activity level. During the physical examination, the doctor will check for signs of instability, such as abnormal shoulder joint movement or a popping sensation when the shoulder is moved.

Imaging tests like X-rays, MRI, or CT scans may provide a more detailed view of the shoulder joint. These tests help identify any structural damage to the bones, ligaments, or cartilage that may contribute to the instability.

A proper diagnosis is crucial because the treatment plan will vary depending on the severity and type of shoulder instability. If you suspect you have shoulder instability, consult a specialist immediately for an accurate diagnosis.

Treatment Options for Shoulder Instability

Treatment for shoulder instability depends on the extent of the condition and the patient’s lifestyle. Here are some of the standard treatment options:

  • Physical Therapy: In many cases, physical therapy is the first line of treatment. A physical therapist will design a program that includes exercises to strengthen the muscles around the shoulder, improve flexibility, and restore the range of motion. Strengthening the rotator cuff muscles and scapular stabilizers is critical to improving shoulder stability.
  • Surgical Intervention: Surgery may involve repairing or tightening the ligaments and tendons that support the shoulder joint. In some cases, surgeons may perform a procedure called a Bankart repair to reattach the torn labrum to the socket. Another option is the Latarjet procedure, which involves transferring a piece of bone to the shoulder socket to prevent dislocation.
  • Medication: Your doctor may recommend anti-inflammatory medication or injections to reduce pain and inflammation in the shoulder joint.
  • Lifestyle Changes: Making specific lifestyle changes, such as avoiding activities that put excessive strain on the shoulder, can also help prevent further instability.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Chronic vs. Acute Rotator Cuffs

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The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

 

What You Need to Know About Navigating Shoulder Instability

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Article featured on OrthoUnited

What Is Shoulder Instability?

Shoulder instability occurs when the shoulder joint is too loose and frequently slips out of place. The shoulder is a ball-and-socket joint, where the ball (the head of the humerus) fits into the shoulder blade’s socket (the glenoid).

When the ligaments, tendons, and muscles surrounding the shoulder joint are stretched or torn, they can no longer keep the joint in place. This condition can lead to partial or complete dislocations and a sensation of the shoulder “giving out.”

People suffering from shoulder instability often experience pain, weakness, and a limited range of motion. The condition can be a result of trauma, repetitive use, or a structural abnormality of the shoulder.

How Does It Develop?

Shoulder instability can occur in several ways:

  • Trauma: The most common cause is a traumatic injury, such as a fall or a sports-related incident that forces the shoulder out of its normal position. Once the shoulder has been dislocated, it becomes more susceptible to repeated dislocations or subluxations (partial dislocations), leading to chronic shoulder instability.
  • Repetitive Strain: Another cause of shoulder instability is repetitive overhead movements, often seen in athletes like swimmers, baseball players, or tennis players. These activities can stretch and weaken the ligaments over time, leading to what is known as atraumatic shoulder instability.
  • Genetic Factors: Certain genetic factors can also contribute to shoulder instability. Some individuals are born with naturally looser ligaments, making them more prone to dislocations and subluxations. This condition is known as congenital shoulder instability.

How Is It Diagnosed?

Diagnosing shoulder instability begins with a comprehensive medical history and physical examination. Your healthcare provider will ask about your symptoms, previous injuries, and activity level. During the physical examination, the doctor will check for signs of instability, such as abnormal shoulder joint movement or a popping sensation when the shoulder is moved.

Imaging tests like X-rays, MRI, or CT scans may provide a more detailed view of the shoulder joint. These tests help identify any structural damage to the bones, ligaments, or cartilage that may contribute to the instability.

A proper diagnosis is crucial because the treatment plan will vary depending on the severity and type of shoulder instability. If you suspect you have shoulder instability, consult a specialist immediately for an accurate diagnosis.

Treatment Options for Shoulder Instability

Treatment for shoulder instability depends on the extent of the condition and the patient’s lifestyle. Here are some of the standard treatment options:

    • Physical Therapy: In many cases, physical therapy is the first line of treatment. A physical therapist will design a program that includes exercises to strengthen the muscles around the shoulder, improve flexibility, and restore the range of motion. Strengthening the rotator cuff muscles and scapular stabilizers is critical to improving shoulder stability.
    • Surgical Intervention: Surgery may involve repairing or tightening the ligaments and tendons that support the shoulder joint. In some cases, surgeons may perform a procedure called a Bankart repair to reattach the torn labrum to the socket. Another option is the Latarjet procedure, which involves transferring a piece of bone to the shoulder socket to prevent dislocation.
    • Medication: Your doctor may recommend anti-inflammatory medication or injections to reduce pain and inflammation in the shoulder joint.
    • Lifestyle Changes: Making specific lifestyle changes, such as avoiding activities that put excessive strain on the shoulder, can also help prevent further instability.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Prevent Injuries with Shoulder Stretches & Hamstring Stretches

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Article featured on NY Orthopedics

Why are Shoulder and Hamstring Stretches Important?

Stretching plays a critical role in maintaining flexibility, improving range of motion, and reducing muscle tension. Loose and flexible muscles are less likely to experience strains or tears during physical activities like backyard sports.

Regular stretching helps to improve blood flow to the muscles, enhancing their ability to recover quickly and efficiently after exertion. Stretching is especially important for those over the age of 30, those with chronic injuries, or those prone to muscular tears. Sudden bursts of activity, like those in football or baseball, can put extra stress on the muscles and joints, making stretching beforehand that much more necessary.

Shoulder Stretches for Injury Prevention 

Shoulder injuries are among the most common in many sports, particularly those that involve throwing or overhead movements like beach volleyball. To prevent these injuries, it’s important to keep your shoulder muscles and joints flexible and strong with some targeted stretches. Here are some common, easy-to-do stretches that can help you limber up before serving up some heat:

  1. Cross Body Shoulder Stretch: This stretch helps to improve the flexibility of the shoulder and upper back muscles. Stand tall and bring one arm across your body, using your opposite hand to pull the arm closer to your chest gently. Hold this position for about 30 seconds before switching sides.
  2. Shoulder Circles: Shoulder circles are the perfect stretch for enhancing the range of motion in your shoulders. Stand with your feet shoulder-width apart and extend your arms out to the sides. Make small circles with your arms, gradually increasing the size of the circles. Perform this for 30 seconds in each direction (forward and back circles).
  3. Doorway Shoulder Stretch: Stand in a doorway with your arms bent at 90 degrees and your forearms resting on the doorframe. Step forward slowly with one foot, keeping your back straight and pushing your chest through the doorway. You should feel a stretch across your chest and the front of your shoulders. Hold this position for 30 seconds, then step back and relax. Repeat as needed.

Hamstring Stretches for Flexibility 

Hamstring injuries are another common issue, especially in sports that involve running and jumping. Keeping your hamstrings flexible with targeted stretches can prevent strains and improve your overall performance. Here are some hamstring stretches to help you stay loose for those one-on-ones:

  1. Standing Hamstring Stretch: Stand upright with your feet hip-width apart. Extend one leg forward with the heel on the ground and toes pointing up. Keep your back straight and hinge at the hips, reaching towards your toes. Hold this stretch for 30 seconds before switching legs.
  2. Seated Hamstring Stretch: Sit on the ground with one leg extended straight and the other bent, with the sole of your foot against your inner thigh. Reach towards the toes of your extended leg, keeping your back straight. Hold the stretch for 30 seconds, and then switch legs.
  3. Lying Hamstring Stretch: Lie flat on your back with one leg extended straight on the ground and the other leg raised in the air. Hold the raised leg behind the thigh or calf and gently pull it towards you, keeping the leg as straight as possible. Hold the stretch for 30 seconds, then switch legs.

Incorporating Stretches into Your Routine 

To maximize the benefits of stretching, you should not only stretch before physical activity but incorporate stretching into your daily routine. Remember that stretches are meant to build muscle, joint flexibility, and strength. This doesn’t happen after one stretching session. Like any other exercise, it takes time and discipline to reap the full rewards.

Fortunately, most people notice results relatively quickly. You can start small with a gentle warm-up as you get out of bed to get your blood flowing before moving into the stretches—something light like jumping jacks. Then, try out some of the stretches we’ve provided here or integrate more full-body stretches.

By properly stretching your shoulders and hamstrings, you can significantly reduce the risk of injuries!

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

7 Suggestions to Help With Mouse Shoulder

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Article featured on The Leagrave Therapy Clinic

If you work in an office, you probably spend hours every day with one arm extended on your mouse, clicking and dragging items. Mouse shoulder is a condition that can create shoulder pain from using a mouse with the computer for long periods of time due to poor ergonomics or inappropriate arm or wrist support.

The pain tends to spread over one side of the neck and into the shoulder, it can develop over weeks or months and is often described as a “burning” or deep aching sensation. This repetitive strain injury (RSI) or work-related upper limb disorder can occur from constant repetitive movements in a limited area can lead to real pain problems in the shoulder, neck, and upper back. It may take several weeks or months to develop, but once established Mouse Shoulder can take less than one hour of mouse use a day to maintain this repetitive strain state.

The Canadian Centre for Occupational and Health Safety reports that we actually use our mouses THREE times as often as the keyboard. This repetitive use could occur during work or while playing video games. If you haven’t set up an ergonomic work station, your mouse with relation to your office desk could be positioned too low or too high. It could also be set up in a way where your arm has no or little support during the day.

If your mouse is too low, you’re constantly reaching your hand towards it. Too high and you’re constantly tensing the muscles in your upper arm, shoulder and neck and cause an imbalance of muscle use. With enough time and stress, any area of the body can succumb to a repetitive strain injury (RSI) which is what occurs with mouse shoulder.

How Do l Get Mouse Shoulder?

The shoulder and shoulder blade attach to the body by various muscles that insert into the spine, ribcage, neck and base of the skull. Holding a mouse with the arm held away from the body causes these muscles to contract and become tight, as they support the weight of the outstretched arm. Sitting like this for several hours with little variation or relaxation can lead to pain and weakness over time.

What can be done to help

Mouse Shoulder responds well to a combination of anti-inflammatory drugs (NSAIDs) and manual treatment. In acute cases medical acupuncture can reduce the severe pain and muscle spasm by treating the painful trigger points.

However, treatment alone is not the answer. Without any modification to work posture or lifestyle these symptoms will return within days or weeks. You are then at risk of becoming dependent on repeated, costly and long-term treatment.

7 Ways To Help Yourself

  1. Become ‘ambi-moustrous’: learn to use the mouse with BOTH hands. This is a difficult skill to learn and will need to be practised little and often each day. Alternatively, learn to hold the mouse closer to your side and remember to drop the shoulder down.
  2. Change your mouse to a Trackball or marble mouse and bring it closer to you. Research has shown that holding the mouse with the arm less than 10° abducted from the body can reduces the muscle activity by a factor of 25-60%.
  3. One of the most important things to remember about Repetitive Strain Injuries is the word REPETITIVE. Add as much variety as you can to your desk and work practice. Share different designs of mouse between members of your office; swap them around every week or so, to add to the variety.
  4. Get up and move about regularly. If possible, rather than emailing or telephoning someone else in your office – go and talk to them in person.
  5. Activities such as racket sports, swimming, Pilates, archery or bell ringing, will exercise the upper back muscles.
  6. Use a resistance band (Theraband) to exercise upper back muscles for 2-3 minutes, 2-4 times a day. Building up the upper back and neck muscles will help improve your neck support and encourage a better posture.
  7. Self massage;  A tennis ball in a sock makes a good, cheap alternative to expensive self-massagers.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is a Frozen Shoulder?

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The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common Rotator Cuff Injuries and How They’re Treated

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The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Total Shoulder Replacement: What is it?

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Article featured on Orthopaedic Institute Brielle Orthopaedics

Total shoulder replacement is a surgical procedure that treats severe shoulder osteoarthritis that does not respond to nonsurgical treatment options.

At The Orthopaedic Institute Brielle Orthopaedics our Shoulder Specialists have extensive experience and utilize the latest technology in performing shoulder replacement procedures.

The procedure is effective because it removes osteoarthritic bone and cartilage and replaces it with functional metal and plastic components that serve as a “new shoulder”. After recovery and physical therapy, patients experience tremendous pain relief and live normal lives with minimal restrictions.

Important procedure steps are:

  1.  Anesthesia. A Board Certified Anesthesiologist administers general anesthesia so no pain or discomfort is felt during the procedure.
  2. Incision. A small incision is made on the front of the shoulder. Muscles and soft tissues are retracted so the joint can be visualized.
  3. Bone preparation. The head of the humerus (arm bone) and glenoid cavity are carefully cut in preparation of implants.
  4. Trial implants. Trial implants are placed in the shoulder until the perfect size is found. A physical examination confirms the implants fit and the shoulder moves properly.
  5. Permanent implants. Biological cement is placed over the bones and permanent metal and plastic implants are put in place. Once the cement hardens, an additional physical examination is performed.
  6. Incision closure. Sutures and skin staples close the incision and sterile dressings cover it. A shoulder sling is put on to keep the shoulder in a neutral position.

Total procedure time is usually 1 hour depending on osteoarthritis severity and shoulder anatomy.

A short hospital stay is necessary for pain management, infection prevention and physical therapy purposes. In some cases, a partial total replacement (one bone is replaced) or reverse total shoulder (implant positions are reversed) replacement are performed.

It is always best to receive a shoulder osteoarthritis diagnosis as soon as possible. Early treatment relieves symptoms and prevents the chronic condition from becoming worse.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Top 5 Causes of Shoulder Dislocations

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Article featured on Coastal Orthopedics

It is a great compliment to be described as having “broad shoulders.” This indicates a person with strength, skill, and experience, able to take on many responsibilities and handle any criticisms without complaint.

The same holds true in athletics, in which big, broad shoulders are an indicator of power, endurance, and durability. And in general, the expression holds considerable truth: strong shoulders are a necessity for most sports, most of which require excellent upper-body skills such as swinging, throwing, and lifting—sometimes with extreme force.

However, no matter how strong or broad one’s shoulders may be, this feature does not change the fact that a dislocated shoulder is the #1 most common joint dislocation injury.

What is a Dislocated Shoulder?

The shoulders are the human body’s most mobile joints. Able to rotate in nearly every direction and every angle, they provide remarkable flexibility and power for every conceivable usage of the arm, from the most demanding athletic activities to the most subtle and delicate of gestures. But this versatility comes with a major compromise: that of structural strength and stability.

Structurally speaking, the shoulder is evolved more for flexibility and motion, and not as much for strength and stability. Our arms normally do not require the heavy lifting power of our legs; our shoulders don’t need to anchor and support the entire weight of the head and torso, as do our hips.

The compromise of freedom-of-motion over stability is what leaves the shoulder so susceptible to dislocation. More than half of all joint dislocations treated across the country are for the shoulder.

How Does a Dislocated Shoulder Happen?

A shoulder dislocation generally occurs when the ball-shaped top of the upper arm bone (humerus) is pulled partially or completely out of its shallow, cup-shaped socket in the shoulder blade (scapula). A ring of tough cartilage lines that socket, and the bones are connected by the ligaments of the joint capsule and the tendons of the rotator cuff, forming a kind of protective sleeve holding the joint together.

The entire structure provides remarkable resiliency to the stresses of everyday motions. Significant force is required to pull the humerus out of its socket, and to overcome the cushioning and shock absorption abilities of the tissues of the joint capsule. This is why a dislocation often includes damage to any or all of the surrounding tissues, adding complications to the injury such as torn ligaments, severed tendons, internal bleeding, inflammation, etc.

Most shoulder dislocations occur when the shoulder is forcibly moved upwards and back—the one direction the shoulder cannot easily go. However, if enough pressure is applied to the joint, the top of your humerus may become dislocated in any direction or angle.

Type of Shoulder Dislocations

Doctors classify shoulder dislocations into three groups:

  1. Traumatic dislocation – With this dislocation, the shoulder has been subjected to a strong traumatic force, one powerful enough to have pulled the shoulder out of joint. This generally results in a serious injury that will require rehabilitation and surgery to correct.
  2. Atraumatic dislocation – With this type dislocation, the shoulder dislocates with little force, caused by everyday activities like reaching for something on a high shelf, or rolling onto the shoulder in bed. This injury may happen repeatedly to a person with loose ligaments (“double joints”) with no pain or damage.
  3. Positional non-traumatic dislocations – Some people’s shoulder muscles operate in unusual patterns, resulting in the ability to pull their shoulders out of joint easily, painlessly, and at will. Physical therapy or surgery may be used to correct the issue, should it become painful or problematic, but most people who can do this trick would rather keep this skill and use it to frighten their children or impress their friends.

The Five Most Common Causes of Dislocated Shoulders

A dislocated shoulder may occur from five common sources: sports injuries, impact injuries, falls, repetitive stress injuries (RSIs), and “loose ligaments.”

1. Sports injury

Shoulder dislocations occur most commonly in sports and athletic activities, particularly those that require repeated, forceful use of the shoulder. In addition, any impact that includes a twisting motion increases the likelihood of a resulting shoulder dislocation.

  • Injuries common in all the following sports often result in a dislocated shoulder (specific activities that can cause this injury are listed for each activity):
  • Football: High-speed impact with other players; full-speed falls to the turf; throwing too hard; overreaching to catch or grab; hyperextensions; hard tackles; overtraining.
  • Hockey: High speed impacts with other players wearing heavy protective gear; crashes into walls and barriers; falls onto the ice; impact with hockey sticks.
  • Rock climbing: Hanging too long with one’s full weight on one arm; slipping and making an emergency grab; catching heavy falling equipment.
  • Rugby: Heavy impacts with one or more players; crashing to the turf with other players (especially when one or more fall on top of you); tackling; falling.
  • Soccer: Falls at all-out running speeds; tackles; impact with hard-kicked balls.
  • Skiing: High-velocity falls; long skidding crashes; impacts onto icy or hard surfaces.
  • Volleyball: Falls; hyperextensions; being hit by a ball hit a high speeds.
  • Gymnastics: Impacts, especially those requiring the placement of one’s full weight on one’s hands; falls from heights; impact with equipment such a balance beam or pommel horse.

2. Impact injury

  • Car accidents: Shoulders often bear the brunt of blows during motor vehicle accidents.
  • Hard impacts to the shoulder: Such as accidentally ramming a door frame while running, or taking a blow to the shoulder during an altercation.
  • Violent seizures or shocks: These may cause powerful muscle spasms that result in injuries throughout the body, including shoulder dislocations.

3. Falls

  • Trying to break a fall: Throwing out your hand is totally instinctive, but this often results in either a dislocated shoulder or, worst case, a snapped clavicle.
  • Any fall: Falling from as little as 4 or 5 feet can be dangerous, whether it is falling off of a ladder onto your shoulder, or tripping and falling full onto the floor. Either may result in a dislocated shoulder.
  • Impacts onto hard surfaces: Falling onto surfaces such as a concrete sidewalk or a wood floor can be hard enough to cause a dislocation.

4. Repetitive Stress Injury

  • Overtraining: Often caused by overtraining in specific sports-related movements, e.g. practicing a golf swing; swimming too many laps; serving too many tennis balls or volleyballs; or throwing too many baseball pitches, football passes, or basketball foul shots.
  • Work-related activities: These may also result in a shoulder dislocation; for example, sawing wood, moving heavy bags, or digging.

5. Loose ligaments

  • Connective tissue loosening: The connective tissue in the shoulder that normally keeps the head of the upper arm bone in the shoulder socket may become “loose” due to injury, overuse, or from previous shoulder dislocations. Such an unstable joint may become likely to suffer repeated dislocations.
  • Multi-directional instability: This is a fancy name for a genetic condition commonly known as “double jointedness.”

Summary

Dislocated shoulders are very common, especially in athletics. If you or your child is headed back into the sports season soon, you may wish to see a doctor for a pre-season physical to rule out risk factors and to learn more about how to prevent this injury.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

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Portland, OR 97209

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